目的 探究采用中药散结化瘀外敷包热敷治疗和揿针联合疗法治疗妇科术后出现胃肠功能障碍患者的临床效果.方法 选取本院2019年7月-2020年6月经妇科腹腔镜手术后出现胃肠功能障碍的患者160例为研究对象,并将其随机分为对照组和观察组,每组各80例.对照组使用常规西医治疗方式后,进行揿针治疗;观察组则在西医常规治疗的基础上,采用中药散结化瘀外敷包热敷和揿针联合疗法进行治疗.结果 经治疗,两组患者症状都有所缓解,治疗5d后对患者进行综合检查,两组患者POGD评分均有所下降,其中观察组治疗效果明显优于对照组(P<0.05).结论 在对腹腔镜手术后出现肠胃功能障碍的患者进行治疗时,以常规西医治疗为基础,应用中药散结化瘀外敷包热敷和揿针联合治疗的方式具有明显治疗效果,能促进患者尽快康复,值得临床推广与应用.

The efficient management and operation of the referral process is the key to the successful treatment of emergency and critical disease pregnant women. On the basis of sorting out the current situation of the referral of emergency and critical disease pregnant women, a hospital established a referral system for emergency and critical disease pregnant women with the hospital as the center through the formulation of the referral indication, the specification of the referral and treatment process, the selection of the referral system structure and the function design, etc. It achieved integrated management of basic information, referral indication identification, consultation, referral and treatment for emergency and critical disease pregnant women, which improved the referral rate of emergency and critical disease pregnant women, the identification accuracy rate of high-risk pregnant women and the treatment effect and satisfaction of referral in primary hospitals.

目的 探究妊娠期糖尿病大鼠子宫内膜组织中核因子κB(NF-κB)及葡萄糖转运蛋白4(GLUT4)表达与胰岛素抵抗发生的相关性.方法 选取40只SD怀孕大鼠,将其按照随机数字表法分成正常组和模型组,每组各20只.正常组孕鼠腹腔注射给予柠檬酸钠缓冲液,模型组孕鼠给予链脲佐菌素(45 mg/kg),2组剂量一致.于分娩前检测孕鼠的空腹血糖和体重,分娩后处死孕鼠,取子宫内膜组织.采用葡萄糖氧化酶法检测空腹血糖和空腹胰岛素.采用酶联免疫吸附试验法检测血清可溶性E-选择素(sE-selectin)和可溶性细胞间黏附分子(sICAM-1)水平,采用免疫组织化学法检测子宫内膜中NF-κB、GLUT4的表达.结果 模型组孕鼠的空腹血糖值显著高于正常组,体重显著低于正常组(P<0.05).模型组孕鼠的HOMA-IR值(36.19±5.70)显著高于正常组(15.20±2.50),差异有统计学意义(P<0.05).模型组孕鼠血清sE-selectin和sICAM-1水平为(67.02±24.01)、(411.02±123.01)μg/mL,均显著高于正常组[(40.11±15.02)、(245.04±77.03)μg/mL],差异均有统计学意义(P<0.05).模型组孕鼠子宫内膜中NF-κB的阳性表达率(70.00％)显著高于正常组(35.00％),而GLUT4的阳性表达率(40.00％)显著低于正常组(80.00％),差异均有统计学意义(P<0.05).NF-κB、sE-selectin、sICAM-1的水平与HOMA-IR值呈正相关关系(P<0.05),GLUT4水平与HOMA-IR值呈负相关关系(P<0.05).结论 妊娠期糖尿病胰岛素的发生伴随着孕鼠子宫内膜组织中NF-κB表达上调和GLU4表达下调,并与血清中sE-selectin、sICAM-1水平上升密切相关.

