Objective: To observe the effect of multimodal analgesia with single venous injection of parecoxib sodium and single epidural injection of morphine combine with dezocine intravenous infusion on the maternal pain, the adverse effects, the maternal activity and lactation and the stress response after cesarean section. Methods: The 90 cases of pregnant were randomly divided into three groups: Morphine and Dezocine (MD) group, Parecoxib sodium and Dezocine (PD) group, Parecoxib sodium, Morphine, and Dezocine (PMD) group. There were 30 cases in each group. The following three analgesic methods and their combinations were used: single epidural injection of morphine 1.5 mg, single intravenous injection of parecoxib 40 mg and intravenous analgesia with dezocine 0.5 mg/kg. Postoperative pain, adverse effects, maternal activity and breastfeeding, and serum substance P levels were observed. Results: These were statistically significant in the differences of VAS of incision pain at 8 h and 12 h after surgery (P < 0.05), in which the VAS in PMD group were lower than that in PD group and MD group, and in which the VAS in PD group was higher than that in MD group. These were statistically significant in the differences of VAS of uterine contractile pain at 8h and 12 h after surgery (P < 0.05), in which the VAS in PMD group were lower than that in PD group and MD group, and in which the VAS in PD group was lower than that in MD group. The time of starting to get out of bed after surgery was earlier in the PMD group than in the PD and MD groups (P < 0.05). The number of steps taken by mothers within 2 days after surgery was higher in the PMD group than in the PD and MD groups (P < 0.05). The step count within two days post-surgery was higher in the PMD group than in the PD and MD groups (P < 0.05). The serum substance P levels at the end of surgery and 1 day after surgery were lower in the PMD and PD groups than in the MD group (P < 0.05). The differences in the number of breastfeeding times within two days after surgery were statistically significant among the three groups (P < 0.05), with that in the PMD group（16.27±2.71) having been higher than in the PD group（12.63±1.67）and MD group（11.03±1.81), and that in the MD group being higher than in the PD group. Conclusion: The single intravenous sodium parecoxib combined with single epidural morphine and dezocine intravenous analgesia can better reduce the incision pain and uterine contractile pain after cesarean section, promote maternal postoperative off-bed activity and breast-feeding times to newborn.

Objective:To explore the effect of parecoxib on Edinburgh depression scores, postpartum depression, and blood levels of brain-derived neurotrophic factor (BDNF) and 5-hydroxytryptamine (5-HT) of puerperants who receive analgesia with single epidural morphine injection combined with dezocine intravenous analgesia after cesarean section.Methods:Eighty full-term pregnant women treated at Department of Obstetrics, Foshan Second People's Hospital from January 2022 to December 2022 were recruited. Their American Society of Anesthesiologists (ASA) grade was Ⅰ-Ⅱ; they were 20-39 years old; their body weight was 50-80 kg; they were 37-41 weeks pregnant. They were divided into a control group and an observation group by the random number table method, with 40 cases in each group. They planned to take selective cesarean section. The single epidural morphine injection combined with intravenous analgesia with dezocine was used in both groups; parecoxib was added in the above analgesic methods in the observation group. The postoperative pain scores [Visual Analogue Scale (VAS)] and analgesic adverse reactions were observed. The maternal Edinburgh Postnatal Depression Scale (EPDS) score was evaluated 1 day before and 3 days and 2 weeks after cesarean section. The incidence of postpartum depression was recorded. The serum levels of BDNF and 5-HT were measured by the enzyme-linked immunization. One-way ANOVA and χ2 test were used for the statistical analysis. Results:The scores of VAS 12, 24, and 48 h after delivery in the observation group were lower than those in the control group [(2.23±0.83) vs. (3.05±0.82), (2.98±0.86) vs. (3.78±1.03), and (3.43±0.87) vs. (3.90±0.96)], with statistical differences (all P<0.05). There was no statistical difference in the overall incidence of adverse reactions during the analgesia between the two groups ( P>0.05). The scores of EPDS 3 days and 2 weeks after delivery in the observation group were lower than those in the control group [(7.23±2.55) vs. (9.55±3.52) and (8.15±3.09) vs. (9.58±2.78)], with statistical differences (both P<0.05). The incidences of postpartum depression in the observation group 3 days and 2 weeks after delivery were lower than those in the control group [7.50% (3/40) vs. 25.00% (10/40) and 5.00% (2/40) vs. 22.50% (9/40)], with statistical differences (both P<0.05). The serum levels of BDNF and 5-HT 3 days and 2 weeks after delivery in the observation group were higher than those in the control group, with statistical differences (all P<0.05). Conclusion:Parecoxib can enhance the analgesia effect of epidural morphine combined with dezocine intravenous analgesia, reduce the EPDS score and the incidence of postpartum depression after cesarean section, and increase the serum levels of BDNF and 5-HT without increasing adverse reactions.

