产褥期产妇的临床护理分析

目的分析产褥期产妇的护理措施。方法每日观察并记录110例分娩后产妇的恢复情况,实施产后护理保健措施。分别在产后1周和2周上门对产妇进行访视,着重对产妇进行保健教育。记录出院后恢复情况并建立完整档案。结果本组110例产妇产后恢复情况良好,均安全渡过产褥期,无1例发生产褥期感染,仅3例存在产后抑郁症,进行心理疏导后好转。结论规范产后护理保健措施,利于产妇安全度过产褥期。     

产褥期抑郁症状发生状况及影响因素的纵向研究

目的 纵向调查产褥期女性抑郁症状的发生状况,分析其影响因素,为产褥期保健提供参考。 方法 采用爱丁堡产后抑郁量表,于产妇产后3 d和产褥期结束时（42 d左右）进行调查。 结果 515名产妇完成研究。产后3 d和产褥期结束时抑郁症状发生率分别为5.8%、6.4%。与配偶关系不好、新生儿性别不符合预期、产后夜间睡眠障碍、没有人帮助喂养新生儿、租房是产后3 d抑郁症状的危险因素（均P＜0.05）;产后3 d发生抑郁症状、产后夜间睡眠障碍、与配偶关系不好及新生儿性别为男是产褥期结束时抑郁症状发生的危险因素（均P＜0.05）。 结论 分娩后早期对产妇进行抑郁症状筛查非常重要,夫妻关系和睡眠问题需要重点关注;男性新生儿导致产妇不良情绪的发生值得进一步研究。     

围生期心肌病患者产褥期的责任制整体护理

目的:探讨PPCM患者产褥期的责任制整体护理。方法:以护理查房的形式,回顾分析我院妇产科收治的6例围生期心肌病病例,讨论总结PPCM患者产褥期的护理。结果:6例PPCM患者平均住院天数17.5天。心衰在产褥期得到有效的治疗和控制,无一例产妇死亡。结论:整体护理在心衰预防、心理护理、健康教育多个环节起到重要作用,提高患者的生存质量。     

院内外团队协作入户对产妇实施母乳喂养与产褥期照护支持研究

目的 通过实施院内外联动母乳喂养与产褥期照护支持,了解母婴产褥期健康问题,总结入户访视经验,为完善产褥期健康管理提供依据。方法由医院指导团队对社区入户指导团队4名成员进行培训和一对一对接指导,协助制订入户照护方案,由入户指导团队对102名存在母乳喂养问题的产妇行入户访视服务,包括母乳喂养与产褥期照护支持。结果共完成118人次入户访视服务。最常见的产妇问题为哺乳姿势问题,占73.7%;最常见的婴儿问题为喂养遇到的难题,占65.2%。产妇对访视服务的满意度为100%,未发生事故和投诉。结论院内外团队协作入户对产妇行母乳喂养与产褥期照护支持,能帮助产妇解决母乳喂养遇到的问题,提高产妇满意度。在实施前应构建访视团队以及相应的指导团队,加强入户指导质量把控,提高院内外联动性、对指导者进行一对一指导以提高服务质量。     

运用舒适护理提高剖宫产产妇的母乳喂养率

目的:探讨舒适护理提高剖宫产产妇的母乳喂养率.方法:将160例剖宫产产妇随机分为观察组(80例)和对照组(80例),对照组采用常规护理方法护理,观察组在常规护理基础上运用舒适护理.结果:观察组产妇在住院期间、出院后3个月纯母乳喂养率均高于对照组,差异有统计学意义(P＜0.01).结论:舒适护理能解决剖宫产产妇因身体不适带来的困扰,使产妇的身心处于最佳状态,从而提高新生儿的纯母乳喂养率.     

