影响剖宫产妇母乳喂养的因素及对策

对１７９例剖宫产妇进行了调查，分析了影响剖宫产妇母乳喂养因素，制订并实施了一系列促进母乳喂养的整体护理措施，包括心理疏导和支持，增强母乳喂养信心；强化母乳喂养知识宣教；根据剖宫产妇的特点，协助并指导母乳喂养的技巧，术后６ｈ进食，促进乳汁分泌；强化免疫接种，阻断母婴传播等使宫产产妇纯母乳喂养率达到９８％。     

孕期乳房按摩对促进母乳喂养的效果研究

目的研究孕期乳房按摩对促进母乳喂养的效果。方法选取2014年3月—2014年12月在广东省清远连州市妇幼保健院定期检查并怀孕36周的产妇84例作为研究对象,抽签随机分为观察组与对照组,每组42例。对观察组每天进行乳房与乳头按摩1~2次(37周前不作乳头按摩);对照组不作乳房乳头按摩,仅采取常规的孕期检查与护理。比较两组产妇产后泌乳始动时间、始动泌乳量、纯母乳喂养率以及不同喂养方式对婴儿体内血红蛋白数、钙、锌、铁含量的影响。结果泌乳始动时间观察组(15.9±2.6)h快于对照组(24.4±2.7)h;始动泌乳量观察组(24.61±4.95)m L多于对照组(13.27±4.56)m L,两组比较均有统计学意义(P0.05)。6个月纯母乳喂养率观察组92.8%高于对照组61.9%,两组比较有统计学意义(P0.05)。6个月母乳喂养的婴儿血红蛋白数、钙、锌、铁含量均高于人工喂养的婴儿,比较有统计学意义(P0.05)。结论孕期乳房按摩对母乳喂养的促进效果显著,能明显加快泌乳始动时间,提高始动泌乳量,增加纯母乳的喂养率,提高婴儿体内血红蛋白数、钙、锌、铁含量。     

三维超声检测不同分娩方式及第二产程产妇肛提肌裂孔差异

本研究的目的为探讨肛提肌裂孔是否受分娩方式及第二产程的影响。选取产妇200例,其中剖宫产100例,阴道分娩100例,同时选取未生育的育龄女性100例作为对照组,采用三维超声观察三组研究对象肛提肌裂孔大小,计算肛提肌裂孔周径及面积。结果显示:阴道分娩组静息、Valsalva状态下肛提肌裂孔周径和面积明显高于剖宫产组与对照组(P<0.05);阴道分娩组第二产程>1 h产妇静息、Valsalva状态下肛提肌裂孔周径和面积明显高于第二产程≤1 h产妇(P<0.05);阴道分娩组总产程>12 h产妇静息、Valsalva状态下肛提肌裂孔周径和面积明显高于总产程≤12 h产妇(P<0.05)。阴道分娩及第二产程明显影响产妇肛提肌裂孔。     

恒温消解测定食品中微量碘方法的改进研究

在原有催化动力学测碘方法的基础上，对样品的消化处理方法进行了改进，使消化时间由原来的平均２ｈ缩短至６０ｍｉｎ，测试费用降低了８０％，结果精密度与准确度未降低。     

舒适护理对剖宫产产妇术后应激反应及疼痛的影响

目的探讨舒适护理对剖宫产产妇术后应激反应及疼痛的影响。方法选取2012年6月至2015年4月来江西省丰城市泉港镇卫生院行剖宫产的足月产妇74例为研究对象。按照入院顺序抽签后随机分为实验组和对照组,对照组孕产妇采取常规护理,对孕产妇进行手术前的准备工作,做好手术中的生命体征监测,术后做好全面的护理。在此基础上,实验组孕产妇进行舒适护理。观察产妇SAS评分、各项临床观察指标时间。结果实验组产妇术后第3 d SAS评分低于对照组(P0.05)。实验组肛门排气恢复时间、下地活动时间、泌乳时间均低于对照组(P0.05)。实验组产妇术后24 h CORT水平低于对照组(P0.05)。结论舒适护理可改善产妇疼痛,减少应激反应。     

