优质护理预防产褥期产妇产后忧郁症效果观察

目的：探讨优质护理对产褥期产妇产后抑郁的预防效果。方法：选取产褥期产妇2200例,随机分对照组1093例、观察组1107例。对照组患者给予常规护理;观察组患者在对照组基础上实施优质护理。结果：2组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)、爱丁堡后抑郁测量表(EPDS)得分均较干预前有所降低,且观察组患者降低更为明显,上述比较差异有统计学意义(P＜0.05);观察组发生抑郁者明显少于对照组(P＜0.05)。结论：对产褥期产妇实施优质护理可以有效预防产后抑郁的发生。     

新产程标准下临产前及临产后急诊剖宫产妊娠结局分析 ——基于临床数据回顾性分析

目的探讨新产程标准下临产前及临产后急诊剖宫产对妊娠结局的影响。方法选取上海交通大学医学院附属国际和平妇幼保健院2018年5月至2019年6月在产程中因急诊原因转剖宫产者853例。其中临产前手术者565例,设为临产前组;临产后手术者288例,设为临产后组。对比两组产后出血量、血红蛋白变化值、新生儿评分、产褥感染率及术后住院天数。结果临产前组与临产后组剖宫产指征排序首位的均为胎儿宫内窘迫(66.19%vs.50.70%),其次临产前组为产前发热(17.88%),临产后组为相对性头盆不称(36.80%)。临产前组产妇的产后出血量少于临产后组[(222.16±90.01)mL vs.(248.30±60.12)mL,t=3.049,P<0.05]、血红蛋白变化值小于临产后组[(4.16±0.29)g/L vs.(6.43±0.61)g/L,t=3.011,P<0.05]、新生儿评分高于临产后组[(9.86±0.59)分vs.(9.68±0.92)分,t=3.441,P<0.05]、产褥感染率低于临产后组(35.58%vs.51.04%,χ²=18.893,P<0.05)、术后住院天数少于临产后组[(4.50±0.43)天vs.(4.75±0.68)天,t=2.420,P<0.05]。结论按新产程标准,临产后急诊剖宫产者产后出血量增多,新生儿窒息率、产褥感染率增高,术后住院天数增多,因此需要加强阴道试产过程中对产妇及胎儿的监测及手术指征的把握,及时干预和有效处理,以降低产妇及新生儿的并发症发生率。     

陈修园辨治产后病探析

总结陈修园关于产后疾病的辨治方法,针对产后生理、病理特性,提出对产后寒热、恶露等症,需明辨虚实、真假;治疗产后病证注重脾胃,以祛瘀为先,温补相兼,以及产后便秘不宜轻下等诸多临证要旨和观点。     

Mental health nurses' attitudes towards severe perinatal mental illness

Title.  Mental health nurses' attitudes towards severe perinatal mental illness.
Aim.  This paper reports on a study exploring the experiences and attitudes of generic mental health nurses towards care of women with severe mental illness during the perinatal period.
Background.  Severe mental disorder in the perinatal period is a global public health concern. However, there are concerns that mental health nurses other than dedicated perinatal mental health teams may lack knowledge, skills and experience in caring for such disorders, because of their low prevalence.
Methods.  Sixteen generic Registered Mental Nurses working in public adult mental health services participated in three focus groups during 2007.
Findings.  Participants did not perceive any difference between symptoms during perinatal and non-perinatal periods. There were mixed attitudes towards caring for women with severe mental illness in the perinatal period. Fear and anxiety was expressed by the nurses when caring or feeling responsible for the babies of clients. Lack of communication between professional groups and decreased clinical decision-making following the introduction of the Edinburgh Post Natal Depression Scale caused frustration. Confidence was displayed when working with known and trusted colleagues.
Conclusion.  Generic mental health nurses would benefit from more education on perinatal mental health and there may be a need for them to be supported by specialist perinatal mental health practitioners.     

Life‐threatening necrotizing myometritis,due to Group A streptococcus – still a life‐threatening condition

Puerperal infection with Group A streptococcus (GAS) can present with few symptoms and rapidly progress to a life‐threatening condition. Often, the infection can be treated with antibiotics. Delay in diagnosis increases risk of sepsis, multiorgan failure, and death. GAS infection is a differential diagnose for all postpartum women with unexplained symptoms.     

产妇产后营养知识态度行为的影响因素及与产褥期并发症的相关性

目的分析产妇产后营养知识态度行为的影响因素及与产褥期并发症的相关性,为临床工作提供借鉴资料。方法选取2018年10月~2019年5月我院收治的产后产妇190例为研究对象,采用自制调查问卷收集产妇的一般资料(年龄、文化程度、居住地、分娩孕周、分娩方式、主要照顾者、产后知识来源、喂养方式),评估其产后营养知识态度行为是否合格,分析其影响因素及与产褥期并发症的相关性。结果产妇产后营养知识态度行为合格率为61.6%,现状不容乐观。单因素分析结果显示,产后营养知识态度行为合格与不合格产妇的年龄、文化程度、居住地、分娩孕周、主要照顾者、产后相关知识来源、喂养方式比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,产妇年龄、文化程度、居住地、主要照顾者、产后相关知识来源、喂养方式是产后营养知识态度行为的影响因素。产妇产褥期并发症发生率为31.1%,有并发症的产妇营养知识评分、态度评分、行为评分均显著低于无并发症的产妇(P<0.05)。Pearson相关分析显示,产褥期并发症发生与产妇产后营养知识、态度、行为评分呈负相关(P<0.05)。结论产后营养知识态度行为受到产妇年龄、文化程度、居住地、主要照顾者、产后相关知识来源、喂养方式多因素影响,而产褥期并发症发生与产妇产后营养知识态度行为呈负相关,临床应针对相关影响因素采取有效干预措施,改善产妇产后营养知识态度行为,减少产褥期并发症,保证产妇产后安全。     

黄芪桂枝五物汤合四物汤加味治疗产后身痛22例疗效观察

目的观察黄芪桂枝五物汤合四物汤加味治疗产后身痛的临床疗效。方法采用黄芪桂枝五物汤合四物汤加味治疗产后身痛患者22例。结果痊愈12例（占54.5%）,有效8例（占36.4%）,无效2例（占9.1%）,总有效率为90.9%。结论黄芪桂枝五物汤合四物汤加味治疗产后身痛临床疗效显著,值得推广应用。