改良泪道冲洗法治疗婴幼儿泪囊炎疗效观察

目的评价研制的婴幼儿专用泪道加压冲洗器治疗婴幼儿泪囊炎的疗效。方法选用一次性静脉输液针,对针头进行加工改造,并在输液管的另一端连接10 ml无菌注射器(内含地塞米松、妥布霉素滴眼液、糜蛋白酶、生理盐水混合冲洗液),制成婴幼儿专用泪道加压冲洗器。用该冲洗器对965例婴幼儿泪囊炎患儿1 056眼行泪道加压冲洗(改良组),并与使用传统泪道冲洗法治疗的320眼(传统组)作疗效对比。结果综合改良方法(一次冲洗和冲洗加泪道探通)一次治愈1 036眼,治愈率为98.1%;综合传统方法(一次冲洗和冲洗加泪道探通)一次治愈253眼,治愈率为79.1%。两组差异有统计学意义(χ2=150.37,P=0.000)。传统组在治疗过程中有泪小点撕裂、眼睑水肿、呛咳窒息、角膜划伤等并发症发生,而改良组仅2例出现眼睑水肿。结论本方法治疗婴幼儿泪囊炎,具有易操作、见效快、成功率高、并发症少的优点,能有效提高婴幼儿泪道冲洗的安全性,提高泪道探通的成功率和泪囊炎的治愈率,具有较高临床治疗推广价值。     

泪道冲洗加泪道探通术治疗婴幼儿泪囊炎的临床疗效

目的探讨泪道冲洗加泪道探通术治疗婴幼儿泪囊炎的临床疗效。方法对我院51例59眼婴幼儿泪囊炎患儿先给予泪道冲洗,不愈后在给予泪道探通术,探讨泪道冲洗加泪道探通术治疗该病的临床疗效与临床安全。结果 <6个月组的有效率为96.88%,6～12个月组的临床疗效为87.50%,>12个月组的临床疗效为54.55%%,经比较<6个月组的临床疗效明显优于其余2组,均(P<0.05)。并发症:所有病例无1例窒息或呛咳发生,泪小点哆开1眼,眼睑皮下水肿3眼。结论泪道冲洗加泪道探通术治疗婴幼儿泪囊炎具有较好的临床疗效,且操作简单,并发症少,值得临床推广应用。     

婴幼儿泪囊炎泪道冲洗及泪道探通的护理配合与体会

婴幼儿泪囊炎是常见的眼病，约占婴幼儿眼病的5％～6％，多继发于先天性鼻泪管阻塞，可单眼或双眼发病，主要表现为婴幼儿出生后不久，即出现泪溢：若泪囊继发感染，则出现粘液脓性分泌物。目前，该病的治疗方法主要有挤压按摩泪囊法、加压泪道冲洗法和泪道探通法等。其中，泪道冲洗是临床常用的有效手段之一。现将我院对婴幼儿泪囊炎泪道冲洗的护理配合及体会介绍如下。     

门诊新生儿及小儿泪道冲洗及泪道探通术的护理

目的:探讨门诊小儿泪道冲洗及泪道探通术的疗效与护理。方法:我院自2012年8月至2013年2月门诊治疗新生儿泪囊炎86例(96眼),对其进行泪道冲洗及泪道探通术,观察治疗及护理效果。结果:38例(38眼)行泪道冲洗治愈,48例(58眼)行泪道探通术治愈。结论:小儿泪道冲洗及泪道探通术治疗新生儿泪囊炎操作简单,安全可靠,疗效显著。     

婴幼儿先天性泪道阻塞320例临床分析

目的探讨先天性婴幼儿泪道阻塞的治疗方法及治疗时机选择。方法回顾性分析320例(379眼)0~20个月婴幼儿病例,2个月内婴儿采用泪囊区按摩及滴用托百士眼水方法,2个月以上的婴幼儿选择泪道冲洗法及局部使用抗生素,3个月以上的婴幼儿采用泪道探通术综合治疗。结果 320例(379眼)患儿,治愈370眼,治愈率97.62%,其中9眼治疗无效,均为大于9个月患儿。经泪囊区按摩通畅40眼(33例),占10.55%;用泪道冲洗法治疗通畅197眼(161例),占51.98%;用泪道探通法治疗通畅125眼(110例)占32.98%;硅胶管植入法8眼(7例),占2.11%。结论泪道冲洗及探通治疗对婴儿泪道阻塞是一种有效的治疗方法,对于病情程度不同的患儿应采取个体化治疗。     