妊娠中期(孕中)产时产后乙肝母婴阻断多重综合干预的效果分析

目的探讨乙肝母婴阻断多重综合干预的临床效果。方法选取广州市花都区妇幼保健院于2013年1月—2014年1月收治的110例慢性无症状乙肝病毒携带者孕妇作为研究对象,按照传染程度分为第1组(高复制传染组)和第2组(低复制传染组),婴儿出生前后多次注射乙肝基因疫苗,监测乙肝病毒感染标志物(HBVM)及HBV-DNA。结果第1组母婴阻断率为65例(97.01%),宫内感染率2例(2.99%),第2组母婴阻断率43例(100%),两组乙肝母婴平均阻断率为98.51%,两组宫内感染率平均为1.495%;新生儿出生时第1组和第2组抗-HBs阳性率分别达68.66%、93.02%,半岁时第1组和第2组抗-HBs阳性率分别达94.03%、100%,两组抗-HBs(+)平均达97.01%,差异有统计学意义(P0.05)。结论通过妊娠中期、产时产后对乙型肝炎母婴阻断实施多重综合干预措施,提高乙肝母婴阻断率,有效阻断了母婴传播途径。     

低位产钳助产术在临床中的应用

目的探讨低位产钳助产术的适应证和术后母婴并发症情况。方法对天津市武清区中医医院2010年1月—2015年6月施行低位产钳助产术的产妇40例的临床资料回顾分析。结果对母体的影响:会阴裂伤发生率7.5%,阴道壁裂伤的发生率为5%,宫颈裂伤发生率为2.5%,产后出血的发生率为7.5%,切口感染的发生率为2.5%。对于新生儿的影响:轻度窒息发生率为5%,面部皮肤擦伤发生率为7.5%,头皮血肿发生率为5%,锁骨骨折发生率为2.5%,臂丛神经受损发生率为2.5%。结论低位产钳助产术作为解决产科难产的一种有效手段其安全性和成功率都比较高,不但能挽救母婴生命,还能有效降低剖宫产率,具有一定的临床应用价值。     

镧对软腐欧文氏菌生长及其胞外酶活性的影响

研究了镧对软腐细菌（Ｅｒｗｉｎｉａｃｈｒｙｓａｎｔｈｅｍｉ，Ｅｃｈ）生长及胞外酶活性的影响。结果表明，Ｌａ３＋浓度为５０、１００、１５０、２００、２５０、３００和３５０ｍｇ／Ｌ时，固体培养中对Ｅｃｈ生长均呈抑制作用，且随浓度提高，抑制作用加强，表现为菌落出现时间比对照延长，７ｄ后的菌落直径比对照减小。液体培养中，浓度＜２００ｍｇ／Ｌ，Ｌａ在２４ｈ内对Ｅｃｈ生长有轻微刺激作用；但随着浓度提高和培养时间的延长，Ｅｃｈ生长明显受到抑制。当Ｌａ３＋浓度＞３５０ｍｇ／Ｌ，Ｅｃｈ生长基本处于停止状态；浓度为２００ｍｇ／Ｌ，对Ｅｃｈ产生胞外酶能力有一定影响，其中对纤维素酶活性增强最明显，其次是蛋白酶，而对果胶酶活性有减弱作用。经稀土处理的无细胞滤液对马铃薯块茎组织的浸离力降低。     

浅析广州市花都区预防梅毒母婴传播的实施成效

目的了解花都区开展预防梅毒母婴传播阻断项目的实施成效,降低梅毒母婴传播率。方法对首次就诊的孕产妇进行梅毒筛查,对检出的梅毒阳性孕产妇进行规范治疗,并对其所生婴儿进行随访管理。结果 2012—2016年感染产妇孕期确诊率达71.18%,接受规范治疗率达53.02%,新生儿预防性治疗率75.8%,儿童3月龄梅毒检测率为50.86%,6月龄检测率42.55%。结论实施预防梅毒母婴传播项目,可以有效地阻断梅毒的母婴传播,降低梅毒母婴传播率,提高妇女儿童的健康水平。     

