目的:探讨医生助理协助的健康管理模式对孕产妇保健的效果。方法:选取2022年1月至2023年12月在暨南大学附属第一医院门诊产检自愿选择医生助理协助通过线上线下健康管理指导至产后42天的全流程服务的健康管理组孕妇1020人,随机配对选取...目的:探讨医生助理协助的健康管理模式对孕产妇保健的效果。方法:选取2022年1月至2023年12月在暨南大学附属第一医院门诊产检自愿选择医生助理协助通过线上线下健康管理指导至产后42天的全流程服务的健康管理组孕妇1020人,随机配对选取同期规律产检提供常规保健服务的1020名孕妇作为对照组,比较两组孕妇对孕期知识掌握度及就医满意度,对两组孕妇心境情绪进行评估,对妊娠常见合并症和并发症及分娩结局进行比较。结果:通过加强孕期保健管理后,健康管理组的孕产妇孕期知识掌握度及就医满意度明显高于对照组,健康管理组的孕妇心理疾病及妊娠期并发症发病率低,其中妊娠期糖尿病孕妇的孕期血糖控制良好,且巨大儿、新生儿窒息率低,围产期并发症总发生率低,差异有统计学意义(P Objective: To explore the effectiveness of a health management model assisted by physician assistants for maternal and child health care. Methods: A total of 1020 pregnant women who voluntarily chose to receive a full-process health management service (including both online and offline health guidance) from January 2022 to December 2023 at the outpatient obstetrics clinic of the First Affiliated Hospital of Jinan University were selected as the health management group. Another 1020 pregnant women who received routine prenatal care were randomly selected as the control group. The two groups were compared in terms of knowledge acquisition about pregnancy, satisfaction with healthcare services, mood assessments, common pregnancy-related complications, and delivery outcomes. Results: Enhanced antenatal care management significantly improved pregnancy-related knowledge and satisfaction with medical services among the health management group compared to the control group. The incidence of mental health issues and pregnancy complications was lower in the health management group. Specifically, pregnant women with gestational diabetes in the health management group had better blood glucose control, and the rates of macrosomia and neonatal asphyxia were lower. The overall incidence of perinatal complications was also lower, with statistically significant differences (P < 0.05). Conclusion: The health management model for pregnant women assisted by physician assistants, combining both offline and online services, significantly improved maternal and child health care outcomes and better ensured the safety of mothers and infants. This model is worthy of clinical promotion and application.展开更多
本文报道一例孕中期先兆流产伴多重耐药菌感染患者,通过有效抗感染及保胎治疗,为有生机儿争取到了宝贵的促胎肺成熟时间、更大的出生体重以及更高的存活几率。妊娠期生殖道感染可造成不良妊娠结局的发生,个体化的治疗方案,尤其是药物种...本文报道一例孕中期先兆流产伴多重耐药菌感染患者,通过有效抗感染及保胎治疗,为有生机儿争取到了宝贵的促胎肺成熟时间、更大的出生体重以及更高的存活几率。妊娠期生殖道感染可造成不良妊娠结局的发生,个体化的治疗方案,尤其是药物种类、剂量和治疗周期的选择,对改善妊娠结局十分重要。This paper reports a case of a patient with threatened abortion with a multi-drug-resistant bacteria infection in the second trimester. Through effective anti-infection and fetal protection treatment, it gained valuable lung maturity time, greater birth weight and a higher survival rate for vigorous children. Reproductive tract infection during pregnancy can cause adverse pregnancy outcomes. A personalized treatment plan, especially the choice of drug type, dose and treatment cycle, is very important to improve pregnancy outcomes.展开更多
卵巢是转移性肿瘤的好发部位,继发性卵巢肿瘤常来源于胃肠道(最常见)、乳房和泌尿生殖道。近年来肠来源继发性恶性肿瘤有逐渐上升趋势,其临床症状与影像学多无特异性表现。本研究以一例继发性卵巢肿瘤为例,通过讨论病史、疾病临床特征...卵巢是转移性肿瘤的好发部位,继发性卵巢肿瘤常来源于胃肠道(最常见)、乳房和泌尿生殖道。近年来肠来源继发性恶性肿瘤有逐渐上升趋势,其临床症状与影像学多无特异性表现。本研究以一例继发性卵巢肿瘤为例,通过讨论病史、疾病临床特征、手术与化疗方案及护理的影响,进一步指导患者诊疗及护理。The ovary is a common site for metastatic tumors, and secondary ovarian tumors often originate from the gastrointestinal tract (most commonly), breast, and urogenital tract. In recent years, secondary malignant tumors of enteric origin have been on the rise gradually, and their clinical symptoms and imaging findings are mostly non-specific. In this study, a case of secondary ovarian tumor was taken as an example to further guide the diagnosis, treatment and nursing of the patient by discussing the history, clinical features of the disease, the influence of surgery and chemotherapy and nursing.展开更多
