健康教育路径对HBsAg阳性产妇母乳喂养依从性的影响

目的探讨健康教育路径对HBsAg阳性产妇母乳喂养依从性的影响。方法便利抽样法选择2009年1月至2011年1月住院分娩的238例HBsAg阳性产妇为观察组,采用健康教育路径方式宣教;选择2006年12月至2008年12月住院分娩的263例HBsAg阳性产妇为对照组,采用传统健康教育方式进行宣教。比较两组产妇母乳喂养依从性及产妇母乳喂养知识知晓情况。结果观察组产妇对于母乳喂养的相关知识知晓情况较好,得分80分以上的占70.59%,与对照组相比,差异有统计学意义(P<0.001)。观察组中,哺乳≥6个月的产妇占69.75%,哺乳<6个月者占19.75%,未采用母乳喂养者仅占10.50%,与对照组相比,差异有统计学意义(P<0.01)。结论 HBsAg阳性产妇进行母乳喂养并不增加婴儿乙型病毒性肝炎病毒(hepatitis B virus,HBV)的感染率,健康教育路径能有效提高产妇母乳喂养的依从性及喂养知识知晓情况。     

川芎嗪注射液治疗新生儿缺氧缺血性脑病的临床疗效

目的分析川芎嗪注射液治疗新生儿缺氧缺血性脑病（HIE）患儿的近期临床疗效。方法选择我院的78例HIE患儿，随机分为川芎嗪注射液治疗组40例与对照组38例。对照组采用包括对症，支持，降颅内压，改善内环境等常规治疗；治疗组在常规治疗的基础上，加用川芎嗪注射液治疗，疗程10～14d。分别于治疗过程中观察患儿临床症状恢复情况。结果治疗组临床症状，前囟张力、意识障碍、肌张力、原始反射恢复时间及惊厥控制时间均短于对照组，且总有效率相差显著沪〈0．005）。结论HIE在常规治疗的基础上，早期应用川芎嗪注射液治疗，能缩短HIE的临床恢复时间，疗效显著，值得临床推广应用。     

An area-based study on intrapartum antibiotic prophylaxis for preventing group B streptococcus early-onset disease: advances and limitations

Introduction: The prevalence of maternal group-B-streptococcus (GBS) colonization and risk factors (RFs) for neonatal early-onset disease (EOD) in Europe are poorly defined. Large-scale information concerning adherence to recommendations for preventing GBS-EOD are lacking.

Materials and methods: This was a 3-month retrospective area-based study including all regional deliveries ≥35 weeks' gestation (in 2012). The sensitivity, specificity, positive and negative predictive values, odds ratio and receiver operating characteristic (ROC) curve for intrapartum antibiotic prophylaxis (IAP) among full-term and preterm deliveries and prolonged membrane rupture (PROM) were calculated.

Results: Among 7133 women, 259 (3.6%) were preterm (35–36 weeks' gestation). Full-term women were 6874, and 876 (12.7%) had at least 1?RF. Most women (6495) had prenatal screening and 21.4% (1390) were GBS positive.

IAP was given to 2369 (33.2%) women (preterm, n?=?166; full term, n?=?2203). Compared to full-term, preterm women were less likely to receive IAP when indicated (73.2% versus 90.3%, p?Conclusions: Large-scale prenatal screening and IAP are feasible. Women delivering preterm are less likely to receive IAP when indicated. Most unnecessary antibiotics are given in cases of PROM.     

红外额式体温计在新生儿体温测量中的应用

目的比较红外额式体温计与传统玻璃水银体温计测量新生儿体温值的差异，研究红外额式体温计应用于新生儿体温测量的准确性及稳定性。方法对广东省妇幼保健院新生儿重症监护室（NICU）住院的202例不同保暖环境下即婴儿床、暖箱、辐射抢救台上的新生儿分别应用红外额式体温计测量前额温度和玻璃水银体温计测量腋下温度，每例新生儿均应用两种方法测量体温，采用自身对照的方法比较两种测量方法的测温效果及相关性。结果红外额式体温计与传统玻璃水银体温计所测得新生儿体温值比较差异无显著性（P〉0．05），且二者呈直线正相关。婴儿床、暖箱和辐射抢救台3种不同保暖环境下额温与腋温比较差异无显著性（P〉0．05）。结论红外额式测温计具有很好的准确性，适用于NICU新生儿。     

Neoadjuvant Chemotherapy for Patients with Synchronous Multifocal Osteosarcoma: Results in Eleven Cases

Abstract

Between January 1995 and December 1999, 11 patients with synchronous multifocal osteosarcoma (SMO) received neoadjuvant treatment with high-dose methotrexate, cisplatinum, Adriamycin, and ifosfamide. After primary chemotherapy in 4 patients who had only two bone localizations, it was possible to treat all tumor foci locally. The remaining patients, with more than three bones involved, were treated surgically only in 3 cases at the primary site, while secondary lesions did not receive any treatment.

