产科护士疼痛知识调查与分析

目的：了解当前产科护士疼痛知识水平和护理态度。方法：采用护士疼痛知识和态度调查问卷,对沧州市区年所医院的产科护士进行调查。结果：产科护士对疼痛知识认知较差。不同年龄、不同护龄,不同学历,不同职称、不同级别医院产科护士的疼痛知识得分无统计学意义（均P〉0.05）。结论：应对产科护士提供疼痛护理课程教育及培训,以提高产科护士的疼痛护理水平。     

产科住院病人对疼痛护理满意度调查与分析

目的：通过调查产科住院病人对疼痛护理的满意度,了解产科护士疼痛知识水平和护理态度。方法：采用病人对疼痛护理满意度问卷,随机抽取沧州市区4所医院的产后第二天的住院病人进行调查。结果：产妇经历了不同程度的疼痛,产痛和术后疼痛仍未得到充分的缓解和处理,不同级别医院产科住院病人的疼痛护理满意度无统计学差异。结论：产科护士对疼痛护理干预能力有待提高,对疼痛药物成瘾性、耐药性及其他副作用过分担忧。应对产科护士提供疼痛护理课程教育及培训,以提高疼痛护理知识水平。     

Making Chorionic Villus Sampling Painless for Both the Patient and the Physician

Currently, in common practice, no pain control is provided to the patient undergoing transvaginal chorionic villus sampling (CVS). Chorionic villus sampling is an invasive procedure involving an 18‐gauge needle stick through the abdomen or passage of a suction catheter through the cervix. Furthermore, CVS is a mechanically difficult procedure for the clinician and requires considerable skill and training. There have been prior studies establishing the efficacy of using a topical anesthetic in similar gynecologic procedures. We share our method of performing CVS, which aids in pain relief for the patient and concurrently aids the practitioner in executing this precise procedure.     

产科护士疼痛知识培训在提高妇产科护理质量中的应用效果研究

目的探讨产科护士疼痛知识培训对提高产科护理质量的应用效果。方法将本院20名产科护士随机分为实验组及对照组各10人。实验组进行疼痛护理相关的理论知识以及疼痛护理的相关培训,对照组不给予任何培训。统计培训后的知识掌握程度,比较疼痛一般知识、疼痛评估知识、疼痛药物知识以及疼痛干预知识4个问卷维度得分,对各组产科患者护理质量进行问卷调查。结果实验组经过疼痛知识培训后疼痛知识得分优于对照组,差异具有统计学意义(P0.05);实验组患者护理质量调查满意度优于对照组,差异具有统计学意义(P0.05)。结论产科护士疼痛知识培训可有效提高护士对疼痛相关知识的掌握,提高患者的满意度,值得临床上进行推广。     

Comparison of application times for ice packs used to relieve perineal pain after normal birth: a randomised clinical trial

Aims and objectives. To compare the effect of an ice pack applied for 10, 15 and 20 minutes to relieve perineal pain after birth. Background. Perineal pain after vaginal birth, with or without vaginal trauma, is one of the most common morbidities reported for postnatal women. Cryotherapy has been used in postpartum period to relieve perineal pain and investigated in several studies. However, cryotherapy treatment protocols in perineal care vary widely regarding temperature, frequency and duration of the application. Design. A controlled trial, randomised for two groups and with a third group as a historical control. Method. The intervention was carried out in a maternity hospital in São Paulo, Brazil. The study population consisted of three groups of 38 women who used an ice pack on the perineum, in a single application: group A‐10 minutes; group B‐15 minutes; group C‐20 minutes (historical control from another clinical trial). Participants’ perineal pain magnitude was evaluated through a numerical scale (0–10), at four different points: before the cryotherapy; immediately after and at 20 and 40 minutes after cryotherapy. Results. After application of the ice pack, there was no statistical difference when comparing the perineal pain among groups in the second, third and fourth evaluations. Most of the postnatal women reported pain relief, with 72·8% reporting a decrease in pain >50%; 21·9% reported a decrease between 30–50%. All postnatal women subjected to cryotherapy were favourable to the procedure. Conclusion. There is no difference in pain scores following ice pack application in three different times (10, 15 and 20 minutes) in women who report moderate or intense perineal pain after normal delivery. Relevance for clinical practice. Ice treatment is safe, and application times of 10 or 15 minutes are as beneficial as an application time of 20 minutes to relieve perineal pain.     