With the progress of modern medicine and the improvement of medical facilities, modern medical research is not limited to traditional medicine, but the treatment of diseases as a new direction; More and more attention has been paid to the tertiary prevention of diseases, especially the prevention of diseases, that is, the prevention and treatment of diseases at the grass-roots level. Vaccination is when a vaccine is injected into a healthy person so that they can produce antibodies that give them specific immunity, even if they don''t have the disease. Because different people and different vaccines will have adverse reactions, this is part of vaccination, it is unpredictable, it is unavoidable. In vaccination, due to the limitations of public understanding of vaccination, especially in newborn immunization, adverse reactions need to be treated in time. Therefore, more and more attention is paid to the prevention and control work. At present, China has achieved good results in vaccination, but due to various reasons, newborns may have adverse reactions after vaccination. In this paper, the causes of adverse reactions in neonatal vaccination and the relevant countermeasures of nursing intervention were analyzed.

目的:探讨自制中药封包联合护理在剖宫产术后产妇中的应用效果.方法:选择2020年1月1日～8月31日行剖宫产术分娩的60例产妇作为研究对象,随机分为对照组和观察组各30例;对照组采取常规产后护理,观察组在对照组基础上使用自制中药封包联合护理;比较两组产后肠鸣音评分,胃肠功能恢复时间,产后72 h泌乳时间,宫缩痛评分,Kolcaba舒适度量表评分及满意度评分.结果:观察组产后12 h、24 h肠鸣音评分正常率均高于对照组同期(P<0.05),首次肛门排气时间、首次排便时间均短于对照组(P<0.01),产后72 h泌乳量多于对照组(P<0.01),宫缩痛评分低于对照组(P<0.01),Kolcaba舒适度量表中生理、心理、精神维度评分及总分均高于对照组(P<0.01),沟通能力、舒适疼痛感受、人文关怀3个方面的护理满意度评分均高于对照组(P<0.01).结论:自制中药封包联合护理有助于剖宫产术后产妇胃肠功能恢复,促进泌乳,减轻产后宫缩痛,提高舒适度和护理满意度.

目的:探讨会阴冰敷贴在预防产后会阴部切口疼痛及肿胀患者中的应用效果.方法:选取2017年1月1日～2018年12月31日收治的60例经阴道分娩会阴部侧切或裂伤产妇为研究对象,按照随机数表法分为研究组和对照组各30例,对照组给予常规护理,研究组给予会阴冰敷贴;比较两组产后1、2、3、4 h疼痛程度[采用视觉模拟评分法(VAS)],产后24 h肿胀程度,产后2、24 h出血量、尿潴留发生情况,下床小便时间.结果:产后1、2、3、4 h,研究组VAS评分低于对照组(P<0.01);产后24 h,研究组产妇肿胀程度、良好率优于对照组(P<0.05);产后2、24 h,研究组出血量低于对照组(P<0.01);研究组下床小便时间<6 h、6～12 h的人数高于对照组(P<0.05).结论:会阴冰敷贴可降低产后会阴部切口疼痛程度、肿胀程度,减少产后出血量,使产后下床小便时间提前.

目的 探讨个性化助产士门诊宣教对孕妇分娩结局的影响.方法 选择2019年6月至2020年5月我院门诊收治的60例产检孕妇,随机分为两组各30例.对照组采用常规门诊宣教,观察组采用个性化助产士门诊宣教.比较两组护理前后的分娩知识认知、心理状况(SAS评分、SDS评分)以及分娩结局.结果 护理1个月后,观察组的分娩知识认知评分显著高于对照组,SAS、SDS评分均显著低于对照组(P<0.05).观察组的自然分娩率显著高于对照组(P<0.05).结论 个性化助产士门诊宣教可改善门诊孕妇的分娩知识认知,缓解不良心理,提高自然分娩率.

