游泳与抚触对剖宫产新生儿健康的影响

目的:探讨游泳与抚触对剖宫产新生儿睡眠及黄疸的影响。方法:将160例剖宫产新生儿分为两组,观察组为新生儿游泳与抚触组,对照组为单纯沐浴组,观察记录两组新生儿的胎便转黄时间、开始退黄时间、完全退黄时间及高胆红素血症发生率,记录新生儿第5天、第7天的睡眠总时间及第3天、第5天经皮测胆红素值的变化情况,对两组间指标进行分析比较。结果:观察组新生儿的胎便转黄时间、开始退黄时间、完全退黄时间均较对照组提前,高胆红素血症发生率显著低于对照组;两组新生儿的睡眠总时间、皮测胆红素值经比较均有显著性差异(P<0·001)。结论:游泳与抚触有助于提高剖宫产新生儿的睡眠质量,并能加速胎便排出,使生理性黄疸消退时间提前,降低高胆红素血症发生率,对新生儿健康起着促进作用。     

新生儿黄疸与母乳喂养关系探讨研究

目的探讨母乳喂养与新生儿黄疸的关系。方法将笔者所在医院200例新生儿根据母乳喂养情况分为纯母乳喂养组（观察组）100例和部分母乳喂养组（对照组）100例,比较两组新生儿胎便初排、每日排便次数、胎便转黄、黄疽指数及高胆红素血症发生率的差别。结果观察组黄疸出现时间延迟,时间短、程度轻,黄疸发生率低。结论母乳有轻微的通便作用,有利于胎粪的排出和胆红素的清除,从而减轻新生儿黄疸。     

水疗加抚触对新生儿黄疸的影响

目的探讨早期新生儿水疗及抚触对新生儿黄疸的影响。方法将320例正常新生儿按分娩顺序分为观察组（水疗加抚触组）170例，对照组（单纯沐浴组）150例，测定2组新生儿摄奶量，胎便初排时间，胎便转黄时间，生后96h皮肤黄疸指数。结果两组新生儿摄奶量，胎便初排时间，转黄时间，皮肤黄疸指数差异均有统计学意义（P〈0．05）。观察组首次排黄便时间明显早于对照组，血液胆红素水平明显低于对照组，黄疸较对照组轻。结论水疗加抚触能减轻新生儿生理性黄疸程度，有效地预防高胆红素血症的发生。     

早期护理干预在新生儿黄疸护理中的应用研究

目的研究早期护理干预对新生儿黄疸的影响。方法将新生儿随机分为2组,对2组新生儿行常规护理,另观察组给予早期游泳和抚触和增加摄入量护理干预。记录经皮测胆红素值、胎便初排及转黄时间。结果从第2d开始,观察组经皮胆红素值显著低于对照组,胎便初排及转黄时间提前。结论早期护理干预能降低胆红素值,降低新生儿高胆红素血症的发生率。     

游泳与抚触对新生儿黄疸的影响

目的探讨新生儿游泳与抚触对新生儿黄疽的影响。方法将120例新生儿随机分为观察组和对照组各60例。对照组在出生24h后给予单纯沭浴，观察组在此基础上连续5d在沭浴后进行游泳和抚触，抚触在游泳后进行。同时观察两组新生儿胎便和排黄便时间，皮测黄疽指数，并观察高胆红素血症发生情况。结果两组新生儿胎便和排黄便时间，皮测黄疸指数值和高胆红素血症发生情况，经统计学分析，均p〈0．05或p〈0．01，差异有统计学意义。结论新生儿游泳与抚触能诱发新生儿胃肠激素的分泌，促进消化动力及胆红素的排泄，明显降低新生儿黄痘指数和高胆红素血症的发生。     

早期综合护理干预对新生儿生理性黄疸的影响

目的:探讨早期综合干预对新生儿生理性黄疸的影响。方法:对照组给予常规新生儿护理,干预组在此基础上给予早开奶、日光浴、缩短脐带结扎时间等护理干预。观察两组首次排便时间、胎便转黄时间、经皮胆红素值测量情况。结果:干预组首次排便时间、胎便转黄时间、经皮胆红素值测量情况与对照组比较差异均有统计学意义(P0.05)。结论:新生儿的早期综合护理干预能够缩短首次排便时间,减轻黄疸程度,减少新生儿高胆红素血症的发生。     