312例婴幼儿泪囊炎治疗体会

目的:探讨婴幼儿先天性泪囊炎的治疗方法及疗效。方法:对312例(470眼)婴幼儿根据病情和年龄情况采用不同治疗方法:1月以下婴幼儿首先以按摩泪囊区为主,5月以上婴幼儿直接采用泪道探通冲洗术。结果:1月以下婴幼儿经按摩治愈61眼,2～4月经按摩治愈20眼,各月龄段泪道探通冲洗治愈374眼,治愈率96.1%。各年龄组泪囊炎发病情况以0～4月年龄组为多数,不同术式差异有统计学意义。说明剖宫产与顺产比较,有使泪囊炎患病率增高的因素。分泌物细菌培养加药敏结果显示,链球菌、肺炎球菌发病例数最多,其次是葡萄球菌。结论:2～4月为泪道探通冲洗术的最佳治疗时间。     

婴幼儿泪囊炎泪道冲洗联合探通术治疗的护理

目的探讨婴幼儿泪囊炎泪道冲洗泪道联合探通术治疗的护理方法。方法对我院2010年6月~2014年6月间收治的婴幼儿泪囊炎病例资料进行回顾性分析,总结患儿行泪道冲洗及探通治疗过程中的护理技巧及要点。结果经随访3个月,本组78例(89眼)经泪道冲洗联合探通术综合治疗的患儿,总治愈77眼(98.7%),且无1例并发症发生或复发。结论泪道冲洗联合探通术治疗是婴幼儿泪囊炎行之有效的治疗手段,充分的术前准备、心理护理及术中系统规范的护理配合对减少并发症,保证疗效作用显著。     

新生儿泪囊炎的临床治疗及探通时机的选择

目的:探讨新生儿泪囊炎的治疗效果及探通的时机。方法:共治疗新生儿泪囊炎120例146眼,分别采用按摩泪囊部位、泪道冲洗、加压泪道冲洗等方法,无效者行泪道探通术,观察治疗效果,选择探通的时机。结果:经按摩通畅10例12眼,泪道冲洗、加压泪道冲洗治愈90例111眼,泪道探通1次治愈14例17眼,泪道探通2次治愈3例3眼,泪道探通3次治愈1例1眼,无效2例2眼,总治愈率98.33%。结论:新生儿泪囊炎应及早诊治,则治愈率高,对泪道冲洗、加压泪道冲洗无效的患儿,可在出生2个月后行泪道探通术。     

婴幼儿泪道阻塞的治疗与护理分析

目的:分析婴幼儿泪道阻塞的治疗与护理效果。方法:按摩泪囊、泪道冲洗及探通,综合护理。结果:本组66例,泪囊按摩和点眼药治愈11例,泪道冲洗治愈23例,泪道探通一次治愈25例,2次探通治愈3例,有效3例,无效1例。治愈率为93.93%。结论:早期综合治疗、护理婴幼儿泪道阻塞症,可提高治愈率,减少并发症。     

新生儿泪囊炎治疗新方法的实践

目的 探讨冲洗式泪道探针治疗新生儿泪囊炎的疗效.方法 对324例(358眼)新生儿泪囊炎患儿采用冲洗式泪道探针行泪道探通术治疗,随访6个月至2年.结果 324例(358眼)一次泪道探通术治愈341眼(95.25％),二次泪道探通术治愈14眼(3.91％),共治愈355眼(99.16％).结论 泪道探通术治疗新生儿泪囊炎疗效好、操作简单、安全.     

婴幼儿春季腹泻的病原学探讨

目的:探讨沈阳地区春季婴幼儿腹泻的病原感染情况,更好的采取防治措施,控制腹泻病的发生。方法:病原菌检测按常规方法,轮状病毒检测用核酸电泳法。结果:从185例标本中检出病原67例,总检出率36.2%;其中轮状病毒检出28例(15.1%);铜绿假单胞菌14例(7.6%);致病性大肠杆菌8例(4.3%);副溶血性弧菌5例(2.7%);变形杆菌4例(2.2%);志贺菌、亲水气单胞菌各2例(1.1%);沙门菌、豚鼠气单胞菌、麦氏弧菌、类志贺邻单胞菌各1例(0.5%)。28例轮状病毒均为典型普通轮状病毒反应模式,核酸图谱分型,短型为25例,长型为3例。结论:加强对轮状病毒的防治是控制婴幼儿春季腹泻的有效措施。     

Turn-taking in early vocal interaction: a comparison of premature and term infants'' vocal interaction with their mothers

AIMS: The present study was designed to test the hypothesis that mothers of premature infants compared with mothers of term infants differ in the structure which they impose on the vocal exchanges with their infants. METHODS: Thirteen mothers and their premature and term babies, were observed at discharge and 2 months later in three situations: free play, changing nappy, and feeding. Maternal child-directed speech was coded as well as the timing of their utterances in respect to the infants' vocalizations. The mean relative frequency of infant vocalizations following maternal child-directed speech was computed. RESULTS: It was found that mothers of premature babies in comparison with mothers of term babies, followed significantly more often their infants' vocalizations with an utterance directed at the child. In contrast, term infants compared with preterm infants followed significantly more often their mother's utterances with a vocalization. CONCLUSION: Mothers of premature and of term babies differ in their timing of child-directed speech. This might have implications for the language development of premature and term infants.     

