新生儿硬肿症并多器官功能不全综合征的回顾性研究

目的 :探讨新生儿硬肿症并多器官功能不全综合征 (MODS)的临床特征 ,探寻有效的治疗对策 ,降低MODS的发生率和病死率。方法 :对 80年代以来入住我院的新生儿硬肿症并MODS患儿 ,分成两个阶段进行回顾对比分析研究。结果 :90年代MODS患儿 ,两个器官受损发生率比 80年代高 ,4个和 4个以上器官受损发生率比 80年代低。 90年代的病死率 ( 9 5% )明显低于 80年代 ( 57 7% ) (P <0 .0 1)。结论 :密切观察新生儿硬肿症的相对稳定期及受累脏器功能失常的特征 ,不失时机地恰当改善循环 ,合理应用抗生素 ,进行代谢营养支持和器官功能支持是降低新生儿硬肿症并MODS的发生率和病死率 ,提高治愈率的重要措施。     

女孩尿道下裂的诊断和治疗(附5例报告)

探讨女孩尿道下裂的病因,临床症状,诊断和治疗。方法：1990－1997年收治5例女孩尿道下裂,Ⅰ型1例,Ⅱ例1例,Ⅲ3例,Ⅰ型行Leadbetter术＋双侧输尿管膀胱再植及锥状肌膀胱颈悬吊术;Ⅱ型行胃膀胱扩大,双侧输尿管胃膀胱再植,锥状肌膀胱颈悬吊及劈耻骨尿道紧缩术;Ⅲ型行阴道前壁粘膜尿道成形和膀胱颈折叠术。结果：Ⅰ型1例排尿满意;Ⅱ型1例排尿好转;Ⅲ型3例控尿正常,临床症状消失。结论：女孩尿道下裂不同分型宜采用不同的手术方法。     

推拿治疗婴幼儿轮状病毒性肠炎42例

目的 :观察推拿在治疗婴儿轮状病毒性肠炎中的疗效。方法 :将72例确诊患儿随机分为二组 ,两组患儿一般治疗相同 ,治疗组加推拿疗法。结果 :治疗组症状消失时间明显缩短 ,止泻时间治疗组为(38 5±15 5)h ,对照组(50 2±18 5)h ,差异有显著性意义(P<0 01)。治疗组总有效率为95% ,对照组为80 %(P<0 05)。结论 :推拿治疗婴儿轮状病毒性肠炎安全、有效、简便、价廉     

山东省首例体外受精、胚胎移植成功报告

１９９４年初我校妇产科学教研室引进了体外受精－胚胎移植（ＩＶＦ－ＥＴ）术,１９９５年１月５日山东省首例“试管婴儿”在山东省立医院出生。作者详述了实施ＩＶＦ－ＥＴ的经过。此项技术的应用成功为开展生殖生理学、遗传学和优生学研究及临床应用奠定了基础。     

微量血25—（OH）D3及相关指标在婴幼儿佝偻病诊断中的评价

探讨婴幼儿维生素Ｄ缺乏性佝偻病的早期诊断。方法应用微量末稍血测定血清２５－（ＯＨ）Ｄ３和相关指标,对２４８名０－３岁儿童进行调查。结果２５－（ＯＨ）Ｄ３、ＡＬＰ、ＡＬＰ３无性别差异,在每半年一个龄龄组分组中,以０－６月龄组婴幼儿的２５－（ＯＨ）Ｄ３最低,而ＡＬＰ、ＡＬＰ明显升高。     

Infant Manipulative Actions upon Customary and Uncustomary Objects in Independent and Joint Activity

Eight 12 month-olds acting on objects were observed in two sessions: 1) the objects were home objects; 2) they were brought by the observer as new exemplars of previous toys. Infants were observed manipulating objects independently and with their mothers. Type and cognitive level of infant's actions were coded. Conventional actions were more frequent in joint than independent activity. In independent activity, conventional actions were more frequent with customary objects. High cognitive level was more frequent with customary objects. Acting with an adult is the major influential factor in promoting conventional usage of an object. However, acting on customary objects influences both conventional usage and organization of the actions. Notion of joint activity as a social practice rather than interactional event can be useful in accounting for this influence.     