医院开展产褥期延续护理的研究进展

介绍医院开展产褥期延续护理的作用及方案,从组建跨学科产后延续护理团队、建立高质量的电话随访流程、聚焦基于网络平台的信息技术支持、践行多元协同护理模式、倡导高级实践护士主导的家庭访视等方面进行详述,并对各干预方式的优势和不足进行思索及展望,为实施由医院开展的产褥期延续护理提供借鉴。     

对剖宫产初产妇实施母婴床旁护理的效果研究

目的探讨对剖宫产产妇实施床旁护理的方法及效果。方法选择剖宫产产妇60例,随机分成实验组与对照组各30例。对照组实施常规护理;实验组实施床旁护理模式,产妇及新生儿各项护理操作由责任护士在产妇床旁进行。结果两组出院时产妇护理知识和技能评分及SDS评分比较,差异有统计学意义(均P0.01)。结论床旁护理有助于提高剖宫产产妇的护理知识和技能水平,并能缓解产妇的负面情绪。     

产后访视护理干预对产褥期妇女健康信念及生活质量的影响

目的:探讨产后访视护理干预对产褥期妇女健康信念和生活质量的影响.方法:选择在我院产科住院分娩的120例孕产妇为研究对象,采取随机分组法将符合本研究纳入标准的产妇分为A组和B组,A组仅给予产褥期常规产后访视,B组妇女则对产褥期进行产后访视护理干预及实施,观察并比较两组妇女健康信念水平和生活质量.结果:B组妇女健康信念水平和SF-36量表中各维度指标得分均明显高于A组妇女,差异有显著性(P＜0.05).结论:产后访视护理干预能够明显提高产褥期妇女采取相应健康行为的信念,改善产褥期妇女的生活质量,具有积极的临床意义,适合应用于我区产褥期产妇的护理.     

乳房护理对剖宫产产妇乳头凹陷的作用

由于剖宫产手术相对增加及孕妇缺乏乳房的护理知识,导致乳头凹陷增多,产后不能顺利进行母乳喂养。且剖宫产后致伤口疼痛,新生儿吸吮明显减少,导致乳房发硬、胀痛,乳头更加凹陷,新生儿无法吸吮,产妇也不愿意喂奶,乳房分泌的乳汁得不到及时排出或乳管阻塞使产妇乳房胀痛加重,自我舒适感下降[1]。我科于2002年2月至2004年8月对60例在我院行剖宫产产后乳头凹陷产妇实施乳房护理,收到满意效果,报告如下。1资料与方法一般资料:60例剖宫产乳头凹陷产妇,年龄22～33(24.5±2.5)岁。均为足月初产,无妊娠并发症。方法:产后1～4d,由从事妇产科工作多年有…     

中医循证护理方法在促进产妇泌乳中的应用研究

目的:探讨中医循证护理措施对产妇乳汁分泌的影响.方法:将200例产妇,随机分为实验组和对照组,实验组实施循证护理,对照组实施整体护理,观察两组产妇初次泌乳时间、产后三天泌乳量情况,并进行统计学分析.结果:实验组产妇初次泌乳时间、产后三天泌乳量对比结果优于对照组.结论:中医循证护理措施能有效促进产妇产后乳汁分泌.     

绝经后骨质疏松症肾虚血瘀型的认识和中医药防治策略研究

绝经后骨质疏松(postmenopausal osteoporosis, PMOP)属于中医“骨痿”范畴，是女性最常见的代谢性骨病之一，其中医证型复杂多样，但总体来说以肾虚为本，血瘀为标。本文主要阐述肾虚血瘀型绝经后骨质疏松症致病机制，并对中医药复方对绝经后骨质疏松症的防治策略加以综述，探讨中医药的优势、发挥中医“治未病”的独特优势，以期为预防和治疗PMOP提供临床指导、为进一步的研究提供思路。     

基于中医“虚瘀理论”探究淋巴系统防治骨质疏松的研究进展

骨质疏松是一种常见的代谢性骨病,以骨丢失、骨质量下降为临床表现。以往研究证实,骨骼周围微循环障碍（炎症反应、脂质代谢）与骨吸收密切相关。但淋巴系统作为微循环的重要环节未引起足够关注。笔者试从中医“虚瘀理论”出发,探讨淋巴管系统在骨质疏松病理进程中的作用和机制,为其防治提供新的研究思路。     

