目的 以适应性体验的交互为切点,整合分析女性尿失禁患者群体的特质并探寻对策.方法 计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、维普资讯中文期刊服务平台、万方数据知识服务平台、中国生物医学文献数据库,搜索关于女性尿失禁患者适应性体验的质性研究,检索时限为建库至 2022 年 6 月.采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献质量进行评价,采用汇集性整合方法对结果进行整合.结果 共纳入15 篇文献,提炼 60 个结果,形成 10 个类别,合成 5 个整合结果,即身体失控和生活失衡、陷入严重的情绪内耗、病症认知偏差、尝试自我重建、内控和发展.结论 女性尿失禁患者遭受长期症状困扰,应发挥临床护理人员的效力,刺激患者主观能动性并满足患者多元的需求,群策群力强化妇女保健意识和推进健康老龄化.

Female pelvic floor dysfunctions are the most common diseases after pregnancy. Vaginal relaxation, stress urinary incontinence (SUI), and pelvic organ prolapse (POP), decreased sexual activity, and mental depression and other clinical symptoms, are the most normal results of childbirth which leading to cause various problems for the mother. We aim to explore the clinical situation and effect of postpartum pelvic floor rehabilitation nursing for patients with postpartum pelvic floor dysfunction. In this study, 100 patients with postpartum pelvic floor dysfunction randomly selected from January 2018 to December 2019. They were randomly divided into two groups for nursing care, including control group and observation group. The control group received routine care, and the observation group received postpartum pelvic floor rehabilitation care. We carry out comparison of the clinical nursing effects of the two groups. After analysis and statistics, the total clinical effectiveness (94.0%) and nursing satisfaction (92.0%) of the observation group were significantly higher than those of the control group (80.0%, 72.0%), and the differences between the groups were significant (P<0.05). In conclusion, implementing pelvic floor rehabilitation nursing for patients with postpartum pelvic floor dysfunction can better promote the rehabilitation of patients' pelvic floor function, improve clinical effects and nursing satisfaction.

目的 评估早孕期血红蛋白(hemoglobin,Hb)水平对妊娠结局的影响.方法 回顾性分析2016年1月至2017年5月在暨南大学附属第一医院定期产检和分娩的1 306例女性的临床资料,根据Hb水平将其分为3组:低Hb组(Hb<110 g/L,490例),中Hb组(110≤Hb<130 g/L,673例),高Hb组(Hb≥130 g/L,143例).再将低Hb组分为2个亚组:极低Hb组(Hb≤90 g/L,64例)和较低Hb组(Hb>90 g/L,426例).分析比较各组的一般资料及妊娠结局.结果 3组孕妇的妊娠期高血压疾病发生率、早产率、NICU住院率、产后出血率、分娩孕周、新生儿出生体重、Apgar评分比较,差异有统计学意义(P<0.05).组间比较,中 Hb组的分娩孕周、出生体重、1 min Apgar评分均较低Hb组和高Hb组高,高Hb组的妊娠期高血压疾病发生率较低Hb组和中 Hb组高,差异有统计学意义(P<0.05).高Hb组的早产率、NICU住院率较高,低Hb组的产后出血发生率较高.极低Hb组和较低Hb组妊娠期高血压疾病患病率比较,差异有统计学意义(P<0.05).结论 Hb水平过高或过低都与不良妊娠结局有关,建议在妊娠期间筛查Hb水平以减少不良妊娠结局,确保母儿平安.

Probing into the Quality Control Circle (QCC) activities in improving the delayed cord clamp rate (DCC) of newborns undergoing vaginal delivery. By setting up QCC team, to investigate and diagnose the problems of DCC rate of newborns undergoing vaginal delivery in our hospital in 2017, therefore, to draw up our new target and the responding measurement. After that, we analyze and discuss the data, and finally filter the valid data. Finally, we compare the two sets of situations and data. According to the investigation of DCC rate undergoing vaginal delivery and the relative Maternal-and-Infant outcome in August to November in 2017, after setting up QCC activities, it shows the DCC rate of newborns undergoing vaginal delivery has an significant increased, from 35.1% to 82.3%, duration of the Third Stage of Labor, hospitalization rate of Neonatal intensive Care Nursing (NICU), Apgar score, incidence of postpartum hemorrhage, asphyxia neonatorum and hyperbilirubinemia has no statistical sence (P>0.05). The Quality Control Circle (QCC) activities can effectively improve the delayed cord clamp rate (DCC) of newborns undergoing vaginal delivery, without affecting the incidence of undesirable Maternal-and-Infant outcome. And the quality control circle activities can be fed back and improved through the PDCA cycle to make it more scientific and practical.

