分娩疼痛与母婴结局的关系及相关影响因素分析

目的：探讨分娩疼痛与母婴结局的关系及相关影响因素分析。方法选择2013年2月至2014年2月期间于本院分娩的216例孕产妇为研究对象,采用视觉模拟评分(VAS)评分对分娩疼痛进行评估,探讨分娩疼痛与母婴结局的关系并分析相关影响因素。结果在宫颈开大2 cm时进行VAS量表评估,其中轻度疼痛者62例(28.7%),中度疼痛者154例(71.3%)。中度疼痛者胎儿窘迫发生率及剖宫产率分别为39.0%(60/154)及40.3%(62/154),显著高于轻度疼痛者19.4%(12/62)及21.0%(13/62)(P<0.05);轻度与中度疼痛产妇新生儿窒息、产后出血差异无统计学意义(P>0.05)。中度疼痛与轻度疼痛产妇在初产妇、年龄、认知水平、家庭关系、文化程度及心理状态差异具有统计学意义(P<0.05)。Logistic回归分析结果显示：初产妇、认知水平、年龄及心理状态是影响分娩疼痛的独立因素。结论分娩疼痛程度影响母婴结局,初产妇、认知水平、年龄及心理状态是影响分娩疼痛的独立因素,临床进行认知及心理干预有助于减轻分娩疼痛。     

妊娠糖尿病对妊娠结局的影响

目的探讨妊娠糖尿病(GDM)对妊娠结局的影响。方法选取鹤壁市妇幼保健院2017年3月至2018年2月妇产科接收的68例GDM产妇作糖尿病组,另选择同期68名正常产妇作为对照组。统计比较两组围生儿情况、产妇并发症情况、分娩方式。结果糖尿病组胎儿宫内窘迫、早产、巨大儿发生率高于对照组(均P<0.05),糖尿病组羊水过多、妊娠高血压、产后出血发生率高于对照组(均P<0.05),糖尿病组剖宫产率为92.65%,高于对照组的32.35%(P<0.05)。结论 GDM产妇妊娠结局欠佳,易造成胎儿宫内窘迫、早产、巨大儿等并发症,且剖宫产率高,临床应及早防治GDM,最大程度改善妊娠结局。     

羊水偏少经缩宫素引产128例分娩结局分析

目的：探讨足月妊娠B超提示羊水偏少产妇经缩宫素引产的分娩结局。方法选择128例足月妊娠羊水偏少的产妇为观察组,128例羊水正常产妇为对照组,观察比较2组分娩方式、胎儿情况及新生儿预后。结果观察组阴道分娩88例、中转为剖宫产40例,对照组分别为113例、15例,2组剖宫产率差异有统计学意义（P<0.05）。观察组羊水轻度粪染率（26.0%）明显多于对照组的8.0%（P<0.05）,2组胎儿窘迫、羊水中至重度粪染等差异均无统计学意义（P>0.05）。结论羊水偏少产妇阴道试产虽对妊娠结局有一定的影响,但在严密的监护下仍可试行。     

不同程度妊娠高血压综合征对妊娠结局的影响分析

目的 探讨不同程度妊娠高血压综合征对妊娠结局的影响.方法 选取2014年1月-2016年4月在我院分娩的105例妊娠高血压综合征产妇为研究对象,根据妊娠高血压综合征的严重程度分为轻度组(n=41)、中度组(n=38)和重度组(n=26),比较3组产妇母婴妊娠结局.结果 轻度组产妇胎盘早剥、剖腹产、产程异常、产后出血的发生率最低,中度组高于轻度组,重度组最高,差异均显著(P＜0.05);轻度组发生新生儿窒息、呼吸窘迫、早产、围生期死亡的概率最低,其次是中度组,重度组的发生率最高,差异均显著(P＜0.05);重度组产后不良反应发生率高于中度组和轻度组,差异有统计学意义(P＜0.05).结论 妊娠高血压综合征对母婴结局具有严重不良影响,随着其程度加重,对母婴的影响加大,临床应尽早控制病情进展,保障母婴安全.     

子痫前期患者血压程度与妊娠结局的相关性

目的 探讨子痫前期患者血压程度与妊娠结局的相关性.方法 回顾分析产科住院分娩的236例不同程度子痫前期患者,其中轻度组115例,重度组121例,对两组患者的新生儿窒息、死产、胎儿窘迫发生率和早产发生率进行统计分析.结果 轻度组新生儿窒息、死产和早产发生率均小于重度组(P<0.05,P<0.01),胎儿窘迫发生率两组间差异无显著性(P0.05).结论 有效控制妊娠期高血压疾病患者血压,有益于妊娠期高血压疾病患者妊娠结局.     

足月妊娠不同时期临界性羊水过少引产对母婴分娩结局的影响

目的 探究足月妊娠不同时期临界性羊水过少引产对母婴分娩结局的影响.方法 选取2019年9月至2020年9月本院接收的120例足月妊娠临界性羊水过少产妇作为研究对象,按照孕周分为甲组(37～38周,n=46)、乙组(39～40周,n=54)、丙组(≥41周,n=20),另选取同期羊水正常、存在阴道分娩指征、无高危因素的120名足月单胎产妇,按照孕周分为对照1组(37～38周,n=46)、对照2组(39～40周,n=54)、对照3组(≥41周,n=20),比较各组母婴分娩结局.结果 甲组和对照1组胎儿窘迫率、中转剖宫产率、羊水污染率、新生儿窒息率、新生儿高胆红素血症率比较差异无统计学意义;乙组和对照2组胎儿窘迫率、中转剖宫产率、羊水污染率、新生儿窒息率、新生儿高胆红素血症率比较差异无统计学意义;丙组和对照3组胎儿窘迫率、中转剖宫产率、羊水污染率、新生儿窒息率、新生儿高胆红素血症率比较差异无统计学意义.甲组、乙组、丙组胎儿窘迫率、新生儿窒息率比较差异无统计学意义;丙组中转剖宫产率高于乙组(P<0.05);丙组羊水污染率高于甲组(P<0.05);甲组新生儿高胆红素血症率高于乙组(P<0.05).结论 对足月妊娠临界性羊水过少产妇在球囊促宫颈成熟后配合缩宫素可达到预期引产效果,期间密切监测胎儿情况以保证顺利完成阴道分娩,保障母婴妊娠结局.     

