在产妇中应用心理护理的方法

目的 观察心理护理在产妇中应用的临床效果.方法 护理组100例,入院前后至分娩全过程运用心理护理;对照组100例,采用常规护理.结果 护理组产后出血量和产程时间分别为100mL和(7～9)h,对组照产后出血量和产程时间分别为140mL和(11～13)h.结论 在产妇中应用心理护理的方法可缩短产程,减少产后出血量,提高产科分娩质量.     

自由体位分娩在产科的应用体会

目的探讨产妇在分娩过程中采取自由体位对分娩的影响。方法选取住院孕产妇156例,随机分为有可比性的2组,观察组产妇在第二产程根据个人情况采取自由体位;对照组采取截石位。统计2组第二产程时间及新生儿窒息情况,并对2组产妇产后2、12h舒适度进行随访。结果观察组第二产程时间较对照组明显缩短;产后2、12h舒适度观察组明显高于对照组。2组比较差异显著,有可比性(P<0.05)。结论将自由体位应用于分娩第二产程,可以有效缩短产程时间,缓解产妇不适。     

产妇的心理特点及心理护理

产妇分娩是人类繁衍的自然规律,但由于躯体的变化,对分娩知识缺乏,剧烈的宫缩痛,引起不良的心理状态,导致产程延长,新生儿窒息,产后出血等并发症,给母婴生命安全带来了威胁。加强心理护理,保证良好心理状态,确保分娩顺利进行。     

分娩镇痛方法的应用

目的探讨分娩镇痛的几种常用方法的应用及效果。方法选择近2年在本院分娩的产妇,对进行不同镇痛方法组与未镇痛对照组的镇痛效果的分析。结果两组在新生儿Apgar评分方面无显著差别,而在降低剖腹产率,缩短产程方面明显优于对照组。结论产妇分娩可以根据实际条件,选择合适的方法实现无痛分娩。     

导乐式分娩的临床观察

目的探讨新的服务模式-导乐陪伴分娩在产程中的作用。方法我院分娩的120例产妇随机抽取导乐陪伴分娩的60例为导乐组,无导乐组陪产的60例为对照组,对新的服务模式及常规服务模式在产程中的作用进行对照分析。结果导乐组产程缩短(平均产程<6.74h),且无需使用镇痛药物;导乐组产后出血量明显少于对照组(P<0.01)。结论导乐陪伴式分娩有利于提高产时服务质量,减少了对自然分娩的干扰,需要手术助产的比率降低,生产和产后的出血量也会减少,新生儿的发病率也呈降低趋势,更加有利于母婴健康。     

罗哌卡因复合芬太尼硬膜外麻醉用于无痛分娩的临床分析

目的探讨罗哌卡因与芬太尼联合应用于分娩镇痛对产程、分娩方式、母婴合并症的影响。方法采用硬膜外腔阻滞麻醉(CEA)用于单胎、初产、足月、无其他合并症产妇300例作为试验组,随机选择同期条件相似,未进行任何镇痛处理的产妇300例作为对照组。分别纪录2组的产程时间、新生儿体重、剖宫产和阴道助产指征、胎儿宫内窘迫、新生儿窒息、产后出血、胎膜残留、尿潴留情况。结果镇痛组活跃期较对照组明显缩短,而第二产程较对照组长,总产程、第三产程及新生儿体重2组比较,差异无显著性。镇痛组剖宫产率差异无显著性,缩宫素使用率明显高于对照组。镇痛组的阴道助产指征产程停滞最为常见,而在剖宫产指征中则枕位异常比例最高。镇痛组的尿潴留发生率高,而胎儿宫内窘迫、新生儿窒息、产后出血、胎膜残留2组比较均无差异。结论分娩镇痛可使第一产程缩短,第二产程延长,不影响总产程,不增加剖宫产和阴道助产几率,对母婴均较为安全。     

产程中安定纱布湿敷处理宫颈水肿32例临床分析

目的探讨形成宫颈水肿的相关因素及其相应处理方法。方法观察我院2004年1月至2007年12月在产程中出现宫颈水肿的住院分娩产妇32例,采用纱布浸安定药液湿敷宫颈,再根据引起宫颈水肿的不同原因采取相应的措施,观察产程的进展以及并发症的发生情况。结果通过以上综合处理可有效防治宫颈水肿,达到缩短产程,减少宫颈撕裂伤的发生。结论纱布浸安定药液湿敷宫颈配合早期徒手复位对宫颈水肿有预防作用,并可缩短产程,降低剖宫产率。     