产程中半卧位分娩效果的临床观察

目的探讨半卧位分娩体位对分娩的影响。方法选择经阴道分娩的单胎头位足月妊娠初产妇50例,采用床头抬高40~60°的半卧位分娩体位作为观察组,同等条件下的常规平卧为对照组,进行分娩方式、产程、产后产妇舒适度、产后出血、新生窒息的观察。结果观察组比对照组的第二产程缩短(P<0.01),自然分娩率提高,产后产妇舒适度明显增加,新生儿窒息发生率明显降低(P<0.05)。结论半卧位分娩体位符合产道生理,有利于胎头入盆下降,可缩短第二产程,提高自然分娩率,增加产妇产后舒适感。     

产科家庭一体化病房母婴床旁护理效果研究

目的探讨产科家庭一体化病房（LDR）中母婴床旁护理的应用及效果,寻求人性化、个体化、家庭化的产科服务模式。方法将2012年1月～10月入住我院LDR产妇80例作为试验组,由专科护士对产妇及新生儿各项护理操作及健康宣教均在床旁进行。取同一时间段内入住产科普通病房产妇80例作为对照组,实施传统护理模式。并对两组新生儿护理技能、宣教知识掌握情况及护理满意度进行问卷调查。结果试验组对新生儿护理技能、健康宣教知识掌握、护理满意度均优于对照组,有显著性差异（P〈0．05）。结论LDR母婴床旁护理有利于产妇及家属掌握新生儿护理技能、健康宣教知识,获得了更高的满意度,促进产妇产后恢复和新生儿健康成长,有利于建立和谐的医患关系。     

丈夫全程陪伴分娩对初产妇身心影响的临床观察

目的探讨丈夫全程陪伴分娩对初产妇身心方面的影响。方法选择由丈夫全程陪伴分娩的初产妇106例（观察组）和无陪伴分娩的初产妇98例（对照组）进行临床观察。对两组产妇分娩时的心理状况、疼痛情况、产程时间、产后出血量及剖宫产率进行比较。结果观察组产妇分娩时心理状态相对稳定，比对照组产妇的担心、焦虑、恐惧心理明显减轻（P〈0．01）；两组产妇产时的疼痛情况比较有显著性差异（P〈0．01）；产程时间缩短（P〈0．05）；产后出血量减少及剖宫产率显著降低（P〈0．01）。结论丈夫全程陪伴分娩可使产妇在分娩过程中身心更为安全、健康，是一种产时服务模式。     

背景音乐在产科护理中的应用

目的　观察产科护理工作中采用音乐疗法对促进胎儿及新生儿生长发育及缓解产科护士工作压力的影响。方法　在产科护理工作中 ,如病理妊娠孕妇入院治疗时的胎教、新生儿沐浴、抚触、高危儿治疗等过程中 ,播放优美舒展的背景音乐。结果　采用音乐疗法 1年来 ,孕产妇及家属对护理服务满意 ,护士工作舒心 ,出院后咨询人员减少。结论　背景音乐在产科护理中有着促进治疗、缓解工作压力的作用 ,且经济、方便 ,适合推广。     

探讨家庭化产科护理模式对初产妇的影响

目的探讨家庭化产科护理模式对初产妇产时疼痛、母亲角色适应和产后48h内母乳喂养的影响。方法选取2012年5月~8月63例正常初产妇实施家庭化产科护理模式作为观察组,2012年1月~4月63例正常初产妇实施产科常规护理作为对照组,比较两组初产妇产时疼痛程度、母亲角色适应情况和产后48h的母乳吸吮时间。结果观察组初产妇分娩时疼痛评分低于对照组,母亲角色适应情况优于对照组,产后48h的母乳吸吮时间长于对照组(P<0.05)。结论实施家庭化产科护理模式有利于缓解初产妇的紧张、恐惧情绪,减轻初产妇分娩的疼痛、促进初产妇母亲角色转变,有利于初产妇实施母乳喂养。     

产科弥漫性血管内凝血33例临床分析

目的：探讨产科弥漫性血管内凝血(DIC)的诊断、治疗、抢救的方法。方法：回顾性分析在本院发生的33例产科DIC的资料。结果：33例产科DIC抢救成功29例，成功率87．9％。结论：早期正确诊断，及时去除诱因，适时结束分娩，及时切除子宫，合理应用肝素，输入大量新鲜血，补充凝血因子及抗纤溶药是治疗的关键。     

产科病房实行人性化护理的新举措

目的探讨在产科病房实行人性化护理的新举措。方法开展全程无缝隙服务、导乐分娩和陪护分娩、创造温馨舒适的环境、构建健康交流平台-孕妇之家。结果护患关系更加融洽,病人满意度从70%上升到98%以上,两个效益增长跃居全院之首。结论人性化护理是提高病人满意度和赢得医疗市场的重要保证。     

Postnatal outcome of fetuses with the prenatal diagnosis of gastroschisis.