母乳喂养与新生儿黄疸相关性探析

目的探析新生儿黄疸的出现和母乳喂养的相关性。方法抽选2011-04-08到2013-02-08我院130例正常新生儿为探析对象,其中,60例单纯母乳喂养,称为母乳组,70例为混合喂养,称为混合组。每日记录母乳组与混合组的胎便初排、体重数量、大小便次数以及哺乳次数,且对胆红素值行皮测,并对黄疸显现与消失状况、皮肤颜色予以观察。根据胆红素测定情况实施评估标准,于部分母乳喂养完毕之后,对混合组予以测定;于纯母乳喂养完毕之后,对母乳组予以测定。结果比较母乳组与混合组的胎便初排状况、高胆红素血症显现几率、大便次数、黄疸指数以及胎便转黄情况,母乳组的各项情况比混合组好,P<0.05。结论母乳具有通便性能,对消除胆红素以及排出胎粪很有帮助,能降低患新生儿黄疸概率。     

新生儿黄疸与母乳喂养的关系探讨

目的总结新生儿黄疸与母乳喂养的关系,指导临床诊疗。方法抽取2009年1月—2012年1月收治的150名新生儿根据母乳喂养情况分为对照组和观察组,各75名,比较两组新生儿每日排便次数、胎便初排时间、黄疸指数及胎便转黄的差别。结果两组黄疸发生率、每日排便次数、胎便初排时间、黄疸指数等比较差异均有统计学意义(均P<0.05)。结论母乳有轻微的通便作用,有利于胎粪排出,可利于胆红素的清除,从而减轻新生儿黄疸。     

鼻饲辅以安慰奶嘴吸吮对早产儿喂养不耐受的疗效观察

目的:探讨早产儿早期给予安慰奶嘴吸吮对其喂养及生长发育的影响。方法:将50例早产儿随机分为观察组25例和对照组25例,观察组在鼻胃管喂养时吸安慰奶嘴(无孔橡皮奶头),对照组单纯给予鼻胃管喂养,两组均给予部分静脉营养。观察两组早产儿体重、喂养耐受情况、胎粪排出时间和排尽时间、完全经口喂养时间、静脉营养时间。结果:观察组恢复出生体重时间较对照组缩短(P0.01),体重下降最大限度两组间比较差异无统计学意义;观察组胃潴留发生率(12.00%)较对照组发生率(40.00%)明显降低;观察组胎粪排尽时间、完全经口喂养时间、静脉营养时间均较对照组缩短(P0.05)。结论:早产儿在鼻胃管喂养期间辅以安慰奶嘴吸吮是一种适宜的辅助喂养方法。     

中西医结合治疗联合健康教育促进剖宫产产妇乳汁分泌的应用效果

目的中西医结合治疗联合健康教育促进剖宫产产妇乳汁分泌的应用效果,为母乳喂养临床健康教育和指导提供参考。方法随机选取2018年3月-2019年2月期间嘉兴市妇幼保健院产科接收的280例剖宫产产妇,根据术后健康教育方式划分为两组。行常规产科健康教育的产妇共132例,设为对照组;在此基础上实施中西医结合治疗联合健康教育的产妇共148例,设为观察组。观察记录两组产妇分娩后泌乳始动时间、泌乳量、乳房胀痛发生率以及新生儿喂养情况,统计产妇对健康教育满意度评价。结果观察组产妇平均泌乳始动时间较对照组显著缩短,且乳汁分泌始动优良率明显高于对照组(均P0. 05);观察组产妇乳汁分泌充足情况优于对照组,组间差异有统计学意义(P 0. 05);比较剖宫产产妇生产后乳房胀痛发生率,对照组高于观察组(P0. 05);观察组新生儿母乳喂养率显著高于对照组,人工喂养率低于对照组,差异均有统计学意义(均P0. 05);两组产妇对健康教育满意度差异有统计学意义(P0. 05)。结论剖宫产后给予产妇中西医结合治疗联合健康教育可有效缩短泌乳始动时间,促进产妇乳汁分泌、降低乳房胀痛发生率,从而提高新生儿全母乳喂养率,产妇对健康教育满意度良好。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

西林瓶装注射用水的装量检查分析

为了检查西林瓶装注射用水的实际分装量是否符合2005年版《药典》三部要求,按照2005年版《药典》三部中“生物制品分装和冻干规程”,分装规格为0．8ml的西林瓶装注射用水10000瓶,随机在分装过程的前、中、后阶段共抽取100瓶,轧盖、目检。分别用1ml标定注射器及1ml普通无菌注射器抽取每瓶注射用水的实际体积,以t检验法对实际抽取量与标示量的差值进行统计学分析,结果显示其与2005年版《药典》三部要求分装附加量为0．1ml相比有显著性差异（P〈0．001）。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。