盆底肌功能锻炼对会阴切口及盆底肌张力的影响

目的探讨盆底肌功能锻炼对会阴切口的愈合及盆底肌张力恢复的影响。方法将67例经阴道分娩产妇随机分为观察组(37例)和对照组(30例)。观察组采用一对一盆底肌功能锻炼指导,对照组采用常规会阴护理。结果观察组产后第3天会阴切口肿胀及产后第5天疼痛情况显著优于对照组(P<0.01,P<0.05),观察组产后第42天盆底肌张力恢复率显著高于对照组(P<0.05)。结论孕产妇坚持盆底肌功能锻炼,可促进会阴切口的愈合,促进盆底肌张力的恢复。     

产后系统指导盆底肌功能锻炼效果观察

将187例初产妇随机分为两组,观察组90例由专人负责进行产前、产后盆底肌功能锻炼指导;对照组97例产后采用一般健康教育方式进行盆底肌功能锻炼指导.于产后第5天、第42天分别评价盆底肌功能锻炼指导效果.结果观察组效果显著优于对照组(均P＜0.05).提示专人系统指导盆底肌功能锻炼可促进产后盆底肌功能的恢复.     

社区老年女性盆底肌锻炼认知与行为调查

目的了解社区老年女性对盆底肌锻炼的认知和行为水平，并探索两者间的关系。方法采用自行设计的盆底肌锻炼认知和行为问卷．对374名社区老年女性进行调查。结果社区老年女性对盆底肌锻炼的知晓率仅8．0％，经常行盆底肌锻炼者仅2．7％。不同文化程度的老年女性盆底肌锻炼知晓率及锻炼频率存在显著差异（均P〈0．05）。盆底肌锻炼的知识与行为之间呈显著正相关（r-0．91，P〈0．01）。结论社区老年女性对盆底肌锻炼的认知和行为水平均较低，且两者间存在显著关系，护理人员应采取有效措施，提高社区老年女性对盆底肌锻炼的认知，以促进其锻炼行为。     

初产妇出院后延续护理服务研究

目的探讨出院延续护理服务对初产妇产褥期生活质量的影响。方法成立出院患者延续护理服务中心，对110例单胎出院初产妇（家访组）进行家庭随访与电话回访，并与以往仅接受电话咨询的110例单胎初产妇（对照组）进行生理问题等指标的比较。结果产后4周家访组切口延期愈合、无乳或少乳、产褥感染、产后便秘、下肢水肿发生率显著低于对照组（P〈0．05，P〈0．01）；生活态度及对相关知识的掌握率显著优于对照组（P〈0．05，P〈0．01）。结论成立服务中心进行家庭随访对促进初产妇产褥期生理功能恢复、维护心理健康及掌握相关知识和技能具有显著促进作用，能有效提高初产妇的生活质量。     

臭氧水用于产妇会阴切口消毒的效果观察

目的：探讨臭氧水用于产妇会阴切口消毒预防感染的临床效果。方法：将经阴道分娩行会阴侧切的134例产妇随机分成两组，观察组66例采用臭氧水消毒会阴切口，对照组68例采用活力碘消毒。观察两组会阴切口愈合情况，并取其分泌物作细菌培养。结果；观察组产妇会阴切口甲、乙、丙级愈合率分别为95．5％、3．0％、1．5％，对照组分别为91．2％、7．3％；1．5％，两组比较，差异无显著性意义（P＞0．05）；两组细菌菌落数比较，差异亦无显著性意义（P＞0．05）。结论：臭氧水用于妇产科会阴皮肤消毒预防切口感染与活力碘具有相同效果，且臭氧水能直接喷射切口创面，具有使术野清晰、促进局部血液循环、减少渗血等作用。     

功能锻炼对髋部骨折术后患者深静脉血栓形成的影响

目的 探讨单独采用功能锻炼预防髋部骨折术后深静脉血栓形成（DVT）的效果。方法 将98例髋部骨折患者随机分为观察组与对照组各19例。对照组按常规护理，观察组术后行早期功能锻炼。结果 术后DVT发生率观察组为8．2％，对照组为24．5％．观察组显著低于对照组（P〈0．05）；观察组术后患肢肿胀程度显著轻于对照组（P〈0．05）。结论 早期功能锻炼能明显减少髋部骨折术后患者DVT的发生率。     

盆底康复操锻炼对产妇产后盆底肌力及心理状态的影响

目的探讨盆底康复操锻炼对减少产后并发症、改善产妇心理状态及盆底肌力的作用。方法将自然分娩的初产妇按住院号奇偶数分为对照组54例和干预组55例。对照组采取常规护理模式,干预组在常规护理基础上于产后采取盆底康复操锻炼方案,比较两组产后14周内并发症发生情况、盆底肌力及心理变化。结果干预组产后尿失禁、子宫复旧不全及产后失眠等并发症发生率显著低于对照组(均P0.05);干预组在产后6周及14周时盆底肌力显著优于对照组(均P0.01);产后14周干预组SAS、SDS评分显著低于对照组(均P0.01)。结论产后盆底康复操的应用,可规范引导产妇进行有效的盆底功能锻炼,促进产后盆底肌功能恢复,减少产后并发症的发生,改善产妇的心理状态。     