目的 研究三七皂苷对高氧诱导的早产儿视网膜病变(ROP)小鼠血管新生及脂联素(APN)和肿瘤坏死因子-α(TNF-α)表达的影响.方法 将45只新生C57BL/6J小鼠按随机数字表法分为正常对照组、ROP组和三七皂苷组,每组15只.采用Smith法建立ROP模型.三七皂苷组小鼠每日腹腔注射三七皂苷药液4μL,正常对照组和ROP组每日腹腔注射同等剂量的0.9％氯化钠溶液.心脏荧光素灌注,做视网膜铺片观察视网膜血管形态.制作视网膜组织切片,苏木素-伊红(HE)染色,观察突破内界膜的内皮细胞核数.酶联免疫吸附法(ELISA)检测血清中APN和TNF-α 的表达水平.结果 形态学观察显示,ROP组视网膜血管有明显增生,而三七皂苷组血管增生减少.ROP组可见大量突破内界膜的内皮细胞核;三七皂苷组仅可见极少量的突破内界膜的内皮细胞核.ROP组和三七皂苷组的内皮细胞核数量为(24.20±6.26)、(3.40±1.03)个,显著高于正常对照组[(0.40±0.12)个],而三七皂苷组较ROP组显著降低,差异有统计学意义(P<0.05).与正常对照组[(16.38±3.56)ng/L、(13.18±1.81)mg/L]相比,ROP组[(33.23±6.96)ng/L、(7.23±1.33)mg/L]和三七皂苷组[(18.54±5.85)ng/L、(11.95±1.79)mg/L]小鼠血清TNF-α的表达水平明显升高,APN的表达水平明显降低,差异有统计学意义(P<0.05),而三七皂苷组则较ROP组小鼠血清TNF-α 的表达水平降低,APN的表达水平升高,差异有统计学意义(P<0.05).结论 三七皂苷可有效抑制视网膜新生血管的生成,其机制可能与上调APN的表达并下调TNF-α的表达有关.

目的 探讨医护一体化工作模式在产科急危重症护理中的应用效果.方法 选取2018年6月至2020年6月我院产科收治的300例急危重症患者为研究对象,按照不同护理方法将其分为观察组和对照组,各150例.对照组给予常规护理干预,观察组给予医护一体化工作模式干预.比较两组患者的护理质量、抢救治疗相关指标、生活质量评分.结果 观察组患者的基础护理、健康教育、危重护理及护理文书质量评分均高于对照组(P<0.05).观察组患者的抢救治疗时长、开始下床活动时间、住院时间均短于对照组(P<0.05).干预后,两组的SF-36量表各项评分均升高,且观察组高于对照组(P<0.05).结论 医护一体化工作模式在产科急危重症护理中的应用效果显著,能够改善患者的护理质量和生活质量.

目的 探讨孕中期胎儿心血管畸形超声检测NT值与染色体核型检测的关系.方法 选取2 01 5年1月至201 7年12月因胚胎发育不良(心脏发育畸形或异常)于本院行产前检测的孕妇1 08例,所有产妇均于孕24 ～ 35w行超声NT检查和经腹脐静脉穿刺术取胚胎绒毛组织的染色体核型检测,观察染色体核型检测情况,分析染色体核型检测正常与异常胎儿的超声NT值差异,并采用spearman相关性分析法分析胎儿超声NT值与染色体核型检测是否正常的相关性.结果 108例病例中,染色体核型检测正常者30例(27.78％),染色体核型检测异常者78例(占比72.22％).染色体核型检测正常胎儿心血管超声NT层厚值(3.83士0.54mm)低于染色体核型检测异常胎儿(4.64±0.63mm) (P＜0.05).spearman相关性分析显示,胎儿超声NT值与染色体核型检测是否正常具有明显的负相关性(r=0.871,P=0.018＜0.05).1 5例继续妊娠至分娩的胎儿中,10例(包括7例染色体核型检查异常胎儿)出生后心脏功能发育异常(或畸形),其余5例出生后未出现心脏功能发育异常(或畸形),且随访至12个月仍未出现心脏功能发育异常(或畸形).结论 通过染色体核型检测对心血管畸形胎儿绒毛组织进行染色体核型检测,可发现染色体中小至100Kb片段的缺失或重复,也可发现潜在致病基因序列,孕中期胎儿心血管超声检测NT值与染色体核型检测是否正常具有明显相关性,可作为心血管发育畸形胎儿染色体核型检查的参考指标,超声检测NT检查和染色体核型检测在胎儿心血管畸形的临床诊断中均具有良好的前景.