目的 分析产后腹直肌分离应用低频电刺激联合Kegle训练的效果.方法 114例产后腹直肌分离产妇,采用随机数字表法分为对照组和观察组,各57例.对照组行低频电刺激治疗,观察组在对照组基础上联合Kegle训练治疗,两组产妇均给予综合护理.比较两组产妇生活质量评分;干预前后腹直肌分离距离和腹围;腰痛发生情况.结果 观察组的社会功能评分为(82.35±4.19)分、精神健康评分为(83.65±3.35)分、身体健康评分为(80.65±4.44)分,均高于对照组的(72.35±3.68)、(73.45±3.47)、(70.65±4.65)分,差异具有统计学意义(t=13.538、15.966、11.743,P=0.000、0.000、0.000<0.05).干预前,两组产妇的腹直肌分离距离和腹围比较差异无统计学意义(P>0.05);干预后,观察组的腹直肌分离距离(1.42±0.31)cm和腹围(710.17±1.15)mm均低于对照组的(2.86±0.57)cm、(752.43±4.46)mm,差异具有统计学意义(P<0.05).观察组产妇产后42 d、6个月腰痛发生率分别为35.09％、14.04％,均低于对照组的64.91％、35.09％,差异具有统计学意义(P<0.05).结论 给予产后腹直肌分离产妇低频电刺激联合Kegle训练治疗,能够有效改善产妇的相关指标变化情况和腰痛症状,具有推广价值.

本文初步探讨新型冠状病毒肺炎疫情期间援鄂医疗队驻地的后勤物资管理策略.医疗队从物资管理的方法 、流程、制度着手,组建后勤物资管理小组,改建临时仓库,制定各项后勤物资管理制度,规范后勤物资管理及审领流程,并进行落实.援鄂期间,后勤物资管理小组为医疗队提供了充足的物资,管理流程高效、合理,队员普遍表示满意,提高了团队凝聚力,为一线医疗救治提供了有力的保障.

目的 探讨综合护理干预对剖宫产产妇泌乳功能及术后康复的影响.方法 选取我院妇产科接诊的2015年1月至2017年12月268例产妇,随机分为对照组130例和研究组138例.对照组给予常规护理,研究组给予综合护理干预,比较两组产妇干预前后心理状态评分(SAS,SDS)及泌乳素变化,并观察产后初乳平均时间、开奶平均时间、乳汁充盈度及泌乳量.结果 干预后研究组患者SAS,SDS评分低于对照组(P<0.05),泌乳素指数高于对照组(P<0.05),两组患者干预后平均初乳时间和开奶时间比较差异无统计学意义(P>0.05);研究组患者干预后产妇乳汁充盈度及产乳量高于对照组(P<0.05).结论 剖宫产产妇实施产后综合护理干预措施,有效促进乳汁分泌,改善患者产乳量,同时降低产妇负性情绪,效果显著,临床可进一步运用.

目的:探讨分娩监护镇痛仪联合催眠分娩技术对分娩结局的影响.方法:将200例有自然分娩意愿的初产妇随机分为对照组和观察组各100例,对照组采用常规方法待产与分娩,观察组在对照组基础上采用分娩监护镇痛仪联合催眠分娩技术待产与分娩,比较两组临床效果.结果:两组产妇产程时间、疼痛数字评分法(NRS)评分、剖宫产率、会阴侧切率、产后出血率、护理满意度及新生儿结局比较差异均有统计学意义(P<0.05).结论:分娩监护镇痛仪联合催眠分娩技术可改善产妇及新生儿分娩结局,提高护理满意度.