W－Mn／SiO_2催化剂甲烷氧化偶联制乙烯流化床工艺条件考察

本文报导了浸渍法制备的Ｗ－Ｍｎ／ＳｉＯ_２催化剂分别在Φ２８和Φ３８毫米反吹式流化床上进行的条件试验和３００ｈ稳定性试验结果。并用ＸＲＤ、ＦＴ－ＩＲ、ＢＥＴ等方法对催化剂进行了表征。结果表明，该催化剂可适用于流化床，并具有较好的ＣＨ４氧化偶联制Ｃ２烃的催化活性和稳定性。催化剂的结构研究表明，经３００ｈ反应后，该催化剂中结晶形式的Ｎａ_２ＷＯ_４和Ｍｎ_２Ｏ_３均已消失；α－方石英结构已完全转变为α－磷石英和α－ＳｉＯ_２石英，但催化剂的这种结构变化尚未对生成Ｃ２烃的收率和选择性产生明显影响。     

产妇及其新生儿全血微量元素含量调查和研究

本文是产妇及其新生儿全血微量元素调查研究系列论文中第一篇。介绍了本研究的起因、目的和本研究的大体情况以及规划。     

Trace elements determination by energy dispersive X-ray fluorescence (EDXRF) in human placenta and membrane: a comparative study

This work is an application of energy dispersive X-ray fluorescence (EDXRF) as an analytical technique for trace elemental determination in human membrane and placenta and elemental concentrations correlations in both tissues. Whole samples were collected during the delivery from healthy mothers and full-term pregnancies. The age of the mother was between 25 and 40 years old, and the weight of the infants ranged from 2.56 to 4.05 kg. Samples were lyophilised and analysed without any chemical treatment. No significant differences in elemental content of placenta and membrane samples were observed except for Ca. Very low levels of Se, As and Pb were observed in all the analysed samples. Zn, considered as one of the key elements in newborn health, was not significantly different in the analysed samples, all of which originated from healthy mothers and healthy babies. The obtained values agree with the literature except for Ca, which is much higher in the studied samples.     

Elemental analysis of human amniotic fluid and placenta by total-reflection X-ray fluorescence and energy-dispersive X-ray fluorescence: child weight and maternal age dependence

This work is an attempt to evaluate the possible influence of the mother's age in trace element concentrations in human amniotic fluid and placenta and whether these concentrations are correlated to the weight of the newborn infants. Total-reflection X-ray fluorescence (TXRF) was used to analyze 16 amniotic fluid samples, and the placenta samples were analyzed by energy dispersive X-ray fluorescence (EDXRF). The whole samples were collected during delivery from healthy mothers and healthy infants and full-term pregnancies. According to the age of the mother, three different groups were considered: 20–25, 25–30 and 30–40 years old. Only two mothers were aged more than 35 years. The weight of the infants ranged from 2.56 to 4.05 kg and three groups were also considered: 2.5–3, 3–3.5 and 3.5–4 kg. The organic matrix of the amniotic fluid samples was removed by treatment with HNO₃ followed by oxygen plasma ashing. Yttrium was used as the internal standard for TXRF analysis. Placenta samples were lyophilized and analyzed by EDXRF without any chemical treatment. Very low levels of Ni and Sr were found in the amniotic fluid samples, and were independent of the age of the mother and weight of the child. Cr, Mn, Se and Pb were at the level of the detection limit. Zn, considered one of the key elements in neonatal health, was not significantly different in the samples analyzed; however, it was weakly related to birth weigh. The concentrations obtained ranged from 0.11 to 0.92 mg/l and 30 to 65 μg/g in amniotic fluid and placenta, respectively. The only two elements which seemed to be significantly correlated with mother's age and newborn weight were Ca and Fe for both types of sample: Ca levels were increased in heavier children and older mothers; however, Fe increased with increasing maternal age, but decreased for heavier babies. The same conclusions were obtained for placenta and amniotic fluid samples. Cu is closely associated with Fe in its function in the organism and has a similar behavior to this element, but not as pronounced.     

产妇及新生儿头发微量元素检测106例

初步调查106对新生婴儿及其母体头发中的锌、铁、铜、钙含量，同时对不同胎龄及体重进行比较，结果胎发与母发的微量元素有一定差异，这个差异在38周以前就已存在，其具体表明为胎发锌，铁高于母发，铜含量低子母发，钙含量同母发相近，但胎发钙同胎龄及新生儿有正相关关系，其它元素在本调查中无此发现。     