OBJECTIVE: To assess the postnatal outcome and complications that arise in infants with the prenatal diagnosis of gastroschisis. METHODS: Prenatal sonograms with the diagnosis of gastroschisis were identified. Maternal age, indication for sonography, gestational age at diagnosis, other sonographic abnormalities, and postnatal outcome were recorded. RESULTS: Twenty-six fetuses at 16 to 36 weeks' gestational age had gastroschisis diagnosed on sonography. In 5 cases, other fetal anomalies were identified, including hydronephrosis and asymmetric hydrocephalus. In 9 of 21 cases followed by serial prenatal sonography, bowel dilatation developed, prompting delivery in 2. Two of the 26 study fetuses were electively terminated. The remaining 24 were born live and had immediate repair of the gastroschisis after birth. Nineteen infants (79%) had postnatal complications, some with multisystem complications, including 3 deaths, 10 with gastrointestinal complications, 6 with infectious complications, and 6 with anomalies involving other systems (genitourinary, cardiac, central nervous system, and respiratory). Only 5 infants (21%) had completely uncomplicated postsurgical courses. Hospital stays for survivors ranged from 10 to 98 days (mean, 38 days; median, 33 days). CONCLUSIONS: Although reported survival rates are good for gastroschisis, the postoperative hospital stay is often lengthy, and complications are very common, especially those related to the gastrointestinal tract. Other anomalies are uncommon but not rare.     

服务营销策略在产科护理管理中的应用

目的 应用服务营销理念提高产科护理质量。方法对外营销策略和对内营销氛围培育相结合,对外拓展服务内涵,满足服务对象的需求,延伸服务空间;对内运用人本管理理论,加强科室文化建设及人员素质建设,树立全员营销意识。结果提高了护士的整体素质及孕产妇对护理工作的满意度。结论运用服务营销理念打造服务品牌,可以提高孕产妇满意度。     

综合ICU危重孕产妇现状的临床研究

目的：分析ICU收治的危重孕产妇的临床特点、治疗干预结果。方法：收集2010-01～2012—10湖南省常德市第一人民医院中心ICU收治的46例急危重症孕产妇的临床资料,进行回顾性分析。结果：46例危重孕产妇平均年龄（28．8±6．4）岁,孕龄（32．2±7．6）周。人住ICU的最常见原因为产后大出血（11例,23．9％）,其次为妊娠相关性高血压（8例,17．4％）,死亡4例（8．7％）。合并基础疾病组ICU治疗时间（5．3±5．1）d,并发重症产科疾病组ICU治疗时间（2．7±1．7）d。结论：危重孕产妇人住ICU的最常见原因为产后大出血、妊娠相关性高血压。应根据孕产妇人住ICU的病因及早干预。     

55名产科护理人员职业压力源调查分析及其对策

[目的]了解产科护理人员在护理过程中的主要压力源,以采取相应的减压对策。[方法]采用工作压力源量表对55名产科护理人员进行问卷调查。[结果]产科护理人员的工作压力源主要包括:①工作量大、负荷过重(100.00%);②角色压力导致高度紧张(100.00%);③疲劳、神经衰弱、失眠(92.73%);④反感、急躁、抑郁心理(74.55%);⑤福利低、晋升难度大(72.73%);⑥产科职业暴露的危险(67.27%);⑦书面工作量大、书写不规范(45.45%);⑧病人不合作、要求过分(45.45%);⑨护士自身抵抗力差等因素(23.64%)。[结论]产科护理人员存在多方面的工作压力,应有针对性地对不同的压力源实施正确有效的减压措施。     

产程中实施自我护理模式的效果探讨

目的 探讨自我护理模式对产妇分娩过程的影响.方法 将2005年6月～12月在我院住院分娩的产妇500例,随机分为自我护理组和对照组.自我护理组要求产妇在产程中参与自我护理,护士根据产妇的自理需要和自理能力分别给予支持教育系统和部分补偿系统以协调和帮助产妇恢复和提高自理能力.对照组按常规观察产程及护理.结果 自我护理组产妇对疼痛的耐受性明显提高,缩短了产程,分娩方式及产后出血的发生与对照组比较差异显著(P＜0.05).结论 产程中实施自我护理模式可缓解产妇的紧张、焦虑情绪,减轻疼痛,加速产程进展,促进自然分娩,减少母婴并发症,使产妇顺利度过分娩过程.