组建产—儿多学科团队,从生命孕育期开始,由产科、新生儿科、儿科共同进行连续性延伸护理服务.产—儿多学科连续性延伸护理服务项目的开展,构建了多学科连续性延伸护理服务模式,充分发挥了护士价值,体现了护理专业内涵质量,提高了家长满意度,提升了医院知名度.

Objective:To explore the value of natural killer T (NKT) like cell in unexplained recurrent spontaneous abortion (URSA).Methods:Total of 120 women in Shaanxi Provincial People's hospital were selected from January 2015 to May 2018, and divided into three groups: URSA group, control group A (normal pregnant women) and control group B (normal non pregnant women), with 40 cases in each group. The expression of CD3 + T lymphocytes and NKT like cell subsets (CD3 + CD16 + CD56 + , CD3 + CD16 + CD56 -) were detected by flow cytometry. The levels of serum interferon-γ(IFN-γ), interleukin(IL)-4, three kinds of progesterone, β-human chorionic gonadotropin (β-HCG), progesterone (P) and estradiol (E2) were measured by enzyme linked immunosorbent assay (ELISA). Results:There were no statistical differences in CD3 + T lymphocytes and CD3 + CD16 + CD56 -NKT-like cell subsets among URSA group, control group A and control group B( P>0.05). The results showed that the expression of CD3 + CD16 + CD56 + NKT like cell subtypes in control group A and control group B was significantly higher than that in URSA group [group A : (4.02±1.54)% , group B: (1.92±1.02)%, URSA group: (6.45±2.09) %, F = 18.596, P<0.05]. The level of IFN-γ in URSA group was significantly higher than that in control group A [(110.27±50.12)ng/L vs (69.38±31.25)ng/L, t=4.380, P< 0.05], the level of IL-4 in URSA group was significantly lower than that in control group A[(21.34±10.02) ng/L vs (40.97±19.85) ng/L, t=5.583, P< 0.05], and the Th1/Th2 ratio in URSA group was significantly higher than that in control group A [(6.84±2.49) vs (2.34±1.74), t=9.370, P< 0.05]. At the same time, the expression levels of serum β - hCG, P and E2 in URSA group were lower than those in control group A ( t values were 45.778, 11.992 and 21.922 respectively, all P values < 0.05). Conclusion:The expression of NKT like cells plays an important role in URSA, which provides a basis for the diagnosis and treatment of URSA patients.

目的 :调查孕妇在妊娠期压力状况及其影响因素,为提出针对性的干预措施提供依据.方法 :收集陕西地区孕妇1044例,采用一般资料调查表 、妊娠压力量表对其进行问卷调查,分析其妊娠期间压力状况及影响因素.结果 :孕妇妊娠压力总分(26.28±14.25)分,按得分指标分类,轻度压力784例(75.1％),中度压力255例(24.4％),重度压力5例(0.5％);压力源各因子中,"为确保母子健康和安全而引发的压力感"得分指标最高,为43.57％.妊娠压力的主要影响因素为:居住地类别 、对住房的满意度 、与伴侣母亲的关系.结论 :经济状况及家庭成员情感支持是影响孕妇妊娠压力水平的重要因素,为经济困难者提供必要的社会援助 、为家庭情感支持不足者实施心理干预,是缓解妊娠压力,帮助其顺利度过妊娠期,提升母婴健康水平的重要措施.

目的 探讨妊娠期血小板减少症(GT)患者的围产期护理措施.方法 回顾性分析我院2017年6月至2018年8月收治的92例GT患者(研究组)以及92例正常妊娠产妇(对照组)的临床资料,分析GT患者的发病孕周及出血情况;比较两组研究对象的分娩方式、产后出血率、住院费用及住院时间.结果 92例GT患者中,51例患者的血小板计数≤50×109/L,其中58.82%患者有出血情况,74.51%患者处于 37~41 孕周;41 例患者的血小板计数>50×109/L,其中 46.34%患者有出血情况,63.41%患者处于37~41孕周.两组的分娩方式及产后出血率比较,差异均无统计学意义(P>0.05).研究组的住院费用高于对照组,差异具有统计学意义(P<0.05);两组的住院时间比较,差异无统计学意义(P>0.05).结论 GT患者经过积极的临床治疗及围产期护理,其剖宫产率、产后出血率及住院时间与正常妊娠孕妇接近,但住院费用相对较高.

