艾灸至阴穴在臀位中的应用

目的探讨艾灸至阴穴在纠正臀位中的临床应用。方法228例分为3组，Ⅰ组：艾灸至阴穴加做改进的膝胸卧位；Ⅱ组：艾灸至阴穴加做传统的膝胸卧位；Ⅲ组：单纯传统膝胸卧位。结果Ⅰ组成功率为96．05％；Ⅱ组成功率为90．79％；Ⅲ组成功率为80．26％。Ⅰ组、Ⅱ组和Ⅲ组问差异有显著性（P〈0．05）。结论艾灸至阴穴铺以改进的膝胸卧位是纠正臀位安全、简便、有效的方法。     

膝胸卧位联合屈膝侧卧位纠正胎儿枕后位的效果观察

目的观察膝胸卧位联合屈膝侧卧位对纠正胎儿枕后位的效果。方法按随机数字表将200例枕后位初产妇分为对照组和观察组,每组100例。对照组采用传统仰卧截石位待产,观察组采取膝胸卧位联合屈膝侧卧位待产。比较两组产妇胎位纠正率、自然分娩率、第一产程和第二产程时间、新生儿窒息率。结果对照组胎位纠正率为62.0%,观察组胎位纠正率为81.0%,观察组高于对照组,差异有统计学意义(P0.05)。对照组自然分娩率为69.0%,观察组自然分娩率为86.0%,观察组高于对照组,差异有统计学意义(P0.05)。观察组第一、二产程时间明显短于对照组,差异具有统计学意义(P0.05)。两组新生儿窒息率比较,差异无统计学意义(P0.05)。结论膝胸卧位联合屈膝侧卧位对纠正胎儿枕后位有效,可缩短产程,提高自然分娩率。     

B超监测下臀位外倒转术的临床效果分析

目的:研究B超监测下臀位外倒转术的临床应用效果。方法:选取2020年5月—2022年3月在新余市人民医院接受检查的单臀或混合臀先露孕妇50例当作研究对象,按照孕妇臀位外倒转意愿将其进行分组,将25例同意接受臀位外倒转的孕妇纳入观察组,另25例孕妇为对照组,观察组在B超监测下实行臀位外倒转术,对照组采取常规膝胸卧位操或者艾灸至阴穴对胎儿头位进行转正,比较两组胎位纠正及分娩方式、并发症、新生儿相关指标。结果:观察组胎位纠正成功率为96.00%,阴道自然分娩率为84.00%,均显著高于对照组的76.00%、56.00%(P<0.05);观察组剖宫产率为8.00%,显著低于对照组的32.00%(P<0.05)。观察组并发症总发生率为28.00%,与对照组的16.00%相比无显著差异(P> 0.05)。两组新生儿血糖(BG)、体重、新生儿重症监护室(NICU)入住率比较差异无统计学意义(P>0.05);观察组血氧分压(PaO2)、1 min阿氏(Apgar)评分显著高于对照组(P<0.05)。结论:B超监测下臀位外倒转术能有效降低剖宫产率,增加阴道自然分娩率,且并未...     

中药膝胸位灌肠治疗慢性盆腔炎的效果观察

目的 :探讨治疗慢性盆腔炎中药保留灌肠的最佳方法。方法 :将 10 0例患者随机分为两组 ,每组 5 0例。观察组予以膝胸卧位灌肠 ,对照组予以左侧卧位灌肠 ,根据症状消失和疗程判断效果。结果 :膝胸卧位灌肠效果优于左侧卧位 ,可缩短疗程 ,有效率提高 12 %～ 16 %。结论 :膝胸卧位灌肠是治疗慢性盆腔炎较好的灌肠方法 ,有助于缩短疗程减轻患者痛苦。     

氦氖激光照射加纯中药艾灸至阴穴纠正臀先露疗效观察

[目的]探讨及寻求纠正臀先露的有效方法。[方法]将B型超声确诊为臀位、妊娠32周以上的孕妇60例，按就诊顺序分为治疗组30例和对照组30例；治疗组采用氦氖激光照射加纯中药艾灸至阴穴转胎，对照组按医嘱采用膝胸卧位转胎。[结果]治疗组转胎成功率明显高于对照组（P〈0．05）。[结论]氦氖激光照射加纯中药艾灸至阴穴纠正臀先露疗效确切。     

氦氖激光照射加纯中药艾灸至阴穴纠正臀先露疗效观察

[目的]探讨及寻求纠正臀先露的有效方法.[方法]将B型超声确诊为臀位、妊娠32周以上的孕妇60例,按就诊顺序分为治疗组30例和对照组30例;治疗组采用氦氖激光照射加纯中药艾灸至阴穴转胎,对照组按医嘱采用膝胸卧位转胎.[结果]治疗组转胎成功率明显高于对照组(P<0.05).[结论]氦氖激光照射加纯中药艾灸至阴穴纠正臀先露疗效确切.     

