目的探讨自由体位联合分娩减痛法在初产自然分娩产妇中的应用价值。方法将122例初产自然分娩产妇随机分为观察组和对照组,每组61例,对照组给予分娩减痛法干预,观察组在对照组基础上给予自由体位干预,观察两组产妇产程时间、疼痛程度、...目的探讨自由体位联合分娩减痛法在初产自然分娩产妇中的应用价值。方法将122例初产自然分娩产妇随机分为观察组和对照组,每组61例,对照组给予分娩减痛法干预,观察组在对照组基础上给予自由体位干预,观察两组产妇产程时间、疼痛程度、剖宫产率、感染率、出血量及新生儿评分等情况。结果观察组产妇各产程时间及总产程时间明显短于对照组（P〈0.05）;观察组产妇分娩期间疼痛程度明显轻于对照组（P〈0.05）;观察组分娩期间出血量〈500 m L产妇所占比例明显高于对照组（P〈0.05）;观察组产妇中转剖宫产率及感染率均显著低于对照组（P〈0.05）;观察组Apgar评分8~10分新生儿所占比例为100.00%,显著高于对照组的88.52%（P〈0.05）。结论自由体位联合分娩减痛法用于初产自然分娩产妇中可缩短产程时间、缓解疼痛程度、提高新生儿Apgar评分,同时可降低出血量及中转剖宫产率,具有较好的应用前景。展开更多
目的观察使用布托啡诺的产妇剖宫产术后镇痛效应及对新生儿的影响。方法选择120例心功能分级（AHA）分级Ⅰ～Ⅱ级的择期剖宫产患者,随机分为布托啡诺组、吗啡组及对照组,各40例。均采用同样的麻醉药和给药方法,麻醉平面控制在（T4～T8...目的观察使用布托啡诺的产妇剖宫产术后镇痛效应及对新生儿的影响。方法选择120例心功能分级（AHA）分级Ⅰ～Ⅱ级的择期剖宫产患者,随机分为布托啡诺组、吗啡组及对照组,各40例。均采用同样的麻醉药和给药方法,麻醉平面控制在（T4～T8）。注入腰麻药液后,布托啡诺组另给予布托啡诺1 mg加0.125%左布比卡因注射液5 m L,吗啡组另给予吗啡2 mg加0.125%左布比卡因注射液5 m L,对照组予0.9%氯化钠注射液5 m L。观察产妇术后2,4,8,12,24 h的疼痛视觉模拟评分（VAS）和布氏评分（BCS）及新生儿阿氏（Apgar）评分和神经行为适应能力（NACS）评分,并详细观察记录手术过程中的不良反应。结果布托啡诺组较吗啡组,术后2,4,8,12,24 h镇痛效果相当（P〉0.05）;布托啡诺组、吗啡组术后各时点镇痛效果均明显优于对照组（P〈0.05）;布托啡诺组较吗啡组术后各时点BCS评分无统计学差异（P〉0.05）,但均明显优于对照组（P〈0.05）;3组新生儿NACS和Apgar评分比较,均无显著统计学差异（P〉0.05）;布托啡诺组和对照组的不良反应,如恶心呕吐、呼吸抑制、嗜睡以及皮肤瘙痒等症状发生率明显低于吗啡组（P〈0.05）,布托啡诺组与对照组不良反应无明显统计学差异（P〉0.05）。结论布托啡诺用于产妇剖宫产术后镇痛效果确切,与吗啡相当,但恶心呕吐、皮肤瘙痒、呼吸抑制等不良反应的发生率明显低于吗啡,舒适度良好,且不会在新生儿体内蓄积,是剖宫产术后镇痛的理想药物,值得临床推广。展开更多
Puerperal and postpartum infections after cesarean section are a leading cause of maternal and neonatal morbidity and mortality worldwide. Postpartum infections account for a significant, and often preventable, portio...Puerperal and postpartum infections after cesarean section are a leading cause of maternal and neonatal morbidity and mortality worldwide. Postpartum infections account for a significant, and often preventable, portion of the global healthcare burden. Puerperal sepsis is one of the top five causes of maternal deaths worldwide and accounts for 10% - 15% of deaths in the postpartum period. Postpartum infections also present a significant social burden: they increase maternal anxiety and the risk of postpartum depression, interfere with bonding, and negatively impact breastfeeding. To prevent complications and improve outcomes, the evaluation of these infections must be accurate and prompt. This review provided a summary of causes, clinical presentation, laboratory tests, imaging modalities, treatment options, complications, and prognosis of puerperal and postpartum infections following cesarean section. Future directions in the evaluation of these infections were also discussed, including the development of novel diagnostic assays, the use of point-of-care testing and risk factors responsible for the onset of infections. This review emphasized the significance of early diagnosis and prompted treatment of these infections in order to prevent complications and enhance maternal and neonatal outcomes. This article also provided an exhaustive overview of the evaluation and management of puerperal and postpartum infections and the clinical outcome of infections for both mother and neonate.展开更多
