拉玛泽减痛分娩法对母乳分泌的影响

目的 探讨在导乐陪伴分娩的过程中实施拉玛泽减痛分娩法对母乳分泌的影响.方法 将106例自然分娩的初产妇随机分为观察组52例和对照组54例,观察组在导乐陪伴分娩的基础上实施拉玛泽减痛分娩法;对照组仅按导乐陪伴分娩进行护理.观察2组产妇泌乳始动时间、泌乳量,采用t检验和χ2检验.结果 观察组比对照组泌乳始动时间提前,泌乳量增加.结论 在导乐陪伴分娩的过程中实施拉玛泽减痛分娩法能促进产后早泌乳,且泌乳量充足.     

Attitudes and knowledge on breastfeeding among paediatricians, family physicians, and gynaecologists in Israel

OBJECTIVES: Many women in Western countries fail to breastfeed long enough. The aim of this study was to examine the attitudes and knowledge of Israeli family physicians (FPs), gynaecologists and paediatricians towards breastfeeding. DESIGN AND PARTICIPANTS: A questionnaire examined Physicians' attitudes towards breastfeeding and their role in encouraging it, their sources of information and adequacy of knowledge. RESULTS: Four hundred and seventy-eight physicians responded to the survey: 123 FPs, 134 gynaecologists and 221 paediatricians. Ninety to -hundred per cent of physicians agreed that breastfeeding is the best feeding method for infants and agree that physicians should encourage it. Less than 20% of physicians discuss breastfeeding with pregnant women, and less than 30% discuss it with women 3 months or more postnatally. On average, physicians correctly answered 3.5 +/- 1.7 out of seven questions examining knowledge. Physicians state their main sources of information as their own experience and reading. One hundred and ninety physicians specified how they encourage breastfeeding--of those, 75.3% speak only of the advantages of breastfeeding. CONCLUSION: Physicians have a positive disposition towards breastfeeding but their knowledge is somewhat low. It seems awareness is lacking to the importance of continuous support and practical guidance beginning before birth and continuing until 3 months or more postnatal.     

哺乳期妇女应用醋酸甲羟孕酮长效避孕针临床效果观察

目的:观察醋酸甲羟孕酮长效避孕针(DMPA)在哺乳期妇女的使用效果。方法:经知情选择,自愿采用DMPA避孕,无禁忌证的哺乳期妇女252例,深部肌肉注射DMPA 150mg,3个月1次,以90天为1个观察周期,统计其避孕效果、乳量改变情况、月经及副反应。结果:①经3228个妇女月的观察,无一例妊娠,有效率达100％;②前3个观察周期,乳量增多比例明显增加,分别为20.9％、57.7％、61.1％;③用药后普遍存在闭经、出血反应,以点滴出血为主,随观察周期的增加,出血反应减少。结论:哺乳期妇女使用DMPA即能及时,完全避孕,又能增加乳量,提高母乳喂养率,且副反应小。是值得推广的哺乳期避孕方法。     

聚丙烯酰胺水凝胶注射隆乳术后哺乳期并发症的处理

目的 探讨聚丙烯酰胺水凝胶注射隆乳术后哺乳期并发症处理的有效方法.方法 对13例行聚丙烯酰胺水凝胶注射隆乳术后在哺乳期并发乳汁淤积、乳漏、急性乳腺炎等患者,采取手术切开清除水凝胶及淤积乳汁、放置引流管、术区加压包扎,并结合有效的药物抑制泌乳等措施予以治疗.结果 13例术后7～15 d全部治愈.随访3个月至4年,效果满意.结论 切开清除水凝胶及淤积乳汁、持续引流,结合有效的药物抑制泌乳措施,是治疗注射隆乳术后哺乳期并发症的有效方法.     

母乳喂养指导路径对产妇泌乳时间、泌乳量及母乳喂养成功率的影响分析

目的：探讨母乳喂养指导路径对产妇泌乳时间、泌乳量及母乳喂养成功率的影响,为产妇提供更优质的护理服务。方法选取本院产科于2011年6月～2012年5月收治的144例初产妇,设为对照组,采取常规产科护理方法与措施;选取本院产科于2012年6月~2013年5月128例初产妇,设为研究组,在对照组基础上采用母乳喂养指导路径指导母乳喂养。观察并比较两组产妇的泌乳时间、泌乳量及母乳喂养成功率。结果观察组产妇的泌乳始动时间短于对照组（P＜0.05）,观察组的产后1周泌乳量明显多于对照组（P＜0.05）,观察组的产后6个月母乳喂养成功率明显高于对照组（P＜0.05）。结论对产妇行母乳喂养指导路径的效果明显,可促进产妇早期泌乳,增加产后泌乳量,并帮助产妇树立母乳喂养的信心,提高产后6个月内的母乳喂养成功率,有利于保证产妇及婴儿的身心健康。     

