剖宫产术后短时间翻身预防褥疮的观察

随着剖宫产率的增高，剖宫产术后的护理亦应引起重视，尤其是皮肤护理更为重要。本科剖宫产均在硬膜外麻醉下进行，要求产妇术后6h内取去枕平卧位，那么产妇只能在术后6h后才能翻身活动，本人在临床护理工作中，发现产妇骶尾部时有褥疮发生，遂要求产妇术后2h就翻身活动，从而杜绝了褥疮的发生。本文对338例剖宫产术后病例进行回顾性分析，旨在探讨预防骶尾部褥疮发生的有效措施。现报告如下。     

剖宫产术后晚期产后出血临床分析

目的探讨剖宫产术后晚期产后出血发生的原因、时间及预防措施.方法对1998～2003年21例剖宫产术后晚期产后出血的临床资料进行回顾性分析.结果发病的主要原因为子宫切口愈合不良,其次分别为子宫复旧不良,产褥感染,胎盘残留.发病时间为术后2～70 d,4例发生在术后42 d以上.结论预防发生剖宫产术后晚期产后出血的关键在于剖宫产手术中的处理.     

康复新液预防褥疮的疗效观察

目的：探讨康复新液预防褥疮的临床疗效。方法：对本院2010年5月-2012年5月所收治的术后患者146例平均分成对照组和治疗组,进行褥疮预防护理实践研究。结果：对照组73例中有9例产生褥疮;治疗组73例患者中,只有1例产生褥疮。结论：康复新液预防褥疮的发生非常简便、经济、且效果显著,值得不断进行推广研究。     

剖宫产术后发生压疮的原因分析及预防措施

目的通过分析剖宫产术后发生压疮的原因,提出预防措施。方法对2例剖宫产术后发生压疮进行回顾性分析。结果皮肤潮湿、局部组织长期受压及术后镇痛泵的应用是剖宫产术后发生压疮的主要原因。结论通过护理干预可以有效预防剖宫产术后压疮的发生。     

术后需长期卧床患者褥疮的早期预防与护理

目的探讨术前、术中进行早期护理干预对预防术后需长期卧床患者褥疮发生的影响。方法采用随机对照试验设计,以2012年1月至2014年1月我院收治的因股骨骨折需手术治疗且治疗后需长期卧床的48例患者为研究对象,试验组24例术前及术中给予褥疮预防护理,术后采用常规护理措施;对照组24例仅给予常规术后护理。记录两组一般情况、褥疮发生人数及褥疮严重程度,并对两组褥疮发生率及其严重程度进行评估。结果住院期间对照组共16例(66.7%)发生褥疮,试验组共10例(41.7%)发生褥疮,两组褥疮发生率比较差异无统计学意义(P>0.05);两组褥疮严重程度比较差异有统计学意义(P<0.05),提示试验组褥疮发生的严重程度较对照组为轻。结论术前、术中进行早期护理干预,可降低术后需长期卧床患者的褥疮发生率,减少因褥疮造成的痛苦,临床应加以关注。     

剖宫产术后近期并发症83例临床分析

目的 探讨分析剖宫产术后近期并发症的种类、原因及治疗方法,为临床应用提供一定的参考数据.方法 选取我院产科2011年2月-2012年12月行剖宫产术后发生近期并发症的产妇83例,对其临床资料进行回顾性分析.结果 83例产妇均发生各种并发症,其中以产后出血、产后发热感染、尿潴留、羊水栓塞、肠麻痹、梗死为主,分别占同期剖宫产总数的8%、3.5%、3.2%、3.%、2.5%,经综合治疗,无一例产妇死亡.结论 剖宫产率的升高,可在一定范围内降低孕产妇及新生儿的死亡率,但其具有创伤性,极易发生并发症.应明确剖宫产的适应症,严格掌握剖宫产手术的医学指证,规范手术操作,重视术后护理,最大限度降低并发症的发生率,提高产妇的生活质量.     