目的 通过专案改善提高妇产儿科护理人员的疼痛知识及疼痛评估执行率.方法 采取现状调查与分析、 培训及抽查病历记录等方式,比较改善前后护理人员对疼痛知识的掌握程度及对患者的疼痛评估执行情况.结果 培训后,护士的疼痛知识得分为(8.94±1.25)分,明显高于培训前的(4.22±1.10)分(P<0.01).培训后,妇科、 产前产房区、 爱婴区(产后)的首次评估率分别为90％、95％、85％,动态评估率分别为94.5％、94.7％、94.1％,较培训前均明显改善(P<0.01).结论 有效的专案改善可提高妇产科护士的疼痛知识水平,提高首次评估率、 动态评估率及疼痛护理评估的执行力.

目的 提高临床疼痛评估质量,强化护士对疼痛病人的人文关怀意识.方法 建立疼痛护理工作标准,在妇产儿科片区,采取抽查病历记录等方式,比较标准使用前后的疼痛评估质量.结果 标准使用后,妇科、 产前产房区、 爱婴区(产后)首次评估合格率分别为91％、96％、93％,动态评估合格率分别为88％、89％、86％,与标准使用前相比差异有统计学意义(P<0.01).结论 建立疼痛护理工作标准,为护士落实疼痛护理及人文关怀提供帮助,可以提高疼痛护理质量,及时发现孕产妇的危急问题,体现优质护理服务内涵.

目的 探讨孕28周前妊娠期糖尿病患者自我管理行为现状及影响因素.方法 采用便利抽样的方法,抽取2017年2—7月在某三级甲等医院妇产科门诊进行产前检查的孕28周前妊娠期糖尿病患者为研究对象.采用一般资料调查表、糖尿病自我管理行为量表及糖尿病自我效能量表对其进行调查.采用多元线性回归分析其影响因素.结果 孕28周前妊娠期糖尿病患者自我管理行为得分为(10.15±3.88)分,得分率为36.3%.多元线性回归分析结果显示,是否接受过妊娠期糖尿病相关知识健康教育及自我效能进入回归方程(P<0.05).结论 孕28周前的妊娠期糖尿病患者的自我管理处于较低水平,受是否接受过疾病相关知识教育及自我效能因素影响.建议加强对妊娠期糖尿病患者知识教育普及以及自我效能干预.

Aim:To investigate the effects of polysaccharide in Ophiopogon japonicus on blood glucose in gestational diabetic rats.Methods: The models of gestational diabetic rats were established with alloxan by intraperitoneal injection administration.Polysaccharide in Ophiopogon japonicus was given by intragastric administration on 14 days.The blood glucose levels of rats at the day 0,7,14 were detected respectively,their body weight and serum insulin levels detected by the method of radioimmunoassay at the day 0,14 were analyzed.Results: The blood glucose levels were significantly decreased in gestational diabetic rats treated by polysaccharide in Ophiopogon japonicus at the day 7,14 compared with model group(P0.01),and it showed no effects on the levels of blood insulin and the body weight of rats.Conclusion:polysaccharide in Ophiopogon japonicus could decrease the levels of blood glucose in gestational diabetic rats.It maybe relate to increase the hepatic cell intakeing the amylaceum,and increase the composition of the hepatic glycogen.

目的探讨乙肝表面抗原(HBsAg)阳性和e抗原(HBeAg)阳性(简称"双阳性")携带孕妇孕晚期应用乙肝免疫球蛋白(HBIG)对产后初乳的影响,及产妇初乳HBsAg阳性时的母乳喂养问题.方法将双阳性携带孕妇分为HBIG组和非HBIG组,并将初乳双阳性产妇所生新生儿分为母乳喂养组和人工喂养组;HBIG组孕妇从28周起肌肉注射HBIG 200IU/4周,共3次(部分仅注射1～2次),非HBIG组仅常规产检及监护;对两组产妇下乳24h～7 d内的初乳和新生儿0,6个月的静脉血作乙肝两对半和HBV-DNA检测.结果HBIG组与非HBIG组比较,产妇初乳的HBsAg阳性率差异无显著性;不同喂养方式0,6个月龄新生儿静脉血的HBsAg、抗-HBs阳性率差异无显著性.结论双阳性孕妇孕晚期应用HBIG对产妇初乳的HBsAg阳性率并无影响;产妇初乳HBsAg阳性时行母乳喂养不影响乙肝病毒(HBV)母儿传播率.

目的探讨陪伴分娩对产后抑郁症的影响.方法将220例产妇分成观察组和对照组,比较两组产妇产后的抑郁水平和抑郁症发生率.结果对照组的产后抑郁水平和抑郁症发生率均显著高于观察组(P＜0.01).结论陪伴分娩有助于降低产后抑郁症发生率和抑郁水平.