摘要目的:探究经孕期体质量管理联合角色代入式健康教育的护理干预对初产妇产程、盆底功能恢复、心理状态改变以及母婴结局的影响。方法:杭州市余杭区第一人民医院从2019年3月开始实施孕期体质量管理联合角色代入式健康教育护理，在此理论基础上制订初产妇孕期体质量管理联合角色代入式健康教育护理方案，2018年8月至2019年2月随机选择120例分娩的初产妇作为对照组，2019年8月至2020年2月随机选择120例初产妇作为观察组，比较2组产程时间、产后盆底肌肌力、汉密尔顿抑郁自评量表（HAMD）和汉密尔顿焦虑自评量表（HAMA）评分及分娩结局。结果:护理后，观察组剖宫产率为20.83%（25/120），低于对照组的32.50%（39/120），差异有统计学意义（ χ2值为4.176， P<0.05）；观察组产妇第一、二、三产程结束所用的时间分别为（517.27 ± 8.95）、（48.33 ± 5.62）、（10.26 ± 1.63）min，均低于对照组的（537.31 ± 7.92）、（57.29 ± 5.58）、（18.28 ± 1.61）min，差异有统计学意义（ t值为18.369、12.393、38.347， P<0.001）；护理后，观察组盆底肌肌力正常率为68.33%（82/120），高于对照组54.17%（65/120），差异有统计学意义（ χ2值为5.074， P<0.05）；观察组护理后HAMD、HAMA评分分别为（4.43 ± 1.02）、（5.56 ± 0.87）分，均低于对照组的（6.09 ± 1.15）、（6.88 ± 0.93）分，差异有统计学意义（ t值为11.830、11.354， P<0.05）；护理后观察组产妇、新生儿不良结局率分别为3.33%（4/120）、5.83%（7/120），低于对照组10.00%（12/120）、15.83%（19/120），差异有统计学意义（ χ2值为4.286、6.211， P<0.05）。 结论:孕期体质量管理联合角色代入式健康教育护理有助于缩短初产妇产程，提高产后盆底肌肌力，改善其不良情绪，从而减少母婴不良结局的发生。

abstractsObjective:To explore the effects of nursing intervention with pregnant body mass management combined with role -based health education on stage of labor, pelvic floor function recovery, psychological status changes, maternal and neonatal outcomes in primiparas. Methods:From March 2019 on, pregnant body mass management combined with role -based health education nursing was implemented in the hospital. On basis of the theory, nursing regimens of pregnant body mass management combined with role-based health education we formulated. During the period from August 2018 to February 2019, 120 primiparas who underwent delivery in the hospital were randomly enrolled as control group. During the period from August 2019 to February 2020, 120 primiparas were randomly enrolled as observation group. The duration of labor stages, postpartum pelvic muscle strength, scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA), and delivery outcomes were compared between the two groups. Results:After nursing, the cesarean section rate was 20.83% (25/120) in observation group and 32.50% (39/120) in control group, there was significant difference between the two groups ( χ 2 value was 4.176, P<0.05). The spending time of ending the first, second and third stage of labor was (517.27±8.95), (48.33±5.62), (10.26±1.63) min in observation group and (537.31±7.92), (57.29±5.58), (18.28±1.61) min in control group, there was significant difference between the two groups ( t values were 18.369, 12.393, 38.347, P<0.001). After nursing, normal rate of pelvic floor muscle strength was 68.33% (82/120) in observation group and 54.17% (65/120) in control group, there was significant difference between the two groups ( χ 2 value was 5.074, P<0.05). After nursing, scores of HAMD and HAMA were (4.43±1.02), (5.56±0.87) points in observation group and (6.09±1.15), (6.88±0.93) points in control group, there was significant difference between the two groups ( t values were 11.830, 11.354, P<0.05). After nursing, adverse outcome rates of primiparas and neonates were 3.33% (4/120) and 5.83% (7/120) in observation group, and 10.00% (12/120), 15.83% (19/120) in control group, there was significant difference between the two groups ( χ 2 values were 4.286, 6.211, P<0.05). Conclusions:Pregnant body mass management combined with role-based health education nursing is conducive to shortening labor stages of primiparas, improving postpartum pelvic floor muscle strength and adverse emotions, and thus reducing the occurrence of maternal and neonatal adverse outcomes.