复方中草药香包吸入改善大学生痛经的随机对照研究

目的 探讨吸入复方中草药香包改善大学生寒凝血瘀型痛经的疗效及安全性。方法 将100名寒凝血瘀型痛经大学生采用分层随机分组法分为对照组和试验组各50名。对照组给予健康教育和安慰剂香包吸入,试验组给予健康教育和复方中草药香包吸入,每晚睡觉时将香包悬挂于侧墙且距鼻30 cm处,持续3个月经周期。结果 对照组46名、试验组48名大学生完成本研究。组间比较,干预后腹痛视觉模拟量表、Cox痛经症状评分表、疼痛灾难化量表评分及疗效差异有统计学意义(均P<0.05);两组在研究过程中均未报告不良反应。结论 复方中草药香包吸入有利于减轻寒凝血瘀型痛经大学生腹痛程度、缓解痛经症状、降低疼痛灾难化水平。     

动脉粥样硬化性肾动脉狭窄中医证候初探

目的：通过对动脉粥样硬化性肾动脉狭窄（ARAS）患者中医证候调查,探讨ARAS患者证候分布特点其与临床指标之间的关系。方法：采用横断面调查,对符合纳入标准的60例ARAS患者进行中医虚损和邪实证候评分;所有病例采集人口学、病史及各种临床资料,包括：一般资料、血压、生化指标、超声、肾小球滤过率等临床指标;分析各项临床指标与虚损证和邪实证积分之间的关系。资料相关分析采用Spearman Correlation,组间比较采用秩和检验。结果：（1）ARAS患者虚损证以脾肾气虚最为多见,邪实则为多湿多瘀;（2）ARAS患者虚损证积分与邪实证积分之间呈正相关关系;（3）病变累及单侧肾动脉与双侧者中医证候方面差异无统计学意义。结论：ARAS患者其病机特点为本虚标实,多见脾肾气虚,挟湿挟瘀证。     

The effects of intrathecal diamorphine on gastric emptying after elective Caesarean section

This study investigated whether intrathecal diamorphine affects gastric emptying following elective Caesarean section. Forty women were randomly allocated to receive either diamorphine 300 microg or 0.9% saline as part of a standard spinal anaesthetic. Gastric emptying was measured in the immediate postoperative period using paracetamol absorption. Paracetamol concentrations were measured by enzymatic assay method using a Beckman CX-7 automated analyser. The time to maximum concentration (Tmax) was statistically longer in the diamorphine group (control 41.8, SD 20.8 min; diamorphine 72.6 SD 41.9 min; p < 0.01). During the 2-h study period, mean morphine consumption via a patient controlled analgesia device was significantly higher in the control group (control 9.3, SD 3.6 mg; diamorphine 2.1, SD 2.1 mg; p < 0.01). We conclude that intrathecal diamorphine may contribute to the delay in gastric emptying that occurs immediately following elective spinal Caesarean section.     

The effect of subhypnotic doses of propofol on the incidence of pruritus after intrathecal morphine for Caesarean section

The effect of subhypnotic doses of propofol on intrathecal morphine-induced pruritus was studied in a prospective, randomly allocated, double-blind controlled trial. Fifty-eight women undergoing elective lower segment Caesarean section for a singleton fetus received spinal anaesthesia with 2.5 ml hyperbaric 0.5% bupivacaine and 0.2 mg of preservative-free morphine. They then received propofol 1 ml (10 mg) or Intralipid 1 ml (control group) intravenously after delivery. Pruritus was assessed using a five-point verbal rating scale at hourly intervals for 8 h. A second dose of their allocated treatment drug was administered at the first recording of significant pruritus. The pruritus score was reassessed after 5 min and the treatment was repeated if pruritus remained. There were no differences between the groups in the onset of pruritus or its successful treatment. No adverse side-effects were associated with this dose of propofol. There were no differences in the incidence of post-operative nausea and vomiting between the two groups. Subhypnotic propofol is not an effective treatment for intrathecal morphine-induced pruritus in women following Caesarean section.     

