目的: 探究分级责任制整体服务在剖宫产女性围术期的应用价值。方法: 前瞻性选取2023年1月—2025年1月于我院产科行剖宫产产妇82例为研究对象,并经随机化排序法随机分为观察组及对照组各41例。其中对照组采用常规护理,观察组采用分级责任制整体服务护理。记录两组产妇术后康复指标（首次排气时间、首次下床活动时间、住院时间）、母乳喂养情况（母乳喂养成功率）、并发症发生情况（切口感染、产后出血、下肢静脉血栓）。于产后4、8、12、24 h比较其疼痛程度[视觉模拟评分法（visual analog scale,VAS）];于干预前及出院前比较其心理状态[简明心境量表（brief profile of mood states,bPOMS）]。结果: 观察组术后康复时间均显著低于对照组;母乳喂养成功率明显高于对照组。产后24 h,观察组VAS评分均显著低于同期对照组。出院前,观察组疲乏、抑郁、紧张、生气、困惑维度bPOMS评分均明显低于同期对照组;活力维度bPOMS评分明显高于同期对照组。两组产妇住院时间、并发症发生率均无明显差异。结论: 分级责任制整体服务护理模式可明显改善剖宫产产妇围产期心理状态,有助于促进母乳的成功喂养,加快术后康复进程。

Objective To explore the application value of graded responsibility system holistic service in the perioperative period of cesarean section women. Methods 82 puerperae with cesarean section in department of obstetrics of the hospital from January 2023 to January 2025 were prospectively selected as research subjects, and were randomly divided into observation group and control group by randomization ranking method, with 41 cases in each group. The control group received routine nursing, while the observation group was given graded responsibility system holistic service nursing. The postoperative rehabilitation indicators (first exhaust time, first ambulation time, hospital stay), breastfeeding status (success rate of breastfeeding) and occurrence of complications (incision infection, postpartum hemorrhage, lower extremity venous thrombosis) were recorded in the two groups. The pain degree[visual analogue scale (VAS) ]at 4, 8, 12 and 24 hours after delivery and psychological status[brief profile of mood states (bPOMS) ]before intervention and before discharge were compared. Results The first exhaust time and first ambulation time in observation group were significantly lower than those in the control group, and the success rate of breastfeeding was significantly higher than that in control group. At 24 hours after delivery, the SF-MPQ scores in observation group were significantly lower than those in control group. The scores of fatigue, depression, tension, anger and confusion of bPOMS in observation group before discharge were significantly lower than those in control group while the score of vitality dimension of bPOMS was significantly higher. There were no significant differences in the hospital stay and incidence of complications between groups. Conclusion Graded responsibility system holistic service nursing model can significantly improve the perinatal psychological status of cesarean section women, help to promote the success of breastfeeding, and accelerate the postoperative rehabilitation process.