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Objective:To analyze the influence of epidural labor analgesia on neonatal breast-seeking behavior and first breastfeeding.Methods:This study was an observational study. According to the cross-sectional study formula and inclusion and exclusion criteria, 150 cases of puerperas and their full-term infants who underwent vaginal delivery in the Affiliated Hospital of Southwest Medical University from March to September 2020 were included as the research objects, and the time of breast searching behavior in newborn crawling was observed and recorded. According to whether epidural analgesia was used or not, the patients were divided into analgesic group and non-analgesic group (the specific names of the two groups), and the outcome variables were analyzed.Results:There were 81 cases of successful breast crawl, 69 cases of failure, including 94 cases of epidural analgesia, 56 cases of non-epidural analgesia. Epidural analgesia had no effect on breast crawl and the time of breast searching behavior ( P>0.05). For puerperas with epidural analgesia, the total score of Breastfeeding Assessment Tool (IBFAT) and the scores of its four dimensions such as feeding time, foraging, sucking and nipple holding behavior were 9(7, 10), 3(2, 3), 2(2, 3), 2(1, 2), 2(1, 2), which lower than those non-epidural analgesia puerperas, which were 10(8, 10), 3(3, 3), 3(2, 3), 2(2, 2), 2(1, 2), the differences were statistically significant ( Z values were -6.36- -4.32, all P<0.05). Conclusions:When epidural analgesia is used clinically, medical staff need to seize the best time of drug use, pay attention to continuous monitoring of drug use duration and dosage, while exerting drug analgesia effect, it is also necessary to minimize adverse outcomes and reduce the impact of analgesics on breastfeeding.
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Objective:To understand and analyze the current situation of core competence of graduate midwives in standardized training in Sichuan Province, so as to provide a reference for the training of midwives in Sichuan Province.Methods:A total of 102 midwives who participated in standardized training and graduated from July 2016 to June 2018 in Sichuan Province were investigated by using general information questionnaire (including 14 items of general information, occupational literacy and hospital conditions) and Midwives Core Competence Scale (including 54 items and 6 dimensions). Among 109 questionnaires distributed, 102 valid questionnaires were collected. SPSS 21.0 was used to analyze the results by single factor analysis and multiple linear regression analysis.Results:The average total score of the core competency scale in this study was (203.470±32.398). The scores of postpartum health care and prenatal health care were relatively high, while the score of public health care was relatively low. Multivariate regression analysis showed that whether the maternal and infant health certificates were obtained during the training period, and whether there was a training system for midwives alone and arrangements of department rotation were the influencing factors of the core competence of the graduate midwives ( P<0.05). Conclusion:The core competence of midwives in standardized training in Sichuan province is at the middle level. The standardized training of midwives is at the initial stage and lack of systematic management. Hence, it is urgent to build a unified and standardized training system.
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Objective To explore the correlation between the occurrence of pulmonary infection after thoracotomy and preoperative pulmonary function indexes in patients with esophageal cancer,and to provide clinical theoretical basis for reducing the incidence of pulmonary infection after thoracotomy.Methods The clinical data of 80 patients with esophageal cancer who underwent thoracotomy from May 2017 to May 2018 in Qinhuangdao Military Industrial Hospital of Hebei Province were retrospectively analyzed.The patients were divided into infected group and uninfected group according to whether pulmonary infection occurred after operation.The preoperative maximal voluntary ventilation (MVV),MVV as a percentage of predicted value (MVV％pred),forced vital capacity (FVC),FVC as a percentage of predicted value (FVC％ pred),forced expiratory volume in one second (FEV1),FEV1 as a percentage of predicted value (FEV1％ pred),peak expiratory flow (PEF),PEF as a percentage of predicted value (PEF％ pred) of the two groups were compared and analyzed.Logistic regression was used to analyze the correlation between pulmonary function indexes and postoperative pulmonary infection.Results Postoperative pulmonary infection occurred in 24 out of 80 patients (30.00％).There was no correlation between gender (t =1.755,P =0.086),nationality (t =2.125,P =0.073) and the severity of pulmonary infection after operation.Age (t =4.084,P =0.024),smoking history (t =5.881,P =0.001),operation duration (t =3.583,P =0.041),intraoperative bleeding volume (t =5.115,P =0.003) and combined basic diseases (t =4.574,P =0.018) were significantly correlated with the severity of pulmonary infection after operation.MVV (x2 =4.242,P =0.039),MVV％ pred (x2 =4.405,P =0.036),FVC (x2 =17.500,P ＜0.001),FVC％pred (x2 =12.382,P ＜0.001),FEV1 (x2 =12.070,P =0.001) were associated with pulmonary infection.FVC (OR =9.102,95％ CI:2.691-28.213,P =0.027),FEV1 (OR =21.621,95％ CI:8.956-81.145,P =0.002) and MVV％ pred (OR =5.648,95％ CI:2.979-15.248,P =0.001) were high risk factors for pulmonary infection.Conclusion Partial pulmonary function indexes are significantly associated with postoperative pulmonary infection.It is necessary to strengthen the detection and improvement of preoperative pulmonary function in order to reduce the incidence of pulmonary infection.
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Objective To investigate the pressure of male nurses in women and children′s Hospital and analyze it, so as to provide decision support for nursing administrators. Methods Used general information questionnaire, Perceptual Stress Scale, China Nurses'Pressure Source Scale (CPSS) in Sichuan,Chongqing,Yunnan,Guizhou,Tibet and other places of the maternal and child hospital male nurses, and analyzed the results. Results According to the CPSS scoring standard,63 in 101 subjects(62.4%)male nurses were in the state of stress, and the average score of stress was 26.0 ± 7.4. Binary Logistic regression showed that the main factors of male nurses′pressure were the lack of support from parents and family,low income, less promotion opportunities and non-nursing work. Conclusion The pressure situation of male nurses in maternity and child care hospitalis affected by family, work, society and so on. Managers should timely relieve the stress for male nurses and maintain the stability of male nurses′team.
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Objective This study aimed to evaluate the relationships between preservation of the intercostobrachial(ICB) nerve and abnormal sensation of the arm,the total time of the surgery,and the number of dissected nodes in patients submitted to axillary lymphadenectomy in surgical treatment of breast cancer.Methods An prospective,randomized,and double blind intervention was performed on 85 patients at the Qinhuangdao Military Hospital in Hebei Province from July 2007 to August 2010.The patients according to whether the ICB nerve was preserved or not were randomly divided into two groups.The surgeries were performed by the same two surgeons.The postoperative evaluations were performed at 2 days,30 days,and 90 days.The abnormal sensation of the arm was subjectively evaluated with an questionnaire and objectively assessed with a neurologic examination.Results In the never preserved group,questionnaire found asymptomatic patients' proportion is up to 16/42,19/41,25/41 after 2 d,30 d and 90 d respectively; while in the resection group the result is 12/43,7/43,12/42.In the never preserved group,neurologic examination reported asymptomatic patients' proportion is up to 22/42,16/41,22/41 after 2 d,30 d and 90 d respectively; while in the resection group the result is 5/43,3/43,7/42.The results suggests that the abnormal sensation propotion in the intercostobrachial nerve preserved group is significantly less than the control group at the three above time points over (P ＜ 0.05).No significant difference was observed on the total time of the surgery and the number of dissected nodes between the two groups.During the 36 months follow up,no local relapse was found in the two groups.Conclusions The research support that the preservation of the ICB nerve is feasible and can lead to a significant decrease in the alteration of abnormal sensation of the arm,without interfering with the total time of the surgery,the number of dissected nodes,and local relapse rate.