目的 探讨孕酮膜受体(PGRMC1)在孕激素抑制卵泡发育及颗粒细胞分化中的作用及作用机制.方法 将10只21 d的SD大鼠按随机数表法分为两组(n=5),其中一组注射孕马血清促性腺激素(PMSG)(20 IU/mL)48 h后取卵巢,另外一组注射PMSG 24 h后注射孕酮(30μg/只),再经过24 h后取卵巢,通过测量卵巢大小、HE染色研究孕酮对卵泡发育的影响.PMSG(20 IU/mL)促排卵48 h后取卵巢,后通过免疫组化观察PGRMC1受体分布情况.用PMSG促排卵48 h后分离卵泡颗粒细胞,加入孕酮(100 ng/mL、250 ng/mL)和PGRMC1抑制剂AG205(10μmol/L)后,采用Western blot检测卵巢颗粒细胞甾体激素生成相关的细胞外信号调节酶(ERK1/2)、甾体激素快速调节蛋白(StAR)、细胞色素P450胆固醇侧链切割酶(P450scc)的表达情况,采用ELISA试剂盒检测培养上清中的孕烯醇酮分泌情况.结果 PMSG处理组卵巢大小为(8.6±0.93)mm,明显大于PMSG联合孕酮处理组的(5.2±0.58)mm,差异有统计学意义(P<0.05);PMSG联合孕酮处理组始基卵泡数明显高于PMSG处理组[(62±8.6)vs(39±2.9)],而有腔卵泡及成熟卵泡显著低于PMSG处理组[(3.8±1.0)vs(8.0±1.2)、(3.7±0.4)vs(8.1±0.6)],差异均有统计学意义(P<0.05);孕酮(100 ng/mL、250 ng/mL)抑制甾体激素生成相关的pERK1/2、StAR、p450scc的表达,进而抑制甾体激素的前体孕烯醇酮的合成[(2.9±0.23)ng/mL vs(5.3±0.18)ng/mL、[(3.0±0.67)ng/mL vs(5.3±0.18)ng/mL],差异均有统计学意义(P<0.05);然而PGRMC1抑制剂AG205(10μM)逆转孕酮的这种抑制作用升高pERK1/2、StAR、p450scc的表达,差异均具有统计学意义(P<0.05);AG205逆转孕酮(100 ng/mL、250 ng/mL)对孕烯醇酮合成的抑制作用[(9.6±0.67)ng/mL vs(2.9±0.18)ng/mL、(9.8±0.91)ng/mL vs(3.0±0.67)ng/mL]差异均具有统计学意义(P<0.05).结论 孕酮抑制卵泡的发育,孕酮的这种抑制作用主要体现在对窦前卵泡的抑制作用.孕酮对卵巢颗粒细胞甾体激素的合成有抑制作用,PGRMC1的抑制剂AG205可以逆转孕酮的抑制作用,提示孕酮抑制卵泡发育,抑制颗粒细胞分化作用部分依赖于PGRMC1.