Introduction: It has been suggested the relationship between infertility treatment and ovarian cancer. Furthermore, endometriosis that is one of the causes of the infertility tends to develop into endometrioid adenoca...Introduction: It has been suggested the relationship between infertility treatment and ovarian cancer. Furthermore, endometriosis that is one of the causes of the infertility tends to develop into endometrioid adenocarcinoma and clear cell carcinoma in many studies. Case: A 38-year-old woman underwent laparoscopic enucleation of bilateral ovarian endometrial cysts at 29 and 33 years old. She then received 11 sessions of artificial insemination and 7 cycles of ovarian stimulation, egg collection,?in vitro?fertilization, and embryo transfer at multiple medical institutions before conceiving and giving birth to her first child. After naturally conceiving her second child, she presented at our hospital for pregnancy/delivery management with a right ovarian tumor. She underwent abdominal right adnexectomy for a mucinous cystic tumor of borderline malignancy at 36 years old (17 weeks of pregnancy with the second child). After vaginal delivery at 38 weeks, a 1-month postpartum checkup revealed a left adnexal mass and ascites. Further workup led to a diagnosis of left ovarian cancer. The cancer was diagnosed by ovarian biopsy as unresectable stage-IIIc endometrioid carcinoma. Despite chemotherapy, the patient developed liver metastasis during treatment and died due to worsened general condition 9 months after childbirth. In addition to ovarian endometrial cyst, repeated cycles of injury and repair of the ovarian surface epithelium are also suggested to mediate the development of epithelial ovarian cancer. Conclusion: Evaluation of long-term outcome and follow-up of patients who have undergone fertility treatment should be addressed.展开更多
文摘目的探讨自由体位联合分娩减痛法在初产自然分娩产妇中的应用价值。方法将122例初产自然分娩产妇随机分为观察组和对照组,每组61例,对照组给予分娩减痛法干预,观察组在对照组基础上给予自由体位干预,观察两组产妇产程时间、疼痛程度、剖宫产率、感染率、出血量及新生儿评分等情况。结果观察组产妇各产程时间及总产程时间明显短于对照组（P〈0.05）;观察组产妇分娩期间疼痛程度明显轻于对照组（P〈0.05）;观察组分娩期间出血量〈500 m L产妇所占比例明显高于对照组（P〈0.05）;观察组产妇中转剖宫产率及感染率均显著低于对照组（P〈0.05）;观察组Apgar评分8~10分新生儿所占比例为100.00%,显著高于对照组的88.52%（P〈0.05）。结论自由体位联合分娩减痛法用于初产自然分娩产妇中可缩短产程时间、缓解疼痛程度、提高新生儿Apgar评分,同时可降低出血量及中转剖宫产率,具有较好的应用前景。
文摘目的观察使用布托啡诺的产妇剖宫产术后镇痛效应及对新生儿的影响。方法选择120例心功能分级（AHA）分级Ⅰ～Ⅱ级的择期剖宫产患者,随机分为布托啡诺组、吗啡组及对照组,各40例。均采用同样的麻醉药和给药方法,麻醉平面控制在（T4～T8）。注入腰麻药液后,布托啡诺组另给予布托啡诺1 mg加0.125%左布比卡因注射液5 m L,吗啡组另给予吗啡2 mg加0.125%左布比卡因注射液5 m L,对照组予0.9%氯化钠注射液5 m L。观察产妇术后2,4,8,12,24 h的疼痛视觉模拟评分（VAS）和布氏评分（BCS）及新生儿阿氏（Apgar）评分和神经行为适应能力（NACS）评分,并详细观察记录手术过程中的不良反应。结果布托啡诺组较吗啡组,术后2,4,8,12,24 h镇痛效果相当（P〉0.05）;布托啡诺组、吗啡组术后各时点镇痛效果均明显优于对照组（P〈0.05）;布托啡诺组较吗啡组术后各时点BCS评分无统计学差异（P〉0.05）,但均明显优于对照组（P〈0.05）;3组新生儿NACS和Apgar评分比较,均无显著统计学差异（P〉0.05）;布托啡诺组和对照组的不良反应,如恶心呕吐、呼吸抑制、嗜睡以及皮肤瘙痒等症状发生率明显低于吗啡组（P〈0.05）,布托啡诺组与对照组不良反应无明显统计学差异（P〉0.05）。结论布托啡诺用于产妇剖宫产术后镇痛效果确切,与吗啡相当,但恶心呕吐、皮肤瘙痒、呼吸抑制等不良反应的发生率明显低于吗啡,舒适度良好,且不会在新生儿体内蓄积,是剖宫产术后镇痛的理想药物,值得临床推广。
