ABSTRACT
Objective To explore the clinical effect of free postnatal delivery in the second stage of labor, and to provide evidence for clinical midwifery. Methods From March 2016 to November 2017, 120 maternity patients from the First People′s Hospital of Hefei were selected and divided into research group and control group, using simple random grouping and the method of random number table, with 60 cases in each group. At the second stage of delivery, the research group used free body position at different stages, while the control group took the position of supine bladder lithotomy position. The delivery outcome, duration of the second stage, postpartum vaginal bleeding within two hours, newborn asphyxia rate, degree of perineal laceration, perineum incision rate, delivery comfort and satisfaction and midwives job satisfaction were compared. Results The vaginal delivery rate of the research group was 96.7％(58/60), which was higher than that of the control group 86.7％ (52/60). The difference was statistically significant (χ2=3.93, P<0.05). The duration of the second stage in the research group was (31.97 ± 9.85) minutes, and that of the control group was (39.50 ± 12.19) minutes. There was a statistically significant difference between the two groups (t=-3.357, P<0.05). There was no significant difference in neonatal asphyxia rate and the amount of postpartum vaginal bleeding within 2 hours between the two groups (P>0.05). The perineum integrity rate in the research group was 10.4％(6/58), higher than that in the control group, which was 0. Perineal side cut rate in the research group was 0, lower than that in the control group, which was 21.1％(11/52). The difference was statistically significant (χ2=11.31, 13.63, P<0.05). Deliverycomfort, delivery satisfaction and midwives job satisfaction in the research group were 91.7％ (55/60), 100.0％ (60/60) and 100.0％ (60/60) respectively, while delivery comfort, delivery satisfaction and midwives job satisfaction in the control group were 38.3％(23/60), 83.3％(50/60) and 76.7％(46/60). The differences were statistically significant (χ2=37.51, 10.91, 15.85, P<0.05). Conclusion The second labor stage free position is effective safe childbirth way of delivery, which can improve the natural births, shorten the labor, lighten the perineal injury, improve the puerpera childbirth comfort and satisfaction, it also raised the midwives job satisfaction, and had no adverse effect on maternal and infant outcomes, so the method has clinical application and dissemination value.
ABSTRACT
Objective To study the relationship between serum retinal binding protein 4 (RBP4) level and acute cerebral infarction,and to analyze the correlation between RBP4 level and the related risk factors of acute cerebral infarction.Methods One hundred and sixty patients with acute cerebral infarction were chosen as observation group,and 80 cases of contemporaneous healthy examined people were selected as control group.The levels of serum RBP4,body mass index (BMI),fasting blood glucose (FBG),fasting serum insulin (FINS),glycosylated hemoglobin (HbA1c),total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) and blood pressure after admission of each group were measured.Statistic analysis was processed between the level of serum RBP4 and acute cerebral infarction or related risk factors.Results The level of serum RBP4 in observation group was increased compared with that in control group [(41.68 ± 5.12) mg/L vs.(23.84 ± 3.26) mg/L],and there was significant difference (P ＜ 0.01).The Pearson relative analysis showed positive correlation between the level of serum RBP4 and related risk factors of acute cerebral infarction FBG,FINS,LDL-C,BMI,systolic pressure.The Logistic stepwise regression analysis suggested that BMI,LDL-C and age were independently associated with the level of serum RBP4.Conclusion RBP4 plays an important role in the incidence of acute cerebral infarction,high RBP4 level may be one of the dangerous factors of acute cerebral infarction patients and could provide reference to prevents the cerebral infarction.