护理干预对减轻产后乳房胀痛的临床效果观察

目的探讨护理干预在减轻产后乳房胀痛中的应用效果。方法选择产后奶胀且常规定期产检的孕妇240例作为观察组,另选择同期未常规产检的孕妇190例作为对照组。对照组实施常规围生期护理,观察组在此基础上给予护理干预。比较2组产后3d内泌乳通畅情况、乳房胀痛情况、硬结情况以及产后4d泌乳量。结果观察组产妇泌乳通畅率明显高于对照组,乳房胀痛、硬结情况明显优于对照组,差异均有统计学意义(P<0.01)。观察组产后第2天、第3天、第4天泌乳量多于对照组,差异均有统计学意义(P<0.01)。结论护理干预可有效减少产后乳房胀痛,有效预防产后奶胀的发生,提高母乳喂养成功率,值得临床推广应用。     

产后康抚对剖宫产术后产妇的影响

目的探讨产后康抚治疗对剖宫产术后产妇早泌乳、子宫复旧、肛门排气的影响。方法选取80例剖宫产术后产妇,随机分为观察组和对照组,各40例。观察组进行康抚治疗,于术后24h开始,每天1次;对照组采用剖宫产术后常规护理。观察2组乳汁分泌情况、子宫复旧情况及肛门排气情况。结果与对照组比较,观察组肛门排气时间明显缩短、泌乳时间提前、泌乳增加、子宫复旧情况改善良好,差异均有统计学意义（P〈0.01或P〈0.05）。观察组肛门排气时间为（28.75±6.2）h短于对照组的（32.5±7.5）h,差异有统计学意义（P〈0.05）。结论剖宫产术后应用康抚按摩治疗对产妇子宫复旧,改善泌乳有积极作用。     

自控镇痛对剖宫产产妇泌乳和新生儿神经及适应能力的影响

目的 探讨剖宫产术后自控镇痛技术对产妇泌乳、新生儿神经和适应能力的影响.方法 选择68例剖宫产术后采取自控镇痛技术的产妇作为自控镇痛组,以60例术后未接受硬膜外自控镇痛的剖宫产产妇为对照组,观察两组术后的母乳喂养和新生儿神经和适应能力情况.结果 自控镇痛组产妇产后24 h内开始泌乳例数及母乳喂养次数明显多于对照组,两组比较差异有统计学意义(P＜0.05);两组新生儿神经和适应能力评分在各时点均大于35分,组间比较差异无统计学意义(P＞0.05).结论 剖宫产术后自控镇痛明显提高母乳喂养的成功率,对新生儿精神、行为无明显不良影响,可安全应用于临床.     

Parity,lactation and hip fracture

The relationship between parity, lactation and the occurrence of hip fracture was investigated in a case-control study of white women. The cases were patients (n=174) aged 45 years and over with a radiologically confirmed first hip fracture sampled from among admissions to 30 hospitals in New York and Philadelphia between September 1987 and July 1989. Controls (n=174) were selected from general surgical and orthopedic services during the same time period and were frequency-matched to cases by age and hospital. Ever having a live birth was associated with reduced odds of hip fracture, controlling for age and hospital of recruitment (odds ratio =0.65; 95% confidence interval =0.41–1.04). When body mass index was also controlled, each birth was associated on average with a 9% reduction in the odds of hip fracture (odds ratio =0.92 [0.78–1.08]), although the trend was not statistically significant. After adjusting for number of births, lactation was not associated with hip fracture (adjusted odds ratio for 12 months of lactation or less =0.80 [0.42–1.55]; adjusted odds ratio for more than 12 months =1.08 [0.45–2.60]).     

Ultrastructural identification of Ia positive dendritic cells in the lactating rat mammary gland

Summary Dendritic cells which express Ia antigen have been demonstrated for the first time in the lactating rat mammary gland. Ultrastructurally, the dendritic cells appear as electron-lucent pale cells interspersed among the epithelial cells of the alveoli, forming a cell population distinct from classical macrophages. They show morphological resemblance to the dendritic cells of lymphoid organs as well as the Langerhans cells of skin. The Ia antigen has been localised by electron microscopic immunocytochemistry on the cell membrane and endocytotic vesicles and tubules. Ia positive cells are also seen in the stroma of the mammary gland. It is proposed that the dendritic cells of the mammary gland belong to the lineage of epidermal Langerhans cells and lymphoid dendritic cells, subserving an immunological role in the lactating breast.