文摘Puerperal and postpartum infections after cesarean section are a leading cause of maternal and neonatal morbidity and mortality worldwide. Postpartum infections account for a significant, and often preventable, portion of the global healthcare burden. Puerperal sepsis is one of the top five causes of maternal deaths worldwide and accounts for 10% - 15% of deaths in the postpartum period. Postpartum infections also present a significant social burden: they increase maternal anxiety and the risk of postpartum depression, interfere with bonding, and negatively impact breastfeeding. To prevent complications and improve outcomes, the evaluation of these infections must be accurate and prompt. This review provided a summary of causes, clinical presentation, laboratory tests, imaging modalities, treatment options, complications, and prognosis of puerperal and postpartum infections following cesarean section. Future directions in the evaluation of these infections were also discussed, including the development of novel diagnostic assays, the use of point-of-care testing and risk factors responsible for the onset of infections. This review emphasized the significance of early diagnosis and prompted treatment of these infections in order to prevent complications and enhance maternal and neonatal outcomes. This article also provided an exhaustive overview of the evaluation and management of puerperal and postpartum infections and the clinical outcome of infections for both mother and neonate.
文摘Introduction: It has been suggested the relationship between infertility treatment and ovarian cancer. Furthermore, endometriosis that is one of the causes of the infertility tends to develop into endometrioid adenocarcinoma and clear cell carcinoma in many studies. Case: A 38-year-old woman underwent laparoscopic enucleation of bilateral ovarian endometrial cysts at 29 and 33 years old. She then received 11 sessions of artificial insemination and 7 cycles of ovarian stimulation, egg collection,?in vitro?fertilization, and embryo transfer at multiple medical institutions before conceiving and giving birth to her first child. After naturally conceiving her second child, she presented at our hospital for pregnancy/delivery management with a right ovarian tumor. She underwent abdominal right adnexectomy for a mucinous cystic tumor of borderline malignancy at 36 years old (17 weeks of pregnancy with the second child). After vaginal delivery at 38 weeks, a 1-month postpartum checkup revealed a left adnexal mass and ascites. Further workup led to a diagnosis of left ovarian cancer. The cancer was diagnosed by ovarian biopsy as unresectable stage-IIIc endometrioid carcinoma. Despite chemotherapy, the patient developed liver metastasis during treatment and died due to worsened general condition 9 months after childbirth. In addition to ovarian endometrial cyst, repeated cycles of injury and repair of the ovarian surface epithelium are also suggested to mediate the development of epithelial ovarian cancer. Conclusion: Evaluation of long-term outcome and follow-up of patients who have undergone fertility treatment should be addressed.