目的 研究降糖宁胶囊联合门冬胰岛素注射液治疗妊娠糖尿病的临床疗效.方法 选取2018年8月-2019年8月在陕西省人民医院和西北妇女儿童医院治疗的120例妊娠糖尿病患者为研究对象,所有患者随机分为对照组和治疗组,每组各60例.对照组患者给予门冬胰岛素注射液,推荐剂量为0.5～1.0 U/kg,2/3用量在用餐时给药,剩余的1/3用量为基础胰岛素;治疗组在对照组的基础上口服降糖宁胶囊,4粒/次,3次/d.两组患者持续治疗4周.观察两组的临床疗效,比较两组的血糖水平和C-反应蛋白(CRP)、血清镁(Mg2+)、脂联素水平、低血糖发生率、每日胰岛素用量、血糖达标时间.结果 治疗后,对照组和治疗组的总有效率分别为83.33％、95.00％,两组比较差异有统计学意义(P<0.05).治疗后,两组血清糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG)和空腹血糖(FBG)水平均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组HbA1c、2 h PG和FPG水平均明显低于对照组,两组比较差异有统计学意义(P<0.05).治疗后,两组CRP水平明显降低,Mg2+、脂联素水平均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组CRP、Mg2+和脂联素水平均明显优于对照组,两组比较差异有统计学意义(P<0.05).治疗后,治疗组低血糖发生率、每日胰岛素用量、血糖达标时间明显低于对照组,两组比较差异有统计学意义(P<0.05).结论 降糖宁胶囊联合门冬胰岛素注射液治疗妊娠糖尿病具有较好的治疗效果,可降低血糖水平,调节CRP、Mg2+和脂联素水平,降低胰岛素使用量,安全性较高,具有一定的临床推广应用价值.

目的 探讨卡前列素氨丁三醇治疗对胎儿娩出后瘢痕子宫阴道分娩产妇产后出血量、产程时问及不良反应的影响,为临床治疗提供参考依据.方法 选择2015年1月-2016年12月在陕西省人民医院行阴道分娩的瘢痕子宫产妇160例为研究对象.随机分为对照组和观察组,每组各80例,对照组给予缩宫素治疗,观察组在对照组的基础上联合卡前列素氨丁三醇治疗.比较两组产妇的疗效、产后出血情况及不良反应发生情况等.结果 观察组产妇的显效率为77.50％,有效率为22.50％,总有效率为100.00％,对照组显效率为21.25％,有效率为68.75％,总有效率为90.00％,观察组总有效率高于对照组,差异有统计学意义(P＜0.05).产后24 h观察组产妇的血红蛋白水平高于对照组,产后2h、产后24 h观察组产妇的产后出血量均低于对照组,差异有统计学意义(均P＜0.05).观察组产妇的第三产程时间、产后出血率均低于对照组,差异有统计学意义(均P＜0.05),两组产妇的子宫切除率相近,差异无统计学意义(P＞0.05).两组产妇常见的不良反应包括恶心呕吐、面部潮红、腹泻、血压波动等,以恶心呕吐为主,停药后均自行缓解,两组产妇不良反应的发生率相近,差异无统计学意义(P＞0.05).结论 卡前列素氨丁三醇可以明显减少瘢痕子宫阴道分娩产妇的产后出血量,缩短第三产程时间,提高临床疗效.

目的 探讨循证护理在剖宫产产妇护理中的应用效果.方法 将我院收治的110例剖宫产产妇根据不同护理模式分为常规护理组和循证护理组,各55例.对比两种护理模式的护理效果.结果 护理后,两组产妇SAS、SDS评分均降低,与常规护理组相比,循证护理组明显更低(P<0.05);循证护理组的感染率、疼痛难忍率及产后出血量均优于常规护理组(P<0.05).结论 循证护理可改善剖宫产产妇的心理状态,降低术后感染,减轻疼痛感,减少出血量,具有良好的可行性和实用性.对此,有必要将循证护理作为日后主流护理模式.

目的 分析不同黄体酮剂量对早孕先兆流产患者妊娠结局的影响.方法 选择我院产科2016年1月至2017年1月收治的72例早孕先兆流产患者,根据治疗剂量不同分为小剂量组、中剂量组和大剂量组,每组24例.三组患者均使用黄体酮进行治疗,仅剂量不同.比较三组患者的临床疗效和妊娠结局.结果 三组患者的临床总有效率比较,差异无统计学意义(P>0.05).三组患者的妊娠至足月率、完全流产率、致畸率比较,差异无统计学意义(P>0.05);小、中剂量组患者的稽留流产率比较,差异无统计学意义(P>0.05),但大剂量组患者的稽留流产率高于小、中剂量组(P<0.05).结论 不同黄体酮剂量对早孕先兆流产患者的临床治疗效果、妊娠至足月率、完全流产率、致畸率无明显影响,但大剂量黄体酮会提高稽留流产率,因此在临床治疗时,不可盲目增加黄体酮剂量.