The effect of the addition of adrenaline to pethidine for patient-controlled epidural analgesia after Caesarean section

We have investigated the addition of adrenaline to pethidine for patient-controlled epidural analgesia after elective Caesarean section. In a randomised, double-blind study, patients received patient-controlled epidural analgesia for 24 h using pethidine 5 mgml⁻¹ with adrenaline 5 μgml⁻¹ (adrenaline group, n  = 40) or pethidine 5 mgml⁻¹ without adrenaline (plain group, n  = 38). Visual analogue scale pain scores at rest and on coughing measured 2 h, 6 h and 24 h after surgery were similar between the two groups. There was a trend towards lower mean total consumption of pethidine in the adrenaline group (231.5 mg; SD 140.5 mg) compared with the plain group (289.5 mg; SD 139.5 mg; p = 0.071). Patients in the adrenaline group had higher visual analogue scale scores for nausea at 2 h and 24 h and higher scores for pruritus at 2 h compared with the plain group. Addition of adrenaline to pethidine for patient-controlled epidural analgesia does not appear to have significant clinical advantages.     

逐瘀通络法对桡骨远端骨折患者锁定加压钢板内固定术后早期康复的影响

目的：探讨逐瘀通络法对桡骨远端骨折手法复位失败患者锁定加压钢板（locking compression plate,LCP）内固定术后早期炎症状态、骨折愈合及关节功能恢复的干预作用。方法：选取2019年4月—2021年4月我院收治的68例桡骨远端骨折术后患者作为研究对象,随机数字法分为LCP组及联合组,每组各34例,LCP组患者采用锁定加压钢板治疗,联合组在LCP手术后采用逐瘀通络法治疗。结果：联合组患者肿胀消退时间、疼痛消退时间、瘀斑消失时间及骨折影像愈合时间均低于LCP组（P <0.05）;治疗后,与LCP组相比,联合组患者血浆中炎症因子C反应蛋白(c-reactive protein,CRP)、白细胞介素（interleukin, IL）-6、IL-1β、丙二醛（malondialdehyde, MDA）、晚期氧化蛋白产物(advanced oxidation protein products, AOPP)降低,超氧化物歧化酶(superoxide dismutase, SOD)及谷胱甘肽过氧化物酶（glutathione peroxidase,GSH-Px）升高（P &l...     

The effect of celecoxib on intrathecal morphine-induced pruritus in patients undergoing Caesarean section

Pruritus associated with intrathecal opioid administration is particularly common in pregnancy. Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the severity of this pruritus but have undesirable side effects. The recent development of drugs that can specifically inhibit the cyclooxygenase 2 isoenzyme have become an attractive alternative. This study was designed to evaluate the efficacy of such a drug (celecoxib) in reducing intrathecal opioid-induced pruritus in a randomised double-blinded study of 60 women undergoing Caesarean section. All of them received spinal anaesthesia with 3 ml of 0.5% hyperbaric bupivacaine and 0.3 mg preservative-free morphine. After delivery of the baby, they received either oral celecoxib 200 mg or placebo. Visual analogue scores for pain and pruritus were measured at 30 min, 2, 4, 8, and 24 h. There was no difference in the severity and onset of pain and pruritus between the two groups. Timing of administration, inadequate dosing and possible altered pharmacokinetics in pregnancy may explain the lack of efficacy.     

The effect of prophylactic fentanyl on shivering in elective Caesarean section under epidural analgesia

The aims of this randomised double-blind study were to investigate whether 25 micrograms of fentanyl administered prophylactically by the epidural route would influence the incidence of shivering in parturients who underwent elective Caesarean section under epidural analgesia and whether it would affect the axillary and calf temperatures. There was a 50% reduction (p less than 0.05) in the overall incidence of shivering in patients who received fentanyl and there was some evidence to suggest that low-dose epidural fentanyl might reduce shivering by an influence on thermoregulation.