无痛分娩对妊娠结局及产程的影响

目的：目的：探讨无痛分娩对产妇妊娠结局及产程的影响。方法：选取2020年3月-2022年8月徐州市睢宁县中医院收治的76例分娩产妇作为研究对象，根据就诊顺序，奇数为研究组，偶数为对照组，两组患者各38例。对照组施以常规分娩，研究组施以无痛分娩。比较两组产程时间、疼痛程度、妊娠结局、疼痛评分、产后出血量、Apgar评分、分娩满意度。结果：研究组第1产程、第2产程、第3产程、总产程时间均短于参照组；研究组重度疼痛0例、中度疼痛2例、轻度疼痛4例，对照组重度疼痛12例、中度疼痛12例、轻度疼痛14例；研究组新生儿窒息率为5.26%，剖宫产率为5.26%，产后出血率为7.89%，均低于参照组的28.95%、31.58%、34.21%；研究组疼痛评分、产后出血量均明显低于参照组，Apgar评分、满意度高明显高于参照组，差异均有统计学意义(P=0.000 0)。结论 ：无痛分娩可以为产妇带来更加舒适和安全的分娩体验，提高产妇的分娩成功率和婴儿的健康状况。然而，在选择无痛分娩前，产妇和医生应根据个人和情况综合决策。     

潜伏期分娩镇痛对产妇妊娠结局及新生儿预后的影响

目的观察潜伏期分娩镇痛对产妇妊娠结局及新生儿预后的影响。方法选取2014年5月至2016年2月于东莞市康华医院行镇痛分娩的160例产妇,随机分为对照组及观察组,各80例。两组分娩镇痛均采用椎管内阻滞麻醉,对照组于第一产程活跃期行镇痛,观察组于潜伏期行镇痛。对比观察两组产妇妊娠结局、新生儿预后。结果观察组第一和第二产程时间较对照组短,VAS评分较对照组低,差异有统计学意义(P<0.05);两组产妇1 min和5 min的Apgar评分比较,差异无统计学意义(P>0.05)。观察组剖宫产率低于对照组,差异有统计学意义(P<0.05);两组顺产、阴道助产及新生儿窒息率差异无统计学意义(P>0.05)。结论于潜伏期给予产妇分娩镇痛可有效缩短产程时间,减轻疼痛感,降低剖宫产率,对产妇妊娠结局及新生儿预后有积极作用,值得推广应用。     

剖宫产术与阴道助产术在足月妊娠临产胎儿窘迫中的疗效观察

目的探讨剖宫产术与阴道助产在足月妊娠临产胎儿窘迫中的效果。方法将我院2012年1月~2013年1月妇产科住院部收治的108例足月妊娠临产胎儿窘迫的产妇随机分为对照组(n=54)与观察组(n=54),分别采取剖宫产与阴道助产,比较两组母婴结局的差异。结果两组胎儿窘迫各因素比较均无显著性差异(χ2=0.842,0.637,0.654,0.664,0.832,P均>0.05);观察组产后出血发生率明显低于对照组(χ2=7.211,P<0.05);观察组新生儿窒息和缺血缺氧性脑病的发生率低于对照组,但差异不具有统计学意义(χ2=0.732,1.563,P>0.05)。结论阴道助产与剖宫产分娩用于足月妊娠临产胎儿窘迫均能获得较好的母婴结局,临床应根据产妇情况选择合适分娩方式,并尽量降低剖宫产率。     

腰-硬联合阻滞镇痛在子痫前期和妊娠高血压产妇阴道试产中的应用

目的:探讨腰-硬联合阻滞(combined spinal-epidural anesthesia,CSEA)镇痛在子痫前期和妊娠高血压产妇阴道试产中的应用效果。方法:回顾性分析2009年1月²013年12月在铜陵市妇幼保健院妇产科住院分娩的子痫前期和妊娠高血压初产妇158例,根据是否施行CSEA分娩镇痛分为镇痛组(n=95)和对照组(n=63)。比较两组潜伏期(T1)、活跃期(镇痛前,T2)、活跃期1 h(T3)、活跃期2 h(T4)、宫口开全(T5)、助产前(T6)、产后2 h(T7)各时段的平均动脉压和分娩结局:产程时间、缩宫素的使用、产时相关主诉症状、产时降压药物的应用、分娩方式、产后出血量、胎心率、新生儿Apgar评分、转诊NICU情况。结果:1镇痛组剖宫产率明显低于对照组(P<0.01),缩宫素使用率较对照组高,第二产程较对照组延长(P<0.05);两组胎儿窘迫率、新生儿窒息率、转入NICU率均无显著差异(P>0.05)。2镇痛组镇痛后的3个时段(T3、T4、T5)血压显著下降,并明显低于对照组对应点血压(P<0.001)。3镇痛组产程中高血压疾病相关主诉症状头昏头痛和呕吐较对照组少见(P<0.05),产程中加用降压治疗的病例较对照组显著减少(P<0.05)。两组产妇无1例子痫和肺水肿发生。结论:CSEA镇痛有效降低妊娠期高血压疾病产妇阴道试产的危险性,降低剖宫产率。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…