[目的]运用森田疗法的理念与方法对妊娠剧吐病人实施护理.[方法]将130例妊娠剧吐病人随机分组,观察组65例由受过森田疗法训练的护士应用森田疗法对妊娠剧吐病人及家属进行病因探讨、饮食、活动度等具体指导,对照组65例应用传统护理措施;比较两组病人每天的主食量、饮水量,住院期间每天的恶心次数、呕吐次数,两组病人平均住院天数、住院费用.[结果]观察组病人平均每天主食量、饮水量均大于对照组,差异有统计学意义(P<0.001);观察组病人平均每天恶心、呕吐次数显著小于对照组,差异有统计学意义(P<0.001);观察组病人平均住院天数、住院费用显著少于对照组,差异有统计学意义(P<0.001).[结论]森田疗法的"顺其自然,为所当为"的理念与方法可应用于妊娠剧吐病人,具有良好疗效.

Objective:To analyze the correlation between the serum interleukin-6 (IL-6) and microRNA-17-5p (miR-17-5p) levels and the survivals after chemotherapy of the patients with ovarian cancer.Methods:65 patients with ovarian cancer treated with surgery combined with postoperative chemotherapy were selected as the ease group.50 healthy subjects were selected as the control groups.50 patients with benign ovarian diseases were selected as the benign disease group.The serum levels of IL-6 and miR-17-5p before the surgery and at 14 d after the surgery of the patients in the case group were detected and compared.The serum levels of IL-6 and miR-17-5p of the subjects in the control group and the benign disease group were detected and compared.The patients in the case group were followed up,the overall survival period (OS) and the progression free survival (PFS) were observed and compared.Results:The serum levels of IL-6 and miR-17-5p of the patients in the case group were significantly higher than those in the benign disease group.The serum levels of IL-6 and miR-17-5p of the patients in the benign disease were significantly higher than those in the control group,there were significant differences between the groups (P＜0.05).The serum levels of IL-6 and miR-17-5p of the patients in the case group at 14d after the surgery decreased significantly compared with those before the operation,the differences were statistically significant (P＜0.05).The ratio in TNM Ⅲ ～ Ⅳ stages in the patients with high expression of serum IL-6 or miR-17-5p was higher than that with low expression of serum IL-6 or miR-17-5p.the differences were statistically significant (P＜0.05).OS and PFS of the patients with high expression of serum IL-6 or miR-17-5p were significantly shorter than those with low expression of serum IL-6 or miR-17-5p,the differences were statistically significant (P＜0.05).OS and PFS of the patients with low expressions of both serum IL-6 and miR-17-5p were the longest,followed by the patients with low expression of single serum IL-6 or miR-17-5p,and OS and PFS of the patients with high expressions of both serum IL-6 and miR-17-5p were the shortest,the differences were statistically significant (P＜0.05).Conclusions:The patients with ovarian cancer show the significant increases of serum IL-6,miR-17-5p levels and the levels decline after the surgery.The high expressions of preoperative serum IL-6,miR-17-5p are associated with shorter survivals and poor prognosis,can be used as an indicator to predict patients' prognosis.