临产妇的心理护理干预的效果分析

在分娩过程中,临产妇的心理状态对分娩影响很大,本文通过257例临产妇的心理护理,使产妇处于最佳的心理状态,对分娩的顺利进行起很好的效果。     

“一对一”陪伴分娩的临床及社会意义研究

目的探寻一种更加人性化的分娩服务模式,以提高孕产妇及围产儿质量,减少医患之间的摩擦。方法以2006年9、10月份在本院实行"一对一"全程陪伴分娩的头位初产妇310例为实验组,2005年9、10月份在我院经阴道分娩的头位初产妇330例为对照组,分别对她们的活跃期间、第二产程时间、软产道裂伤及新生儿窒息等情况进行回顾性调查,并同时对实验组的产妇及其丈夫针对陪伴分娩的多项事宜进行产后随访及实行"一对一"陪伴分娩1年来和1年前医疗纠纷的发生情况进行对照比较等社会意义的调查。结果实验组与对照组相比,实验组的产程时间明显缩短,产后出血及软产道裂伤减少,新生儿窒息率明显降低,社会满意度明显增加,医患矛盾明显减少。结论"一对一"陪伴分娩较少了产妇分娩时的恐惧心理,增强了她们对阴道分娩的信心,从而改善和加速了产程,更好的完成了阴道分娩过程。同时,丈夫陪伴后更加深夫妻之间的感情,淡化了他们对婴儿性别的看法,减少性别歧视,其意义深远。     

谈基层医院产房的安全隐患与防范

目的探讨基层医院产房存在的安全隐患及防范措施,减少和杜绝医疗纠纷的发生。方法查找并分析产房工作中现存和潜在的护理安全问题,学习相关法律法规知识,完善产房管理制度,提高产房人员业务素质,规范书写分娩过程相关记录。结果工作质量明显提高,差错事故及护理纠纷显著下降,产妇满意度提高。结论通过查找基层医院产房存在的安全隐患并制定防范措施,我院产房工作质量有了很大提高,减少了医疗纠纷的发生,提高了我院的社会效益和经济效益。     

低成本大口径碳纤维复合材料天线反射面制造及应用

通过对室温固化环氧树脂/碳纤维体系材料的选择和成型工艺的研究,采用室温湿法固化和真空袋压相结合的成型工艺成功制造出大口径碳纤维复合材料天线反射面,其成本较中温固化成型降低50%以上。该反射面已用于口径1.2m的车载抛物面天线,满足Ka及Ka以下频率的使用要求。     

Ozone applications for after‐clearing of disperse‐dyed poly(lactic acid) fibres

In this study, the effectiveness of the ozonation process, in neutral distilled water at room temperature, as a clearing process for disperse‐dyed poly(lactic acid) fibre fabrics is investigated. The efficiency of simultaneous decolorisation of dyebath effluent and clearing of dyed poly(lactic acid) in the cooled dyebath after completion of the poly(lactic acid) dyeing cycle is also explored. Conventional alkaline reduction clearing with sodium dithionite was chosen as a control clearing process for comparison. Wash fastness, colour difference, colour removal (in Hazen) and chemical oxygen demand values were determined and compared. Long ozone treatment times at high ozone dose resulted in unacceptable colour differences. The colour difference problem was solved by use of lower ozone dose; however, a warm soaping step had to be added to the after‐clearing sequence in order to achieve the desired fastness properties. A 33% reduction on the chemical oxygen demand load of the total process (dyeing + after‐clearing) could be achieved by ozone after‐clearing instead of using a conventional reduction clearing treatment. The addition of the warm soaping step to improve the fastness properties of the ozonated samples increased the total chemical oxygen demand of the process (dyeing + ozonation in water + warm soaping), but a 12–18% reduction on the chemical oxygen demand load of the total process was observed when compared with the conventional treatment sequence (dyeing + reduction clearing).     