巨大儿的分娩方式及其对妊娠结局的影响

目的:比较足月巨大儿与正常体重儿的分娩方式、母婴并发症,探讨巨大儿的不同分娩方式与妊娠结局的关系。方法:回顾性调查哈尔滨市16所医院在2000年1月1日~2005年12月31日分娩的单胎、无出生缺陷、足月(非早产、过期产)活产的巨大儿和正常体重儿的产妇病案(其中包含新生儿病案),比较2138例巨大儿和18233例正常体重儿的分娩方式与妊娠结局。结果:巨大儿组的剖宫产率、产妇住院天数、产妇产后出血比例、新生儿窒息比例高于正常体重儿组。巨大儿组的阴道助产率(7.51%)高于正常体重儿组(5.60%),但无统计学意义。分娩巨大儿的产妇产后出血比例、巨大儿窒息比例均与分娩方式无关。结论:足月巨大儿也具有较高的母婴并发症,故应探索并使用正确的产前预测巨大儿的方法,产时给于充分重视,适时正确处理,适当放宽剖宫产指征,降低母婴并发症。     

A comparison of cry-behaviours of clinic-referred and non-referred infants 4-12 weeks old

The purpose of this study was to find whether babies of between 4 weeks and 12 weeks, referred to clinics because of their crying do cry more than their non-referred peers. In an attempt to increase the accuracy of maternal report measures and find if there were critical variables, three measures of crying were used: (1) Episode frequency (2) Mean episode duration (3) Total episode duration.

These dimensions were measured using a 24 hour maternal diary and a 24 hour contemporaneous audiotape recording method.

The data collected indicated that clinic-referred babies do cry more than their non-referred peers. They cry more frequently and for a longer total episode duration than their normative peers. These differences were significant according to maternal report data and were confirmed by audiotaped data but not at a significant level. Maternally reported frequencies for referred and non-referred infants correlated significantly with audiotaped data. No significant differences were found between the two groups for mean episode durations and correlations for these data were inconsistent across groups.

Results are discussed in the context of recent studies of infant crying and the literature concerning the validity of maternal reports.     

哺乳期辅助食物对婴儿发育的影响

31名四个月龄的婴儿在正常喂乳的情况下,分三组进行系统观察和医学指导,每隔周随访1—2次共六个月。第一组任意其用传统方法添加米糊和辅助食物;第二组在以米糊为主的辅食中加入L-赖氨酸(2-3％);第三组则 由我们提供全脂奶粉作为添加食物,三组的摄食情况均作记录,每隔周测量体重一次,每月测量血红蛋白一次。 在指导和监测下,三组婴儿的血红蛋白均有明显的增高,体重增长比本地区平均值也有明显的增高趋势,但三组在第四个月后出现不同程度的疾病,主要为上呼吸道炎症(42.3％)、腹泻(34.6％)及发热(包括感冒)23.1％,这对婴儿的生长有明显的干扰,本文讨论并对比英国婴儿的增长情况,提出在适当添加辅助食物的同时,预防呼吸道及消化道疾病十分重要,科学指导家庭育儿是一项重要任务。     

2013 - 2017年芜湖市预防梅毒母婴传播综合干预效果评估

目的 了解芜湖市实施预防艾滋病、梅毒母婴传播（PMTCT）项目以来的梅毒阳性孕产妇及其所生婴儿的干预及感染情况,评价预防梅毒母婴传播工作的效果,为今后更好地开展预防梅毒母婴传播工作提供依据。方法 以2013年1月 - 2017年12月期间芜湖市所有接受孕产期保健服务的孕产妇为目标人群,从国家预防艾滋病、梅毒和乙肝母婴传播项目信息系统中导出芜湖市相关数据,应用 SPSS 16.0 软件进行数据统计分析,差异比较使用卡方检验。结果 2013 - 2017年芜湖市住院分娩梅毒阳性产妇总数为467例,阳性率为0.28%;2013年梅毒阳性孕产妇规范治疗率为12.86%,2017年规范治疗率上升至55.13%,呈逐年升高的趋势（χ2趋势 = 47.224,P＜0.001）;499例梅毒感染孕产妇分娩的509例婴儿,7 d内死亡2例,出生即诊断为先天梅毒儿的7例,后续随访诊断为先天性梅毒的3例,先天性梅毒儿发生率为5.88/10万。结论 梅毒阳性孕产妇及其所生婴儿干预比例也在逐年上升,预防梅毒母婴传播工作取得了初步的成效,但是梅毒阳性孕产妇规范治疗率较低,其所生婴儿干预比例仍需提高。     