Objective To study the effect of single injection of morphine into epidural space combined with dezocine intravenous analgesia on the incidence of postpartum depression (PPD) and serum 5-hydroxytryptamine (5-HT)levels in parturients undergoing cesarean section(CS).Methods A total of 200 parturients with ASA statusⅠ-Ⅱundergoing elective CS,who admitted to Department of Obstetrics and Gynecology of the Second Hospital of Foshan from August 2015 to December 2016,were selected and divided into the experimental group and the control group ac-cording to random number table,with 100 cases in each group.The patients of control group received single injection of 1.5 mg morphine into epidural space and normal saline 1 mL injected intravenously then normal saline 100 mL infused intravenously postoperatively.The patients of experimental group received single injection of 1.5 mg morphine into epi-dural space and dezocine 5 mg injected intravenously then dezocine 25 mg infused intravenously postoperatively.The an-algesic effects were evaluated by visual analogue scoring(VAS),and the adverse reactions was observed and recorded. The 5-HT levels were measured by enzyme-linked immunosorbent assay at 1 day before CS and 1 days,3 days after CS, and the depressive status was evaluated with Edinburgh Postpartum Depression Scale(EPDS)at 1 day before CS and 1 day,3 days after CS.Results The level of 5-HT in two groups showed no significant differences at 1 day before or after CS(P>0.05).The 5-HT level at 3 days after CS in the experimental group was(433.16±90.90)ng/L,which was significantly higher than(388.77±84.37)ng/L in the control group(P<0.05).There was no statistically significant dif-ference in the EPDS score between the two groups at 1 day before CS(P>0.05).The EPDS score at 3 days after CS in the experimental group was(7.24±3.35),which was significantly lower than(8.39±4.08)in the control group(P<0.05). The incidence of PPD in the experimental group was 11.0%,which was significantly lower than 22.0% in the control group(P<0.05).Conclusion The epidural injection of morphine combined with dezocine intravenous analgesia is of better analgesia effect,which can reduce the EPDS score and the incidence of PPD in parturients after CS,and improve the 5-HT levels.

目的 探讨全产程人文关怀式护理对自然分娩产妇心理状态及产程的影响.方法 将我院产科2016年10月至2017年10月收治的200例自然分娩产妇随机等分为观察组和对照组,对照组给予产科常规护理,观察组联合全产程人文关怀式护理,比较两组患者护理前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分及产程时间、产程疼痛评分、产后2 h出血量、并发症发生率(会阴撕裂、产褥感染、产后伤口感染、产后尿潴留)及新生儿窒息率.结果 观察组护理后SAS,SDS评分均显著低于对照组(P<0.05).观察组产妇第一产程时间、第二产程时间均显著短于对照组(P<0.05).观察组产程疼痛评分显著低于对照组(P<0.05).观察组产妇产后2 h出血量显著少于对照组(P<0.05).观察组产妇并发症发生率及新生儿窒息率显著低于对照组(P<0.05).结论 自然分娩产妇分娩过程中应用全产程人文关怀式护理可显著改善产妇负性心理状态及分娩疼痛感,缩短产程时间,减少产后出血风险,使产妇在最佳状态下分娩,从而起到改善母婴结局的作用,值得临床推广.

目的:探讨助产士预防新生儿羊水咽下综合征的最佳羊水清理方法。方法:将足月阴道产或剖宫产出生,自然呼吸母亲妊娠期血糖正常的新生儿240例,随机分为观察组、对照组各120例。观察组新生儿在出生1 min、5 min、30 min,实施间歇多次呼吸道、胃内羊水黏液清理吸引;对照组常规地在新生儿出生时实施单一呼吸道清理吸引。结果:两组新生儿羊水咽下综合征发生率以及低血糖、高胆红素血症等并发症比较,差异具有统计学意义(P<0.01)。结论:助产士在新生儿出生时、出生5 min、出生30 min,实施间歇、多次清理吸引呼吸道、胃内羊水黏液的方法,对预防新生儿羊水咽下综合征的发生效果明显;对促进新生儿生长发育、降低新生儿黄疸、低血糖,提高助产护理质量具有积极作用。

Objective To compare the clinical effect between umbilical cord exposure and tradition umbilical cord bandage method in the prevention of neonatal umbilical region infection and umbilical departure time. Methods From Octomber to November 2012, 356 neonates were randomized into umbilical cord exposure group and umbilical cord bandage group. After ligature of the cord, umbilical cord exposure group received WHO "dry and clean" protocol that the umbilical cord was exposed to air(with loosing clothes), cleaned by clear water instead of alcohol; umbilical cord bandage group used tradition method that the umbilical cord and surrounding skins were sterilized with 75% alcohol and dressing. Umbilical departure time, expulsion rate, navel region secretion and the rate of omphalitis were analyzed. Results The umbilical cord departed majorly at 6 to 7 days in the umbilical cord exposure group, and the umbilical cord bandage group departed majorly more than 7 days, with statistically significant difference in umbilical departure time(P <0.01). The condition of navel region secretion and the rate of omphalitis show that umbilical cord exposure group was obviously lower than the umbilical cord bandage group(P <0.01, P <0.05). Conclusions Navel exposure is a safe and effective method that can shorten umbilical departure time and reduce the rate of umbilical region infection.