摆臀纠正孕妇胎臀位

1998年 5月～ 2 0 0 2年 5月我们采用了摆臀疗法 ,纠正孕妇胎臀位 ,取得满意的效果 ,现报告如下。1　资料与方法1 1　一般资料　 1998年 5月～ 2 0 0 2年 5月 ,在我院门诊产前检查妊娠 3 0周仍为胎臀位的孕妇 ,年龄 2 2～ 3 4岁。皆为单胎 ,无内外科合并症。将 10 0例随机分为两组 ,治疗组采用摆臀疗法 ,对照组采用胸膝卧位 ,观察胎位纠正情况1 2　摆臀方法　孕妇排空膀胱 ,松解裤带。双手扒在床沿 ,头低臀高 ,轻轻的摇摆臀部 ,每日 2次 ,每次 15min。平时有时间尽可能朝着胎背反方向倾斜半坐卧位于沙发或床上。两组均按时观察 ,治疗期间每…     

两种不同方法矫正臀位的效果比较

目的 寻找矫正臀位更有效和安全的方法。方法 将2000年1月至2007年12月产检并经B超诊断为臀位的孕妇随机分为2组，对340例指导采用托臀法，对264例指导采用胸膝卧位法，从两组矫正胎位的成功率、所需时间及效果进行比较，统计学处理采用X2检验或t检验。结果 托臀法的成功率为94%，所需时间3～5天，胸膝卧位法的成功率为77%，所需时间6～14天，统计学分析有显著性差异（P﹤0.05）。结论 托臀法矫正胎位成功率高，所需时间短，动作简单、易被接受，无不良反应，效果优于胸膝卧位法，值得推广应用。     

膝胸卧位对肛门括约肌松弛病人灌肠的效果观察

目的:探讨膝胸卧位在肛门括约肌松弛病人灌肠中的应用。方法:随机将60例需要灌肠的肛门括约肌松弛病人分为观察组和对照组各30例,对照组病人按常规的左侧卧位进行灌肠,观察组病人采取膝胸卧位进行灌肠,对两组病人在灌肠中漏液现象进行观察与比较。结果:观察组总有效率为83.33%,对照组为47.5%,两组比较,差异有显著性意义(P<0.05)。结论:膝胸卧位在避免肛门括约肌松弛病人灌肠时漏液现象有较好的效果。     

改良式膝胸卧位法纠正臀位300例效果观察

2005年1月～2007年12月，我院对300例门诊检查确诊为臀位的孕妇采用改良式膝胸卧位法纠正臀位，效果满意。现报告如下。     

胸部肿瘤放射治疗不同体位固定技术摆位误差及临床效果分析

目的探讨胸部肿瘤放射治疗不同体位固定技术摆位误差及临床效果.方法收集2016-11-05—2018-12-05来某院进行治疗的80例患者的临床资料作为研究目标.按照入院的先后顺序依次交替纳入观察组和对照组,各40例.观察组:采取翼型板联合真空垫体位技术进行固定.对照组:真空垫体位技术进行固定.观察不同体位固定技术摆位偏差情况、肺癌患者疗效、食管癌患者疗效.结果两组在左右方向(X轴)、上下方向(Y轴)方面摆位偏差对比,差异无统计学意义,P>0.05;观察组在头脚方向(Z轴)、三维方向(3D)摆位偏差低于对照组,差异有统计学意义(P<0.05);食管癌患者,观察组治疗总有效率为90.00%,高于对照组的52.63%,差异有统计学意义(P<0.05);肺癌患者,观察组治疗总有效率为95.00%,高于对照组的61.90%,差异有统计学意义(P<0.05).结论胸部肿瘤患者,采取不同体位固定技术摆位误差有差异,翼型板+真空垫体位技术进行固定技术较好,患者治疗总有效率较好.     