FA composition of cholesteryl esters and phospholipids in maternal plasma during pregnancy and at delivery and in cord plasma at birth

The purpose of this study was to assess the FA composition of both cholesteryl esters (CE) and phospholipids (PL) in maternal plasma during pregnancy and at delivery and in umbilical plasma at birth. A longitudinal study of 32 normal pregnant women was carried out with three cutoff points during pregnancy (first, second, and third trimester) and at delivery. Few significant differences occurred in the FA profile of maternal CE: 18∶1n−9 increased, 18∶2n−6 dropped slightly, and 18∶3n−3 decreased with progressing gestation. In maternal PL, long-chain highly unsaturated FA concentrations dropped and were replaced by saturated FA as gestation progressed. Additionally, changes in saturated FA in PL occurred: Shorter-chain 16∶0 was higher whereas longer-chain 18∶0 was lower at delivery compared to early pregnancy. The FA profile of umbilical venous plasma was strikingly different from that of maternal plasma at delivery. Cord plasma CE contained more saturated and monounsaturated FA than maternal CE. The polyunsaturates 18∶2n−6 and 18∶3n−3 are lower in umbilical CE than in maternal CE whereas 20∶4n−6 and 22∶6n−3 are twice as high in umbilical CE. Cord plasma PL have a higher content of long-chain highly unsaturated FA than maternal plasma PL at delivery. In contrast to maternal plasma PL, 16∶0 was lower and longer-chain saturated FA were higher in cord plasma PL. The FA profile of umbilical plasma at birth shows preferential accumulation of 20∶4n−6 and 22∶6n−3, with low concentrations of 18∶2n−6 and 18∶3n−3 in CE and PL, indicating a preferential supply of the fetus with long-chain highly unsaturated FA needed for fetal development.     

Thermal modeling of a controlled environment greenhouse cum solar distillation for composite and warm humid climates of India

The present study is concerned with the analysis of solar desalination system combined with a greenhouse for both composite and warm humid climate of India. Analytical expressions for water temperature, greenhouse room air temperature, glass cover temperature, flowing water mass over the glass cover, hourly yield of fresh water and thermal efficiency have been derived in terms of design and climatic parameters for a typical day of summer and winter period. Temperature rise of flowing water mass with respect to distance and time in solar still unit has also been incorporated in the mathematical modeling. The effects of various still and design parameters on its performances have been discussed in detail. The yield of fresh water was found to be higher in warm humid climate than composite climate.     

Synthesis,degradation, and drug delivery of cycloaliphatic poly(ester anhydride)s

The high melting point of poly(1,4‐cyclohexanedicarboxylic anhydride) [poly(CHDA)] is a disadvantage, in that it is intractable in the melting process of a drug delivery system. This report relates to diols introduced into the polyanhydride main chain to decrease its melting point. Various poly(ester anhydride)s containing ethylene glycol, 1,3‐propanediol, 1,4‐butanediol, or 1,6‐hexandiol [poly(CHDA–XDO)] were synthesized by the esterification reaction and melt polycondensation. FTIR, DSC, WAXD, and intrinsic viscosity of polymers were recorded and hydrolytic degradation, as well as in vitro drug delivery, was conducted. The results show that the samples are stable in an anhydrous environment at room temperature and degrade in water following a surface erosion mechanism. The degradation period of poly(CHDA–XDO) ranged from 130 to 320 h as a result of the different diols and amounts of XDO introduced. The in vitro drug delivery gave 130–350 h of stable delivery along with the typical surface erosion mechanism. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 86: 2509–2514, 2002     

Kinetics of sol-to-gel transition for poloxamer polyols

Kinetics of gelation for aqueous solutions of poloxamers 407 and 288 were determined using pulse shearometry. The principle of this method for determining the shear modulus of a semisolid was based on generation of a torsional force that is transmitted through the poloxamer sample at discrete time intervals. Three distinct linear phases were observed for the log dynamic shear modulus (G′) vs. time profiles as poloxamer 407 and 288 solutions of varying concentrations were allowed to passively warm at room temperature to a temperature exceeding the sol-to-gel transition temperature, T_m. The beginning of the second exponential phase coincided with the onset of the gelation process as determined by visual observation. Although gelation appeared visually to be complete at the beginning of the third exponential phase of the log G′ vs. time profiles, this last exponential phase may indicate the rate of formation of the polymer network. A comparison of poloxamer 407 [30% (w/w); T_m = 10.9°C] and poloxamer 288 [37% (w/w); T_m = 11.1°C] would suggest that the concentration of poloxamer required to achieve approximately the same gelation temperature for poloxamers having a similar ratio of poly(oxypropylene):poly(oxyethylene) units decreases with increasing molecular weight of the poly(oxypropylene) hydrophobe contained in the copolymer. Results of these preliminary studies suggest that the gelation process was significantly (p < .05) more rapid for poloxamer 407 at a 30% (w/w) concentration compared to a 30% (w/w) solution of poloxamer 288 when the poloxamer solutions were allowed to passively warm at room temperature. In addition, it appears that the rate of gelation for the poloxamer solutions studied was dependent on the rate of heat transfer through the polymer solution.     