2次剖宫产两种术式34例临床分析

目的:探讨两种剖宫产术式的影响,以期改良现有手术方式,减少或减轻并发症的发生。方法:回顾性分析34例首次为新式剖宫产及传统子宫下段剖宫产术后在第2次剖宫产术中及术后情况的比较。结果:新式剖宫产组与传统子宫下段剖宫产组比较,在再次剖宫产术中开腹时间、术中重度粘连、术中总出血量、术后24 h内排气有显著差异。结论:新式剖宫术导致的粘连较传统子宫下段剖产术严重,给再次手术增加了难度。     

剖宫产术后晚期产后出血临床分析

目的 :探讨剖宫产术后晚期产后出血发生的原因、时间及预防措施。方法 :对 1998～ 2 0 0 3年 2 1例剖宫产术后晚期产后出血的临床资料进行回顾性分析。结果 :发病的主要原因为子宫切口愈合不良 ,其次分别为子宫复旧不良 ,产褥感染 ,胎盘残留。发病时间为术后 2～ 70 d,4例发生在术后 4 2 d以上。结论 :预防发生剖宫产术后晚期产后出血的关键在于剖宫产手术中的处理     

浅谈褥疮的预防

褥疮又称压疮 ,中医称席疮 ,是临床常见的并发症之一 ,尤其是高龄患者病情危重长期卧床更易发生。自 1998年以来 ,我院老年科收治的老年患者中 ,有 10 9例褥疮高危性的患者由于采取早期预防措施后无一例褥疮发生 ,现将预防褥疮的体会报告如下。1　褥疮发生的原因1.1　内因　营养不良、低蛋白血症、维生素 C缺乏症等均会增加褥疮形成的危险性 ,贫血、休克等可改变血供 ,降低皮肤抵抗力 ;体温的变化亦是发生褥疮的重要因素。1.2　外因　主要是剪切力、直接压迫、磨擦和破损皮肤 ;局部软组织持续受压 ,导致组织、细胞缺血、缺氧引起皮肤受损 ;…     

剖宫产术后子宫下段积血74例临床分析

目的探讨分析剖宫产术后子宫下段积血的发生原因和防治手段.方法选取2008年11月—2011年11月期间该院收治的剖宫产术后子宫下段积血74例患者,进行回顾性分析.结果74例患者中:35例患者通过药物治疗,显效20例,有效15例,无效0例;35例患者通过宫颈扩张术联合药物治疗,显效14例,有效11例,无效10例;4例患者通过吸宫术治疗,显效4例,有效0例,无效0例.结论剖宫产术后子宫下段积血的发生原因为子宫下段收缩不良,宫颈过紧,产后早期活动少和术后护理差;主要防治手段是减少择期剖宫产,剖宫产术中进行扩张宫颈,剖宫产术后加强护理,加强警惕性早发现早治疗.     

Cholera in Haiti and other Caribbean regions, 19th century

Medical journals and other sources do not show evidence that cholera occurred in Haiti before 2010, despite the devastating effect of this disease in the Caribbean region in the 19th century. Cholera occurred in Cuba in 1833-1834; in Jamaica, Cuba, Puerto Rico, St. Thomas, St. Lucia, St. Kitts, Nevis, Trinidad, the Bahamas, St. Vincent, Granada, Anguilla, St. John, Tortola, the Turks and Caicos, the Grenadines (Carriacou and Petite Martinique), and possibly Antigua in 1850-1856; and in Guadeloupe, Cuba, St. Thomas, the Dominican Republic, Dominica, Martinique, and Marie Galante in 1865-1872. Conditions associated with slavery and colonial military control were absent in independent Haiti. Clustered populations, regular influx of new persons, and close quarters of barracks living contributed to spread of cholera in other Caribbean locations. We provide historical accounts of the presence and spread of cholera epidemics in Caribbean islands.     

Clinical Update on Nursing Home Medicine: 2013

This is the seventh article in the series of Clinical Updates on Nursing Home Care. The topics covered are antiresorptive drugs, hip fracture, hypertension, orthostatic hypotension, depression, undernutrition, anorexia, cachexia, sarcopenia, exercise, pain, and behavioral and psychological symptoms of dementia.     

Evidence-Based Recommendations for an Optimal Prenatal Supplement for Women in the U.S., Part Two: Minerals

The levels of many essential minerals decrease during pregnancy if un-supplemented, including calcium, iron, magnesium, selenium, zinc, and possibly chromium and iodine. Sub-optimal intake of minerals from preconception through pregnancy increases the risk of many pregnancy complications and infant health problems. In the U.S., dietary intake of minerals is often below the Recommended Dietary Allowance (RDA), especially for iodine and magnesium, and 28% of women develop iron deficiency anemia during their third trimester. The goal of this paper is to propose evidence-based recommendations for the optimal level of prenatal supplementation for each mineral for most women in the United States. Overall, the evidence suggests that optimal mineral supplementation can significantly reduce a wide range of pregnancy complications (including anemia, gestational hypertension, gestational diabetes, hyperthyroidism, miscarriage, and pre-eclampsia) and infant health problems (including anemia, asthma/wheeze, autism, cerebral palsy, hypothyroidism, intellectual disability, low birth weight, neural tube defects, preterm birth, rickets, and wheeze). An evaluation of 180 commercial prenatal supplements found that they varied widely in mineral content, often contained only a subset of essential minerals, and the levels were often below our recommendations. Therefore, there is a need to establish recommendations on the optimal level of mineral supplementation during pregnancy.     