老年膝骨关节炎患者应用赋能理论指导居家康复锻炼方案对其膝关节功能改善效果

【】目的:分析老年膝骨关节炎患者予以赋能理论指导下的居家康复锻炼方案的干预效果及对其膝关节功能的改善作用。方法:采取便利抽样的方法选取2019年12月-2021年12月本院骨科收治的100例老年膝骨关节炎患者,按数字随机表法分作两组,对照组50例予以常规康复训练,观察组50例予以赋能理论指导下的居家康复锻炼方案,12周后比较两组患者的干预效果、康复自我效能、下肢肌力水平及膝关节功能。结果:护理后,观察组患者的西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分是(16.70±3.56)分,低于对照组的(19.24±3.86)分(P＜0.05);观察组患者的康复自我效能量表(SER)评分是(82.04±10.45)分,高于对照组的(73.73±10.22)分(P＜0.05);观察组患者双下肢的肌力水平均高于对照组(P＜0.05);观察组患者的美国特种外科医院膝关节功能(HSS)分数是(82.70±7.12)分,Lysholm膝关节分数是(74.68±6.20)分,分别高于对照组的(73.65±6.55)分与(63.37±5.15)分(P＜0.05)。结论:老年膝骨关节炎患者予以赋能理论指导下的居家康复锻炼方案可取得显著效果,不仅能增强其康复自我效能,还能促进患者下肢肌力水平提高,并且改善膝关节功能。     

改变产妇体位对促进产程进展的临床探讨

目的 探讨产妇在第一产程和第二产程各采取不同分娩体位对促进产程进展和自然分娩的效果.方法 选择孕37～41周头位分娩初产妇152例,随机分为2组,观察组(80例)第一产程可选择行、走、蹲、侧卧、半卧等自主体位;第二产程采取半卧位,胎头拨露时采取截石位.对照组(72例)产妇第一产程采取卧位(平卧、侧卧交替),第二产程采取截石位.观察2组产程进展和产妇舒适度的变化.结果 观察组第一产程(361.83±58.02)min,第二产程(36.39 4-11.97)min,总产程(398.21±59.72)min;对照组第一产程(560.85±131.98)min,第二产程(58.11±15.44)min,总产程(618.96±139.61)min.观察组较对照组各产程时间均缩短(t值分别为12.24、9.74、12.90,P均<0.01).观察组产后2 h下肢酸麻13例,对照组25例;观察组产后12 h下肢酸麻2例,对照组10例.观察组较对照组不同时段产妇舒适度增加(x2值分别为6.90、5.28,P<0.01、P<0.05).结论 第一产程自主体位及第二产程半卧位可有效缩短产程并缓解产后不适.

Abstract：

Objective To discuss the effect on promoting the progress of the stage of labor and the natural delivery as the parturient adopts the different delivery position in the first and the second stage of labor. Methods One hundred and fifty-two cases of delivery primiparas of cephalic presentation whose pregnancy was from 37 to 41 weeks were enrolled and divided into two groups randomly. In the observation group (80 cases) ,the free positions of delivery like walking,squating,lateral position,half lying and others could be selected in the first stage of labor, the semi-reclining position was selected in the second stage of labor and the lithotomy position was adopted when the head was visible on vulvae gapping. The parturient in the control group (72 cases) selected the decubitus (alternation between prostration and lateral position) in the first stage of labor and the parturient selected routine lithotomy position of supine position in the second stage of labor. The progress of labor and the comfort of the parturient in the two groups were observed. Results In the observation group, time spent in the first stage and second stage were (361. 83 ± 58. 02) mins and (36. 39 ± 11. 97) mins, and (398.21 ±59. 72) mins in the total birth process, which were significantly shorter than those of (560.85 ± 131. 98)mins and (58.11 ± 15.44) mins, and (618. 96 ± 139. 61) mins, respectively (t = 12. 24,9. 74 and 12. 90, Ps <0. 01). There were 13 and 25 cases experienced tingle in two hours after delivery, and 2 and 10 cases in 12 hs after delivery, in the observation and control group, respectively. The comfort of parturient in the observation group was higher than that in the control group (x2 = 6. 90, P < 0.01; x2 = 5. 28, P < 0. 05)respectively. Conclusion The free position in the first stage of labor and the semi-reclining position in the second stage of labor can shorten the birth process effectively and relieve the discomfort after the delivery.     

