心理护理对妊娠剧吐患者疗效的影响

目的探讨心理护理对妊娠剧吐患者疗效的影响。方法将92例无内科及外科合并症的妊娠剧吐患者随机分成研究组和对照组。对照组采用对症治疗、常规护理,研究组在此基础上给予心理护理。观察两组患者焦虑抑郁及尿酮体转阴情况。结果研究组患者焦虑抑郁情况明显好转,尿酮体转阴时间缩短,与对照组比较,均差异有显著性意义(P<0.01)。结论心理护理辅助治疗妊娠剧吐能有效地改善患者的焦虑抑郁症状,缩短尿酮体转阴时间。     

穴位艾灸联合耳穴压豆治疗妊娠剧吐临床研究

目的:观察穴位艾灸联合耳穴压豆治疗妊娠剧吐的临床疗效。方法:选取100例妊娠剧吐患者为研究对象,按随机数字表法分为观察组和对照组各50例。对照组给予静脉补液治疗,观察组在此基础上给予穴位艾灸联合耳穴压豆治疗,2组均治疗7~10 d。比较2组临床疗效、症状评分、妊娠剧吐评分(HGS)、胃动素水平、β-人绒毛膜促性腺激素(β-HCG)水平、尿酮体转阴时间及电解质指标水平。结果:观察组总有效率为98.00%,高于对照组的80.00%(P<0.05)。治疗后,2组呕吐、恶心、进食障碍评分均较治疗前降低(P<0.05),观察组上述3项症状评分均低于对照组(P<0.05)。治疗后,2组HGS及β-HCG水平均较治疗前降低(P<0.05),胃动素水平均较治疗前升高(P<0.05);观察组HGS及β-HCG水平均低于对照组(P<0.05),胃动素水平高于对照组(P<0.05);观察组尿酮体转阴时间短于对照组(P<0.05)。治疗后,2组血钾、血钠水平均较治疗前升高(P<0.05),观察组血钾、血钠水平均高于对照组(P<0.05);2组二氧化碳结合力均较治疗前降低(P<0.05),观察组二氧化碳结合力低于对照组(P<0.05)。结论:穴位艾灸联合耳穴压豆治疗妊娠剧吐,可显著改善患者的临床症状及电解质失衡状况,促进胃肠运动,降低复发率。     

Treatment of hyperemesis gravidarum with anthroposophic complex therapy in 3 case reports

BackgroundHyperemesis gravidarum (HG) is generally characterized by intractable nausea and vomiting which interferes with daily life. As the cause of HG has not yet been clearly identified, conventional medicine therapies address only the symptoms. Conventional treatment is also effective for a comparatively short time and may have unfavorable side effects. Given that the condition affects more than 1% of pregnant women, there is a significant need for effective long-lasting treatments with limited side effects.Case reportsThis paper is based on three case reports of pregnant women suffering from HG. They received inpatient treatment based exclusively on anthroposophic medical approaches at the Paracelsus Hospital Richterswil, Switzerland. Treatments were selected individually based on the specific patient profiles and included infusion therapy with Nux vomica, Solum uliginosum compositum and Bryophyllum pinnatum as well as art therapy (wet-on-wet painting), eurythmy therapy and rhythmical massage therapy. Anthroposophic complex therapies induced an improvement in symptoms of nausea and vomiting within one week in all three cases.ConclusionAnthroposophic complex therapy is a valuable option in the treatment of HG. Well-tolerated and long-lasting, it represents a holistic and causal approach that does not only address symptoms.     

中西医结合治疗妊娠剧吐28例临床观察

目的:观察中西医结合治疗妊娠剧吐的临床效果。方法:将52例患者随即分为两组,治疗组28例,对照组24例。对照组采用妇科常治疗,治疗组采用中西医结合的方式进行治疗。两组均以7d为1个疗程,1个疗程后检查尿酮体变化。结果:治疗组的效果显著优于对照组。结论:中西医结合疗妊娠剧吐有显著效果。     

Mirtazapine (Remergil) for treatment resistant hyperemesis gravidarum: rescue of a twin pregnancy

Case report We present the case of a 25-year-old woman with treatment resistant hyperemesis gravidarum in the 15th week with a 13 kg loss of body weight. When the patient asked for termination of the pregnancy because of the unbearable symptoms, treatment with intravenous mirtazapine (Remergil) was started.Results Nausea and vomiting disappeared within hours, pregnancy termination was no longer desired. The patient was discharged two weeks later in good health and at 36 weeks gestation a cesarean section was performed. Post partum evaluation as well as 6-month post-partum revealed no dysmorphology or laboratory abnormalities in the children.     

Plasma 5'-nucleotidase activities increase in women with hyperemesis gravidarum

OBJECTIVES: To investigate plasma activities of 5'-nucleotidase, a key enzyme in the production of adenosine and evaluate the relationship between changes in 5'-nucleotidase activities and pregnancy-related hormones, estrogen, progesterone and human chorionic gonadotropin (hCG) in women with hyperemesis gravidarum. DESIGN AND METHODS: Plasma 5'-nucleotidase activities and estradiol, progesterone and hCG levels were measured in 21 women with hyperemesis gravidarum and normal pregnancies, matched for age, parity and gestational week. RESULTS: In women with hyperemesis gravidarum, plasma 5'-nucleotidase activities averaged 8.1 +/- 0.6 IU/L, which were significantly increased compared to those in normal pregnant women (5.5 +/- 0.5 IU/L)(p < 0.05). The increases in plasma 5'-nucleotidase activities were accompanied by elevations of plasma estradiol, progesterone and hCG levels. CONCLUSIONS: The increase of plasma 5'-nucleotidase activities may be at least partly attributed to elevations of pregnancy-related hormones, suggesting changes in purine metabolism in women with hyperemesis gravidarum.     

暗示在妊娠剧吐孕妇健康教育中的应用

目的:探讨暗示教育对妊娠剧吐孕妇健康教育的影响。方法:65例首次确诊为妊娠剧吐孕妇,随机分为2组,对照组采用传统教育法,观察组采用暗示教育法。2组的教育内容均包括妊娠剧吐基础知识、合理饮食、适当运动、规律用药等。6个月后对2组进行遵医嘱的问卷调查,比较2组间的差异。结果:2组孕妇均能按教育者的要求去做,观察组在合理饮食、自我检测方面合格率高于对照组(P<0.05),6个月后监测的生理指标观察组明显优于对照组(P<0.05)。结论:暗示健康教育能有效地增强患者遵医嘱行为,进而提高疗效。