剖宫产后再次妊娠的手术选择讨论

目的研究和探讨剖宫产后再次妊娠的手术选择和对母婴的影响。方法对进行剖宫产后再次妊娠的71例孕妇做回顾性分析,其中再次剖宫产59例,阴道分娩12例;并选取同期相同人数的孕妇进行对比。结果剖宫产后阴道分娩(VBAC)组和首次阴道分娩(VBNC)组分娩数据没有明显差异;产后出血、切口愈合和发生粘连方面,再次剖宫产(RCS)组明显高于首次剖宫产(PCS)组;VBAC组在产后出血和康复阶段明显优于RCS组。结论剖宫产后阴道分娩对比再次剖宫产,在产后出血量、切口恢复情况明显较好,住院天数也较短。     

Mechanical and Tribological Behavior of Warm Rolled Al-6Si-3Graphite Self Lubricating Composite Synthesized by Spray Forming Process

In this investigation, the mechanical and tribological behavior of warm rolled Al-6Si-3Gr (graphite) self-lubricating composite have been studied. A spray forming process was used to synthesize the composite. The graphite particles were reinforced externally into the jet of the spray of molten Al-Si alloy. The porosity was generated under the spray forming process that was eliminated by the secondary process (warm rolling). Warm rolling was carried out with 20, 40, 60 and 80% thickness reduction in multi-passes on high non-reversing mills. Refinement and distribution of silicon and graphite particles in the composite were increased. The mechanical properties namely hardness and strengths were also improved by warm rolling. Wear properties of the composite after each thickness reduction were also investigated under dry sliding condition. Composite after warm rolling showed the better results in the coefficient of friction and wear rate. Wear properties improvement, nature of the debris particles and mechanical properties of the composite after warm rolling were discussed in details with its microstructural features. Different characterization techniques were also used to support the prediction of change in properties. The load bearing capacity of the composite was increased by warm rolling. These composites could be used for those applications where load bearing capacity and less wear is required.     

63例头位难产临床特点分析及处理

目的探讨头位难产的临床特点及处理方法,以提高产科质量。方法对我科近期分娩的569例产妇进行回顾分析,发生头位难产63例。分析其发生难产的原因、处理方法、分娩方式以及产后的并发症等。结果63例头位难产,行剖宫产38例,占60.3%;产钳术9例,占14.3%;胎头吸引术18例,占28.6%;自然分娩8例,占12.7%。无新生儿及孕产妇死亡病例发生。结论正确识别,及时处理和选择合适的分娩方式是减少头位难产的关键。     

The composition of saturated fatty acids in plasma phospholipids changes in a way to counteract changes in the mean melting point during pregnancy

It has been demonstrated that in pathological conditions with an increase in the calculated mean melting point (MMP) of phospholipid (PL) fatty acids (FA) there are changes in the composition of the saturated FA (SFA), which partially counteract this effect: shorter-chain SFA with lower melting points are increased, while longer-chain less fluid SFA are suppressed. The aim of this study was to determine whether there are differences in MMP during pregnancy and in the newborn and, if so, whether similar adaptive changes occur in the composition of the SFA The FA composition of plasma PL was determined in healthy women (n-16) twice during pregnancy (15–24 wk and 29–36 wk) and at delivery and in umbilical venous blood obtained at birth. The MMP of maternal PL was significantly higher at delivery compared to mid-gestation, due to a loss of highly unsaturated FA (HUFA) which were replaced by SFA. In addition, changes in the SFA occurred; 16∶0 with lower melting point was higher while 18∶0 with higher melting point was lower at delivery. MMP of PL FA in umbilical plasma was lower than in maternal plasma at delivery, which was due to higher HUFA content. In contrast to maternal plasma, 16∶0 was lower while 18∶0, 20∶0 and 24∶0 were higher in umbilical plasma resulting in a higher MMP of SFA, tending to raise the overall MMP. It can be concluded that, during pregnancy and in the newborn, the FA composition of SFA changes in a way to counteract changes in MMP induced by reduced and increased HUFA, respectively.