产程中实施特殊体位矫正胎方位的观察研究

目的 :探讨产程中实施特殊体位护理矫正胎方位的临床效果。方法 :选择 37～ 42周 ,先兆临产经B超检查证实为枕后位的初产妇 6 2例为观察组。在产程中指导观察组产妇取高坡侧俯卧位、手 -膝位 ,并与以往未做体位护理组对照。结果 :观察组有 5 5例经阴道分娩 ,占 88.7% ,对照组仅 14例经阴道分娩 ,占 2 2 .6 % ;观察组剖宫产 7例 ,占 11.3% ,对照组 48例 ,占 77.4% ;两组比较 ,差异有非常显著性意义 (P <0 .0 0 1)。而且对照组比观察组产程各期明显延长 ,胎先露下降速度明显减慢 ,胎儿宫内缺氧、新生儿窒息率明显增加 ,两组差异有非常显著性意义 (P <0 .0 1)。结论 :产程中实施特殊体位护理可以矫正胎头枕后位 ,降低难产发生率。     

Chest sonography versus lateral decubitus radiography in the diagnosis of small pleural effusions

PURPOSE: The aim of this prospective study was to assess the value of chest sonography in the radiologic diagnosis of small pleural effusions (relative to expiratory lateral decubitus radiography) and to suggest gray-scale sonographic criteria for detecting the presence of small pleural effusions. METHODS: Patients referred for abdominal or chest sonographic evaluation for various reasons were also examined for sonographic features of pleural effusion from May 1, 1997, until January 31, 2000. Patients who had evidence of small pleural effusions were included. Patients with no such evidence served as a control group. Subsequently, all patients underwent erect posteroanterior and expiratory lateral decubitus chest radiography. RESULTS: On chest sonography, 52 patients were found to have small pleural effusions. The control group consisted of 17 patients. The mean thickness of the pleural effusion was 9.2 mm on sonography and 7.6 mm on expiratory lateral decubitus radiography (p < 0.01). Compared with radiologic examination, chest sonography had a positive predictive value of 92% in the diagnosis of small pleural effusions in our study population. CONCLUSIONS: Chest sonography showed a high degree of accuracy relative to that of lateral decubitus chest radiography in the diagnosis of small pleural effusions, which appeared as thin (usually 15 mm thick or less) anechoic areas that changed shape with the phases of respiration.     

左旋多巴联合智能多维视觉训练对青少年屈光不正性弱视的疗效

目的探讨左旋多巴联合智能多维视觉训练对青少年屈光不正性弱视的治疗效果。方法选取2017年5月至2018年10月我院眼科门诊就诊的56例(98只患眼)屈光不正性弱视青少年为研究对象,按照随机数表法将其分为观察组(28例,50只患眼,左旋多巴联合智能多维视觉训练)与对照组(28例,48只患眼,智能多维视觉训练)。比较两组患儿治疗前、后的视觉敏感度、P-VEP、视功能、临床疗效及治疗前、后的生活质量。结果治疗后,两组患儿100%、50%、25%及10%空间频率视觉对比敏感度、P100波幅均显著升高,潜伏期均缩短,且观察组优于对照组(P<0.05)。治疗后,观察组患儿的矫正近立体视锐度低于对照组,矫正辐辏范围及矫正分开范围高于对照组(P<0.05)。观察组患儿的治疗总有效率为84.00%,高于对照组的70.83%(P<0.05)。治疗后,两组患儿的生活质量评分均升高,且观察组高于对照组(P<0.05)。结论相较于单纯的智能多维视觉训练,左旋多巴联合智能多维视觉训练更有利于青少年屈光不正性弱视患儿视觉敏感度、视功能的提高及视觉中枢神经元功能的改善,疗效显著,有利于患儿生活质量的提高。     

Continuous monitoring of ventilatory mechanics during one-lung ventilation

Objective. The Ultima SV respiratory monitor can be used to monitor the intraoperative effects of the lateral decubitus position and one-lung ventilation on ventilatory mechanics.Methods. Eight patients with esophageal cancer who required one-lung ventilation for esophagectomy and reconstruction were enrolled in the study. We monitored pressure-volume or flow-rate-volume loops continuously throughout the operation. Respiratory parameters were evaluated closely during five conditions of ventilation: two-lung ventilation in the supine position, two-lung ventilation in the lateral decubitus position, dependent one-lung ventilation in the lateral decubitus position, nondependent one-lung ventilation in the lateral decubitus position, and dependent one-lung ventilation in the lateral decubitus position with the chest opened. Respiratory rate was controlled at 10 breaths/min, and tidal volume was kept constant (10 ml/kg) during surgery.Results. Peak inspiratory pressure increased to 29.0 ± 9.0 (mean ± SD) cm H₂O in the dependent one-lung in the lateral decubitus position with the chest opened (p < 0.01). Dynamic compliance decreased to 29.4 ± 4.9 ml/cm H₂O in the dependent one-lung in the lateral decubitus position with the chest opened (p < 0.01). The changing configuration of the loops also offered additional and instantaneous information during one-lung ventilation.Conclusions. One-lung ventilation caused several changes in the whole respiratory system (lung, thorax, and endotracheal tube). Continuous monitoring of flow-rate-volume or pressure-volume loops with in-line spirometry provided comprehensive information regarding parameters in one-lung ventilation.     