新生儿与孕妇间发中锌钢关系探讨

将１０４１名新生儿与１０００名孕妇发中Ｚｎ、Ｃｕ含量进行了统计对比分析，发现新生儿发中Ｚｎ、Ｃｕ含量分别高于和低于孕妇发中的Ｚｎ、Ｃｕ值．新生儿发Ｚｎ分布曲线与孕妇的显著不同．峰形尖锐，峰值右移．趋近正态分布，而两者的发Ｃｕ分布曲线比较类似。说明在一定范围内，胎儿体内的Ｚｎ含量可能受母体Ｚｎ含量影响不大，Ｃｕ含量关系密切。可能是由于母体向胎儿输送Ｚｎ、Ｃｕ的机制及胎儿对两元素的吸收和排泄机能存在差异所致。     

贯彻落实"一法两纲"、全面实现妇幼卫生工作目标

１９９９年是全面实现“两纲”目标的关键一年,莆田市卫生局以改革为动力,以初级卫生保健为龙头,认真贯彻落实“一法两纲”,深化妇幼卫生改革,为解决提高住院分娩率,降低孕产妇女及婴儿死亡率的工作难点,狠抓乡镇卫生院的产科建设和基层专业人员的业务培训,加强卫生信息管理,加大执法监督力度,提高服务质量,坚持依法行政。     

糖尿病母亲及其新生儿全血14种微量元素的研究

为了解糖尿病母亲及其新生儿全血微量元素的分布情况，采用日本岛津ICPQ－1012型高频等离子体发射光谱仪检测了糖尿病母亲及其新生儿的全血14种微量元素。以正常产妇及足月新生儿病例为对照组，观察糖尿病母亲及其新生儿的全血14种微量元素的改变。结果糖尿病母亲铜元素高于正常产妇，铬、锰、锌元素低于正常产妇，糖尿病母亲新生儿铜元素高于正常新生儿，锌、锰、镁、铬元素低于正常新生儿。糖尿病母亲新生儿镁、镍、铜、锌、钙、钼、锶、铁低于糖尿病母亲。结论：糖尿病母亲血铬、锌、锰元素低于正常，铜元素增高是由于糖尿病疾病所引起，糖尿病母亲新生儿铜元素增高，血镁、钙、锰、锌等低于正常，与糖尿病母亲本身微量元素特点有关。糖尿病母亲新生儿血镁、镍、铜、锌、钙、钼、锶、铁元素低于糖尿病母亲与先天发育不足有关。     

Detection of the embryonic zeta chain in blood from newborn babies by reversed-phase high-performance liquid chromatography

Reversed-phase high-performance liquid chromatography (RP-HPLC) using the large-pore Vydac C4 column has been used to detect and quantitate the embryonic zeta chain in blood samples of normal babies and of newborns with varying degrees of alpha chain deficiencies. The zeta chain eluted at the end of the chromatogram at about 130 min using a modified and extended gradient. Its identity was confirmed by structural analysis of zeta chain isolated from a blood sample of a fetus without active alpha globin genes, i.e. with hydrops fetalis (--/--). The quantity of zeta in normal babies is less than 0.7% [% of (alpha + zeta)] and is dependent upon the maturity of the baby as it was only present in babies with low levels of beta chain or hemoglobin (Hb) A. The presence of a zeta globin gene deletion [A. E. Felice et al., Hum. Genet., 73 (1986) 221; and P. Winichagoon et al., Nucleic Acids Res., 10 (1982) 5853] did not affect the level of zeta in the newborn. All babies with an alpha-thalassemia-2 heterozygosity, i.e. with three active alpha globin genes or -alpha/alpha alpha, had zeta in a range of 0.1-0.9%; again the level showed a negative correlation with that of the beta chain. Newborns with an alpha-thalassemia-2 homozygosity or -alpha/-alpha had a varying level of zeta of 0.3-2.3%, which did not correlate with the level of beta, suggesting that zeta chain production persists after birth in this condition. Macrochromatographic analyses in combination with RP-HPLC indicated that the zeta chain is present as zeta 2 gamma 2 or Hb Portland-I, as expected.     

Establishment of an analytical method for accurate purity evaluations of acylcarnitines by using quantitative 1H NMR spectroscopy

Accreditation and Quality Assurance - Recently, it has become possible to examine metabolism abnormalities by detecting increases in specific acylcarnitines in blood tests of newborn babies using...     

维生素K缺乏致新生儿颅内出血病例讨论

报道了产妇长期未进食新鲜蔬菜导致维生素Ｋ缺乏引起新生儿颅内出血的病例。