氯丙嗪联合异丙嗪治疗婴幼儿腹泻106例疗效观察

目的：探讨氯丙嗪联合异丙嗪治疗婴幼儿腹泻的疗效。方法：将216例小儿腹泻患儿随机分为治疗组106例,对照组110例,两组均给予常规治疗,治疗组加氯丙嗪及异丙嗪0.5～1mg/kg/次,每日1～2次肌注,与对照组进行比较。结果：平均止泻时间：治疗组为2.2d,对照组为3.3d。治疗组在止泻时间及总疗程方面均优于对照组,两组有显著差异（P〈0.01）。结论：氯丙嗪联合异丙嗪治疗婴幼儿腹泻效果显著,副作用小,费用低,值得临床应用。     

Contamination of breast milk obtained by manual expression and breast pumps in mothers of very low birthweight infants

The objective of this study was to compare the rates of bacterial contamination of expressed breast milk (EBM) obtained by manual expression and breast pumps in mothers of very low birthweight (VLBW) infants (<1501 g). This was a randomized, controlled study carried out on 28 mothers of such babies and 92 specimens of EBM were collected: 41 specimens from 13 mothers assigned to the manual group and 51 specimens from 15 mothers in the breast-pump group. EBM was cultured quantitatively by the Miles and Misra method. Breast milk expressed by breast pumps (86.3% or 44/51 specimens) had a significantly higher rate of bacterial contamination than milk expressed by the manual method (61.0% or 25/41 specimens) (P= 0.005). When breast milk was expressed in the hospital, there was no significant difference in contamination rates between the two methods. When breast milk was expressed at home, the rates of bacterial contamination by staphylococci (P= 0.003) and Gram-negative bacilli (P= 0.002) were significantly higher in the breast-pump group than the manual group. In conclusion, the rate of bacterial contamination of EBM of mothers of VLBW infants was high, especially when EBM was obtained by the breast pump or when expression was carried out at home.     

阴道助产掌助产的临床应用分析

目的:应用一种新的阴道助产技术——阴道助产掌术并评估其在阴道助产中的价值。方法:介绍阴道助产掌并对2008年1月～2009年6月应用阴道助产掌分娩的50例与同期间应用产钳助产及胎头吸引助产各50例进行比较分析,比较阴道助产掌与自然分娩及其他阴道助产方法对母儿损伤的情况。结果:阴道助产掌组产后出血量及软产道损伤例数较产钳组显著减少(P<0.05),但助产掌组的单次助产成功率90%低于产钳组的100%,而与胎头吸引组比较差异无统计学意义(P>0.05);阴道助产掌组的新生儿损伤发生率显著低于产钳组及胎头吸引组(P<0.05)。结论:阴道助产掌助产是一种安全有效、操作简单、易于掌握、助产快、母婴损伤小的新的助产技术,在一定条件下可以代替产钳术,但单次助产成功率低于产钳术,可取代胎头吸引术,值得临床推广应用。     

新生儿泪囊炎的治疗时机与方法

目的 探讨新生儿泪囊炎的最佳治疗时机和方法.方法 回顾性分析2005年6月～2009年5月在新郑市辛店镇中心卫生院眼科门诊就诊的94例105眼新生儿泪囊炎患儿,其中男56例62眼（59.05%）,女38例43眼（40.95%）,年龄1～14个月,平均（4.25±1.03）个月.治疗方法包括抗生素眼液点眼、按摩泪囊区、冲洗泪道及探通冲洗泪道.结果 药物治疗1周及泪道冲洗1次无效后,年龄大于1个月,经患儿家属知情同意,给予泪道探通术.经泪道探通治疗后,新生儿泪囊炎治愈率为93.33%.小于6个月的患儿治疗效果较大于6个月的患儿要好,差异有统计学意义.结论 新生儿泪囊炎一旦发现,短期保守治疗无效即可行泪道探通治疗,泪道探通术是治疗新生儿泪囊炎安全有效的方法.