Objective:To observe the effect of oral administration of dietary fiber (DF) on flatus and defecation promotion and abdominal distension reduce,as well as the impact on exclusive breastfeeding and adverse reactions.Method:A total of 80 pregnant women who received repeated cesarean section at obstetrics department in Shanxi Provincial People's Hospital(2016.12 ～ 2017.03) were randomly divided by computer into two groups.DF group included 40 cases,and the patients took DF (1 bag,15g,with 200ml warm boiled water) 6h after cesarean section in 10min,and repeated it 8 ～ 12 h after operation.Patients in control group only received 200ml warm boiled water at the same point-in-time.The two groups shared the same dietary guidance,nursing and medical treatment.Bowel sound,flatus and defecation conditions as well as the incidence rates of abdominal distension and exclusive breastfeeding were compared between two groups.The adverse reactions after administration of DF were collected.Result:There were 38(97.4 ％)cases that had bowel sound in 12h pro-operation in DF group.There were 25(62.5 ％) cases that had bowel sound in 12h pro-operation in control group.There were 30(76.9 ％) and 12(30.0 ％) cases had first flatus during 24h pro-operation respectively in DF group and in control group.There were 22 (56.4 ％) and 7 (17.5 ％)cases had first defecation ＜48h pro-operation respectively in DF group and in control group.The differences were all statistically significant (P ＜ 0.01).In the comparison of gastrointestinal reaction,there were more cases reported abdominal distension(3,7.7％;12,30.0％) and nausea (3,7.7％ ∶10,25.0 ％),with statistical significances (P ＜ 0.05).There was no statistical significance (1,2.6 ％ ∶ 4,1.0 ％,P ＞ 0.05) in vomiting.Breast feeding rate was no statistical significance (56.％ ∶52.5 ％,P ＞ 0.05).One case of DF group discovered adverse reactions,such as nausea and vomiting.Conclusion:Oral administration of soluble DF significantly promoted the flatus and defecation after repeated cesarean section,however,patients with intestinal irritability need to be paid more attention to the adverse reactions,such as nausea and vomiting.

Objective To investigate the efficacy and safety of different applications of oxytocin during caesarean delivery in the patients with severe preeclampsia.Methods Clinical data of 124 patients with severe preeclampsia in Shanxi Provincial People's Hospital from March 2012 to May 2014 were selected.All cases were divided into study group and control group with 62 patients in each group according to different treatments.The patients in control group were injected oxytocin in corpus alone, The patients in observation group were received intravenous infusion combined with oxytocin injection in corpus.Intra-operative and postoperative&nbsp;bleeding amount, hospital stays, anus exhaust time, activity time and adverse reactions were compared between two groups.Results The bleeding amount of intra-operative, 2 h after and 24 h postoperative in the study group [(368 ±35.7) mL,(112 ±18.7) mL, (467 ±50.4) mL] were lower than that in control group [(445 ±34.5) mL,(174 ±20.5) mL,(610 ±75.3) mL] (P<0.05).The incidence of adverse reactions in the the study group (14.5 %) was lower than that in control group (46.8 %), (P<0.05).The hospital stay in the control group was ( 7.8 ±1.35 ) d and ( 5.6 ±0.96 ) d in the study group.The mean anus exhaust time were [(42.2 ±4.85) h and(30.4 ±4.57) h respectively].Postoperative activity out of bed days were(31.5 ±2.68)h and(23.8 ±2.57) h, the differences were statistically significant ( P <0.05 ) .Conclusion Oxytocin intravenous infusion combined with oxytocin injection in corpus can effectively reduced intra-operative or postoperative bleeding amount and incidence of adverse reactions, also improve clinical indexes.

目的：调查导乐仪对产妇分娩镇痛的作用效果。方法采用自行设计的导乐仪镇痛随访调查表，对拟实行导乐仪镇痛的300例产妇分别于分娩镇痛前与镇痛后进行问卷调查，评价产妇对导乐仪镇痛的态度，并与同期未实施镇痛的515例分娩产妇在总产程、阴道出血量、助产方法、新生儿评分方面进行对比。结果分娩镇痛前93％的产妇认为产痛难以忍受，表现紧张、恐惧，91％的产妇迫切要求分娩镇痛，25％的产妇担心导乐仪镇痛会对胎儿产生影响。分娩镇痛后97％的产妇对镇痛的效果表示满意，与同期未行镇痛分娩的产妇相比总产程有显著统计学意义（P ＜0．01），2组产妇阴道出血量、助产方法、新生儿评分差异无统计学意义（P ＞0．05）。结论导乐仪分娩镇痛有利于加快产程，促进自然分娩，减轻产妇疼痛，是一种科学的助产方式，有必要在临床积极开展。