The final results of our study were disappointing. All patients died of the tumor 6 to 24 months after the beginning of treatment (mean 11.9 months). Nevertheless, the survival time of the 4 patients with locally treated lesions was significantly longer than the one of 7 patients in whom the secondary lesions were not locally treated (18.2 vs 9.1 months; P<0.008). It should be noted that those patients simultaneously operated on two sites, the response to chemotherapy of “primary” and “secondary” lesions was always similar. This homogeneity supports the thesis that in synchronous multifocal osteosarcoma the tumors are not multicentric in origin but represent bone-to-bone metas-tases from a monocentric tumor.     

综合护理干预对缓解住院新生儿家长焦虑的效果研究

目的探讨综合护理干预对减轻住院新生儿家长焦虑的效果。方法对120名住院新生儿家长进行心理反应和应激因素研究,并随机分组进行综合护理干预,在干预后1周和2周釆用焦虑自评量表(SAS)分别测量患儿家长的焦虑状况。结果住院新生儿家长明显存在焦虑情绪;与无综合护理干预组比较,综合护理干预组住院新生儿家长焦虑程度显著减轻(P0.01)。结论护理人员应高度重视住院新生儿家长焦虑情绪,综合护理措施能有效减轻其焦虑情绪。     

产妇对新生儿性别满意度对其产后出血量的影响

目的探讨产妇对新生儿性别满意度对其产后出血量的影响。方法选择2010年6月至2011年12月在温岭市妇幼保健院产科住院的单胎头位顺产的980例初产妇和528例经产妇,按照她们对新生儿性别的满意程度分为满意组和不满意组,记录产程时间,测量产时、产后2h及24h的出血量,计算产后出血的发生率。结果不满意组产后2h及24h出血量多于满意组,产后出血发生率也明显高于满意组(P<0.01),特别是不满意组经产妇产后出血率高达15.51%。结论产妇对新生儿性别的满意程度对其产后出血有一定影响,医护人员应及时发现潜在的高危因素,对新生儿性别不满意产妇进行必要的心理辅导,以减少产后出血量,降低产后出血发生率,确保产妇的身心健康。     

Management of pain in ventilated neonates: current evidence

Management of pain in neonates has gained importance in the last two decades. We have just begun to understand the expression of pain by the neonates and we are still exploring pharmacologic and non-pharmacologic management strategies. This article reviews the pharmacological treatment of pain in ventilated neonates, the clinical and neuro-developmental impact of most used drugs for analgesia and sedation and discusses various options and recommendations.     

Understanding sickle cell carrier status identified through newborn screening: a qualitative study

The expansion of newborn screening (NBS) is increasing the generation of incidental results, notably carrier results. Although carrier status is generally understood to be clinically benign, concerns persist that parents may misunderstand its meaning, with deleterious effects on children and their families. Expansion of the NBS panel in Ontario, Canada in 2006 to include sickle cell disorders drew attention to the policy challenge of incidental carrier results. We conducted a study of consumer and provider attitudes to inform policy on disclosure. In this paper, we report the results of (i) qualitative interviews with health-care providers, advocates and parents of carrier infants and (ii) focus groups with new parents and individuals active with the sickle cell community. Lay and provider participants generally believed that carrier results were clinically insignificant. However, some uncertainty persisted among lay consumers in the form of conjecture or doubt. In addition, consumers and advocates who were most informed about the disease articulated insistent yet dissonant claims of clinical significance. Meanwhile, providers referenced research knowledge to offer an equivocal assessment of the possibility and significance of clinically symptomatic carrier status. We conclude that many interpretations of carrier status are in circulation, failing to fit neatly into the categories of ‘clinically significant'' or ‘benign.'' This creates challenges for communicating clearly with parents – challenges exacerbated by inconsistent messages from screening programs regarding the significance of sickle cell carrier status. Disclosure policy related to incidentally generated infant carrier results needs to account for these complex realities.