Interdisciplinary health professional education: a historical review

A historical review was conducted to examine the advances made, nationally and internationally, in interdisciplinary health professional education since the mid-1960s. One hundred and nineteen articles were reviewed and divided by decade into the following subheadings: models, courses, communication/group process issues, and international perspectives. Twenty-seven articles, categorized as models, defined the conceptual field, described curriculum and program development, or provided a framework for evaluation.Thirty-two articles dealt with interdisciplinary courses, focusing on objectives, content areas, or innovative methods. Nine articles contributed contenton interdisciplinary communication and group process issues, from which guidelines were abstracted. Fifty-one articles contributed an international perspective, leading to the recognition that interdisciplinary health professional education, practice, and research is a global movement.This revised version was published online in October 2005 with corrections to the Cover Date.     

妊娠期糖尿病与妊娠期高血压疾病病理机制的相关性

妊娠期糖尿病(GDM)为妊娠期特有疾病,易造成孕产妇难产、产褥期感染、酮症酸中毒,胎儿窘迫、胎儿畸形甚至胎死宫内等不良妊娠结局。妊娠期高血压疾病(HDP)包括妊娠期高血压、子痫前期(preeclampsia)、子痫,以及慢性高血压并发子痫前期和妊娠合并慢性高血压,临床表现为高血压、蛋白尿及水肿,严重影响孕妇体内各脏器功能,是孕产妇及围生儿死亡的主要原因。HDP中子痫前期,尤其是重度子痫前期,是造成新生儿不良妊娠结局的重要原因,通常需要及时剖宫产终止妊娠。近年国内外许多研究已经证实GDM和HDP在内皮功能紊乱、血脂异常、炎症因子、肾素-血管紧张素-醛固酮系统(RAAS)等多方面有相关性。现就两种疾病在上述相关性方面进行综述。     

Heavy Metals in Aquatic Macrophytes from Two Small Rivers Polluted by Urban,Agricultural and Textile Industry Sewages SW Poland

This article presents the results from a study of the comparison of 2 lowland rivers: the Olobok and the Pilawa in southwest Poland polluted by urban, agricultural, and textile industry sewages. pH and concentrations of Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Ni, Pb, Zn, nitrate, nitrite, ammonia, phosphate, and sulfate were measured in water samples and concentrations of Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, N, Na, Ni, P, Pb, S, and Zn were measured in stream bottom sediments and in the aquatic macrophytes Elodea canadensis, Callitriche verna, Potamogeton crispus, Potamogeton natans, and Ceratophyllum demersum from the river Olobok and Elodea canadensis, Polygonum amphibium, Potamogeton crispus, and Veronica beccabunga from the river Pilawa. The matrix of concentrations of 16 elements in 27 plant samples of 7 species from 15 sampling sites of 2 rivers and concentrations of 15 elements and pH in water samples and 16 elements and pH in bottom sediment samples of these sites was submitted to numerical classification, which revealed that sampling sites from the rivers were differentiated by the value of factor 1 of principal component analysis (PCA), which was related to the pH of water, Ca, Cu, Mg, Mn, and Ni in water and Cd, Cr, Cu, Fe, K, Mg, Na, Ni, P, and S in bottom sediments. More polluted parts of both rivers were differentiated from less polluted parts by the value of factor 2 of PCA, which was related to Pb, Zn, and sulfates in water and Ca and Zn in bottom sediments. Macrophytes from the Olobok and Pilawa rivers were differentiated by the value of factor 1, which was related to Ca, Co, Cr, Cu, Fe, Mg, Ni, N, Na, Pb, and S. Groups of macrophytes of more and less polluted parts of both rivers differed by the value of factor 2, which was related to P, K, and Mn. Downstream of the sewage outputs in both rivers, a significantly increased level of pollution occurs with elements correlated with factor 1: Among others were Cu and Cr, typical for the textile industry along the river Pilawa, and among others were Mn and Ni, typical for the urban and agricultural activities in the river Olobok.     