改良侧卧位在手术体位中的应用

目的探讨常规侧卧手术体位摆放的改进与应用效果。方法将160例侧卧手术患者随机分为改良组与传统组两组,每组为80例。传统组采用第四版《医疗护理技术操作常规》方法摆放。改良组：麻醉前胸壁下方垫一小软枕,麻醉后根据病变位置选择左侧或右侧卧位,双手曲置面前呈睡眠状,两手臂之间垫一小软枕;两腿前后分开,上腿屈膝,下腿伸直;头部垫高后再将耳廓置于头圈空隙处;胸腹部及背部各固定一圆柱纱袋,最后用缚带固定髋部、膝部。分别观察两组体位摆放平均完成所需时间、术中体位移动发生率、术后皮肤组织受压以及术后随访肢体疲劳、神经损伤等情况。结果改良组摆放法平均完成时间短于传统组,皮肤组织受压、肢体疲劳、神经损伤术后并发症发生率也明显低于传统组,组间比较差异具有统计学意义[（13．97±1．63）vs（6．71±12．9）,t=31．238,P〈0．01;）x2=6．8267,8．9011,11．7566,P〈0．01）。结论采用改良侧卧摆放法可缩短摆放时间,对BP、HR、SpO2、呼吸次数改变没有明显影响,而且可以明显降低因体位摆放不当而引起的并发症,能进一步提高手术护理质量。     

Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: a systematic review

OBJECTIVE: A systematic review of studies assessing the effectiveness of acupuncture-type interventions (moxibustion, acupuncture, or electro-acupuncture) on acupuncture point BL 67 to correct breech presentation compared to expectant management, based on controlled trials. DATA SOURCES: Articles published from 1980 to May 2007 in databases of Medline, EMBASE, the Cochrane Central Register of Controlled Trials, AMED, NCCAM, Midirs and reference lists. STUDY SELECTION: Studies included were original articles; randomised controlled trials (RCT) or controlled cohort studies; acupuncture-type intervention on BL 67 compared with expectant management; ultrasound confirmed breech presentation and position of the fetus after treatment confirmed with ultrasound, position at delivery, and/or the proportion of caesarean sections reported. DATA EXTRACTION: Three reviewers independently extracted data. Disagreements were resolved by consensus. DATA SYNTHESIS: Of 65 retrieved citations, six RCT's and three cohort studies fulfilled the inclusion criteria. Data were pooled using random-effects models. In the RCT's the pooled proportion of breech presentations was 34% (95% CI: 20-49%) following treatment versus 66% (95% CI: 55-77%) in the control group (OR 0.25 95% CI: 0.11-0.58). The pooled proportion in the cohort studies was 15% (95% CI: 1-28%) versus 36% (95% CI: 14-58%), (OR 0.29, 95% CI: 0.19-0.43). Including all studies the pooled proportion was 28% (95% CI: 16-40%) versus 56% (95% CI: 43-70%) (OR 0.27, 95% CI: 0.15-0.46). CONCLUSIONS: Our results suggest that acupuncture-type interventions on BL 67 are effective in correcting breech presentation compared to expectant management. Some studies were of inferior quality to others and further RCT's of improved quality are necessary to adequately answer the research question.     

Efficacy of the lateral decubitus position in preventing pneumothorax after needle biopsy of the lung

We evaluated the efficacy of the lateral decubitus position in preventing the development of pneumothorax after percutaneous needle biopsy of a well defined lung lesion. Fifty patients had such a procedure and were immediately placed in the lateral decubitus position for ten minutes, with the biopsied lung below. A chest x-ray film was obtained after the ten minute period, four to six hours later, and on the following morning. The number of pneumothoraces and the type of treatment needed in each case were recorded. Results in these 50 patients were compared to those previously obtained in 132 patients who had had an identical procedure and follow-up during the preceding four years. In all patients included as controls, we did the biopsy using an identical technique and in accordance with a specific written protocol. Both groups of patients were closely comparable in age and sex distribution, baseline values for arterial blood gases, results of prebiopsy tests of pulmonary function, and type, size, location, and distance from the pleural surface of the pulmonary lesions. A postbiopsy pneumothorax developed in 21 of 50 (42%) study patients, and in 46 of 132 (35%) controls (P not significant). Specific therapy was needed in ten (48%) and 26 (56%) of these cases, respectively (P = NS). We conclude that placing patients in the lateral decubitus position is not effective in significantly reducing the incidence of postbiopsy pneumothorax or the proportion of patients who will require specific therapy for this complication.