贯彻实施《母婴保健法》 促进山区妇幼卫生工作的发展

《中华人民共和国母婴保健法》（下称《母婴保健法》）的颁布实施,标志着我国妇幼卫生工作纳入了法制化管理的轨道。我县依法开展了各项妇幼卫生工作,进一步推动了山区县妇幼卫生工作的发展。１　加强领导　广泛宣传自１９９６年６月１日实施《母婴保健法》以来,我县在县政府和县卫生局领导下,通过多种形式和多种渠道广泛宣传,使《母婴保健法》家喻户晓,深入人心,提高了全社会贯彻实施《母婴保健法》的积极性和自觉性,为依法开展妇幼卫生工作打下了良好的思想基础。２　强化妇幼保健服务功能２１　根据《母婴保健法》关于婚前医学…     

A predictive model to estimate the risk of serious bacterial infections in febrile infants

Low risk criteria have been defined to identify febrile infants unlikely to have serious bacterial infection (SBI). Using these criteria approximately 40% of all febrile infants can be defined as being at low risk. Of the remaining infants (60%) only 10%–20% have an SBI. No adequate criteria exist to identify these infants. All infants aged 2 weeks-1 year, presenting during a 1-year-period with rectal temperature 38.0°C to the Sophia Children's Hospital were included in a prospective study. Infants with a history of prematurity, perinatal complications, known underlying disease, antibiotic treatment or vaccination during the preceding 48 h were excluded. Clinical and laboratory variables at presentation were evaluated by a multivariate logistic regression model using SBI as the dependent variable. By using likelihood ratios a predictive model was derived, providing a post test probability of SBI for every individual patient. Of the 138 infants included in the study, 33 (24%) had SBI. Logistic regression analysis defined C-reactive protein (CRP), duration of fever, a standardized clinical impression score, a history of diarrhoea and focal signs of infection as independent predictors of SBI.Conclusion CRP, duration of fever, the standardized clinical impression score, a history of diarrhoea and focal signs of infection were the independent, most powerful predictors of SBI in febrile infants, identified by logistic regression analysis. Although the predictive model is not validated for direct clinical use, it illustrates the clinical potential of the used technique. This technique offers the advantage to assess the probability of SBI in every individual infant. This probability will form the best basis for well-founded decisions in the management of the individual febrile infant.     

Relationship between anterior fontanelle pressure measurements and clinical signs in infantile hydrocephalus

The treatment of choice in progressive hydrocephalus is drainage of cerebrospinal fluid in order to reduce elevated intracranial pressure (ICP). Defining the right moment for surgical intervention, however, in a hydrocephalic infant on the basis of clinical signs alone can be a difficult task. Clinical signs of raised ICP are known to be unreliable and sometimes even misleading. In the present study, the relationship between long-term anterior fontanelle pressure (AFP) measurements and clinical signs was investigated in 37 infants with hydrocephalus. The decision as to whether to operate or not was based on clinical signs alone; AFP values were not taken into account. There was an overall difference between the non-operated group and the preoperative measurements in the operated group, and also between the preoperative and the postoperative measurements in the latter, in regard to both AFP measurements and clinical signs. Almost all preoperative AFP values were increased. The direct correlation () between most individual clinical signs and AFP levels, however, was low (=0.15–0.41). The clinical sign tense fontanelle showed the best correlation with the AFP levels (=0.75). Furthermore, using logistic regression analysis, no combination of clinical signs could be found which reliably predicted the AFP. The relationship between the AFP pressure variables and clinical signs was also examined. The pathological A-waves occurred only in the presence of raised (baseline) AFP, a situation in which considerably more frequent B-waves were observed as well. It was concluded that clinical signs of raised ICP in infantile hydrocephalus are not very reliable and AFP monitoring can therefore provide valuable information on intracranial dynamics in patients with dubious neurological manifestations of progressive hydrocephalus.