Self-efficacy and health behaviors toward the prevention of diabetes among high risk individuals living in appalachia

Recent clinical trials indicate that type 2 diabetes can largely be prevented through lifestyle factors. In order to identify important modalities for the prevention of diabetes in medically underserved counties of Virginia (Appalachia), a questionnaire was administered to 135 at-risk individuals, having reported at least one risk factor for diabetes. The questionnaire assessed attitudes, self-efficacy, diet, and physical activity toward the prevention of type 2 diabetes. Overall, none of the respondents reported being told by a physician that they were at risk for diabetes. Overweight was the most frequently reported risk factor (87.0%), followed by physical inactivity (67.3%). More than one-third (38.9%) reported at least three diabetes symptoms. When stratified by low and high risk level, there were no significant differences in self-efficacy, control, and healthy dietary behaviors (p < .05). High risk individuals did report having lower rates of full health insurance coverage, being less active and running out of food more frequently than low risk individuals, however. The findings suggest that cost-effective prevention efforts should incorporate physician education, include screenings, and address self-efficacy enhancing strategies toward preventing type 2 diabetes. Elena Serrano, Department of Human Nutrition, Foods, and Exercise, Virginia Tech 201 Wallace Annex Blacksburg, VA 24061-0430, USA; Jennifer Leiferman, Rocky Mountain Prevention Research Center, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Box C-245, Denver, CO 80262, USA; Sarah Dauber, Center for Pediatric Research, Eastern Virginia Medical School, Norfolk, VA, USA. Requests for reprints should be addressed to Elena Serrano, PhD, Department of Human Nutrition, Foods, and Exercise, Virginia Tech 201 Wallace Annex Blacksburg, VA 24061-0430, USA;e-mail: serrano@vt.edu     

A six country study of young children’s media exposure,logo recognition,and dietary preferences

Childhood obesity is a global public health concern. Previous research, mainly conducted in developed countries, suggests that marketing and media exposure is associated with unhealthy eating behaviors. This cross-sectional study was done with 2422 children, mean age 5.5 years, SD = .5, from six low- and middle-income counties (LMICs) (Brazil, China, India, Nigeria, Pakistan, and Russia). The analyses investigated media exposure, logo recognition, and preferences for international foods and beverages, such as globally distributed items like McDonald’s hamburgers and Coca-Cola soft drinks. Overall and in each country, path analysis models showed that media exposure and logo recognition directly and indirectly predicted the selection of international foods and beverages, controlling for child’s sex, age, home location, and parental education. Public health and communication experts must continue to investigate and understand these relationships, so as to inform regulations around food and beverage marketing.     

Visits to Physicians after the Oxygenation of Gasoline in Philadelphia

During the period between 1992 and 1997, there was an increase in levels of methyl tertiary butyl ether (MTBE) in gasoline in the Philadelphia, Pennsylvania, area. In this study, the authors analyzed billing records from clinical practices that were extensions of the University of Pennsylvania. The authors based their selections on the International Classification of Diseases-9 diagnostic codes, which were determined from (1) previous studies of methyl tertiary butyl ether conducted by the Centers for Disease Control; (2) respiratory symptoms, including asthma and wheezing; and (3) symptoms associated anecdotally with methyl tertiary butyl ether levels in gasoline. The authors normalized all data by the total number of office visits. The incidences of headache, throat irritation, allergic rhinitis, cough, nausea, dizziness, upper respiratory infections, wheezing, otitis media, skin rash, anxiety, insomnia, palpitations, generalized allergy, and malaise were increased during the period studied. Large increases occurred during the winters of 1993–1994 and 1994–1995 (during which there were high levels of MTBE), but not in the preceding summers (during which there were low levels of MTBE). This was especially true for asthma and wheezing. During the summers of 1995, 1996, and 1997, the incidences of the aforementioned symptoms increased greatly.     

抽动障碍儿童血清锌、铁、铅、铜、镁、钙含量的Meta分析

目的 探究抽动障碍儿童血清微量元素含量与正常健康儿童的差异,为抽动障碍的防治提供参考.方法检索中国知网数据库(CNKI)、重庆维普中文科技期刊数据库(VIP)、万方数据库(Wanfang Data)、临床试验注册中心、Pubmed、Embase、Cochrane Library及Web of Science等数据库,检...