会阴侧切皮下美容缝合术联合综合护理干预对产后切口愈合的影响

目的 探讨会阴侧切皮下美容缝合术联合综合护理干预对产后切口愈合影响。方法 选取2022年 10月-2023年3月我院收治的74例会阴侧切初产妇作为研究对象，以随机数字表法分为观察组和对照组，对 照组应用会阴侧切皮下美容缝合术联合常规护理，观察组应用会阴侧切皮下美容缝合术联合综合护理干 预，比较两组切口美观度、总产程时间、切口愈合时间及线结反应情况。结果 观察组VSS各项评分均低于 对照组（P＜0.05）；观察组总产程时间、切口愈合时间、疼痛程度均优于对照组（P＜0.05）；观察组线 结反应程度优于对照组（P＜0.05）。结论 会阴侧切皮下美容缝合术联合综合护理干预可有效改善切口美 观度，减轻线结反应，有利于缩短总产程时间及切口愈合时间，促进产后恢复。     

渐进式功能锻炼对老年髋部骨折患者术后肢体功能恢复的影响

目的探讨渐进式功能锻炼对老年髋部骨折患者术后肢体功能恢复的效果。方法将68例老年髋部骨折患者按入住病房分为干预组和对照组各34例。干预组于术后第1天至出院后3个月给予渐进式功能锻炼方案,对照组接受常规护理和门诊随访。比较两组骨折前、出院时、出院后1个月、出院后3个月的Harris评分。结果干预后,干预组Harris髋关节总评分和疼痛维度、功能维度及关节活动度维度评分显著高于对照组（P〈0．05,P〈0．01）;全髋置换术患者术后髋关节功能预后水平高于内固定手术患者（P〈0．01）;不同组别和不同手术方式之间在髋关节总评分和各维度评分方面无交互作用（P〉0．05）。结论渐进式功能锻炼可有效促进老年髋部骨折患者术后髋关节功能恢复。     

容量感觉训练法用于脊髓损伤患者膀胱功能重建的研究

目的探讨缩短脊髓损伤患者膀胱功能恢复时间的方法。方法按入院顺序将42例脊髓损伤患者分为对照组（22例）与观察组（20例），对照组采用生物反馈训练法进行膀胱功能重建，观察组采用容量感觉训练法进行膀胱功能重建。观察两组患者尿管留置时间、膀胱排尿功能恢复情况及泌尿系感染情况。结果观察组尿管留置时间显著短于对照组（P〈0．01），泌尿系感染发生率显著低于对照组（P〈0．05）；两组自主排尿量及排尿正常恢复率比较，差异无显著性意义（均P〉0．05）。结论采用容量感觉训练法可使膀胱得到合理的容量刺激，缩短尿管留置时间，有效预防泌尿系感染及促进膀胱功能尽早恢复。     

Emergency Stabilization of Pelvic Instabilities with the Pelvic C-Clamp

Abstract Objective: Emergency stabilization of translationally unstable injuries/fractures of the pelvic ring (type C injuries). Temporary, rarely definitive, restoration of form and function of the posterior pelvis. Indications: Emergency stabilization of sacroiliac disruptions and fractures of the sacrum in type C pelvic injuries. Type B injuries with clinically apparent instability (rotational instability) and type C injuries (disruption of sacroiliac joint, fractured sacrum) with associated circulatory instability. Contraindications: Pelvic type A fractures. Pelvic fractures involving the iliac wing(s). Rotational instability of the pelvis without associated circulatory instability (type B). Surgical Technique: Closed reduction applying traction, pressure and rotation to the affected hemipelvis. Stab incisions and bilateral percutaneous introduction of the pins. Compression of the C-clamp under fluoroscopic monitoring stabilizes the posterior pelvic ring. Depending upon the patients general condition, open reduction and internal fixation (ORIF) will often be performed at a later time. Results: 39 patients with type C pelvic injuries underwent primary stabilization with the pelvic C-clamp. The patients average age was 36 years (11–89 years), 29 were men, ten woman. With the exception of two, all patients had sustained either multiple injuries, or polytrauma. The mean Hannover Polytrauma Score (HPS) was 39.9 points (11–79 points). Ten patients had a disrupted sacroiliac joint, 29 an unstable fracture of the sacrum. On admission, all patients with the exception of four were considered hemodynamically unstable. The initial hemoglobin count was 6.7 g/dl (3.1–12.3 g/dl) on average, the average base excess amounted to –8.7 mmol/l (+2 to –28.0 mmol/l), average systolic blood pressure on admission was 82 mmHg (0–130 mmHg), corresponding to marked findings of shock. At the time of C-clamp application, the indication for the C-clamp was a pelvic instability in 13 patients alone, and in 26 patients the pelvic instability was associated with a circulatory instability. In 15 patients the circulatory situation stabilized after application of the C-clamp. Complications occurred in seven patients (excessive compression of sacral fractures in three patients, one pin malpositioning, two bleeders from pin channels, one perforation of the ilium). This reflects a steep learning curve.The following is a reprint from Operat Orthop Traumatol 2004;16:192–204 and continues the new series of articles at providing continuing education on operative techniques to the European trauma community.Reprint from: Operat Orthop Traumatol 2004;16:192–204 DOI 10.1007/s00064-004-1101-3.     

Pelvic exenteration

Pelvic exenterations are the most extensive surgeries performed for patients with gynecologic cancer, and the surgical team and patients have to be fully aware of the many issues that come into the discussion. This article discusses the history, indications, surgical techniques, and complications of pelvic exenteration.     

Pelvic hemangiopericytoma

An additional case of pelvic hemangiopericytoma is described, emphasizing the difficulty in diagnosis. If surgery is undertaken, excessive blood loss must be anticipated.     

Pelvic lipomatosis

A case of pelvic lipomatosis and review of the literature are presented. The diagnosis is usually made by careful review of the physical findings and radiologic examinations. Distortion and elevation of the bladder with elongation of the posterior urethra should arouse suspicion. Excision is the treatment of choice but is only effective in 10 to 35 per cent of cases. Conservative therapy using antibiotics and steroids is disappointing.