目的:调查孕晚期妇女睡眠状况与妊娠期营养和情绪的关系,为通过饮食干预改善孕期睡眠质量、降低围产期心理疾病提供依据。方法:选取2023年1月至2023年12月于暨南大学附属第一医院产检的245名孕晚期(孕周 ≥ 28周)孕妇进行横断面调查。...目的:调查孕晚期妇女睡眠状况与妊娠期营养和情绪的关系,为通过饮食干预改善孕期睡眠质量、降低围产期心理疾病提供依据。方法:选取2023年1月至2023年12月于暨南大学附属第一医院产检的245名孕晚期(孕周 ≥ 28周)孕妇进行横断面调查。使用匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index, PSQI)量表评价孕妇的睡眠质量,采用抑郁量表(Patient Health Questionnaire, PHQ-9)和焦虑量表(Generalized Anxiety Disorder-7, GAD-7)评估孕妇的抑郁和焦虑情绪。通过食物频率问卷(Food Frequency Questionnaire, FFQ)收集孕妇对29种营养素和12种食物种类的摄入量,同时记录其不同社会人口学资料、产科资料及心理学资料。结果:调查显示245名孕妇中有89例(36.33%)存在妊娠晚期睡眠障碍,156例(63.67%)无睡眠障碍。膳食纤维摄入量、坚果类食物摄入量、GAD-7评分和PHQ-9评分均与孕妇妊娠晚期睡眠障碍有关(P Objective: To investigate the relationship between sleep status and nutrition and mood during pregnancy in women in late pregnancy, and to provide a basis for intervening in sleep quality during pregnancy through diet and reducing perinatal mental illness. A cross-sectional survey was conducted on 245 pregnant women in late pregnancy (gestational age ≥ 28 weeks) who received prenatal check-up at the First Affiliated Hospital of Jinan University from January to December 2023. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of pregnant women. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) were used to assess whether pregnant women had depression and anxiety, respectively. The intake of 29 nutrients and 12 food types of pregnant women was collected through a food frequency questionnaire (FFQ), and the relationship between various nutritional components in the diet of pregnant women with different sociodemographic, obstetric and psychological data and sleep disorders in late pregnancy was recorded. Methods: A total of 245 pregnant women were investigated, 89 cases (36.33%) had sleep disorders in late pregnancy, and 156 cases (63.67%) had no sleep disorders. Dietary fiber intake, nut food intake, GAD-7 score, and PHQ-9 score during pregnancy were all associated with sleep disorders in late pregnancy (P < 0.05). Logistic regression analysis showed that depression (OR = 0.089, 95% CI = 0.048~0.165) was an independent risk factor for sleep quality in late pregnancy (P < 0.05). The dietary fiber (13.28 ± 9.02 g/day) and nut intake (10.69 ± 14.73 g/day) of pregnant women in the sleep disorder group were lower than those in the non-sleep disorder group (18.18 ± 11.09 g/day;19.28 ± 38.86 g/day), which was statistically significant (P < 0.05). Compared with the sleep disorder group, the proportion of depression and anxiety in the non-sleep disorder group was also lower (P < 0.05). Conclusion: Sleep disorders in women during late pregnancy may be related to insufficient intake of dietary fiber and nuts. Targeted dietary intervention may improve mood during pregnancy by regulating maternal sleep.展开更多
妊娠合并急性胰腺炎是一种少见但潜在严重的疾病,甚至可能危及母婴生命。因此及时诊断和有效治疗对改善母婴预后十分重要。胆结石疾病与高甘油三酯血症是妊娠合并急性胰腺炎的常见病因。其中并发症风险最大的是由高甘油三酯血症引起的...妊娠合并急性胰腺炎是一种少见但潜在严重的疾病,甚至可能危及母婴生命。因此及时诊断和有效治疗对改善母婴预后十分重要。胆结石疾病与高甘油三酯血症是妊娠合并急性胰腺炎的常见病因。其中并发症风险最大的是由高甘油三酯血症引起的急性胰腺炎。此种类型胰腺炎的治疗重难点在妊娠期高脂血症的管理。目前国内外尚无指南。本文报道了一例妊娠合并急性胰腺炎的患者,并探讨了其诊断和治疗策略。本案例患者在使用双重血浆置换、非诺贝特、omega-3脂肪酸等降脂药物及其他治疗后病情得到显著改善,顺利分娩一活婴,为该疾病的诊治和妊娠期高脂血症的管理提供了很好的参考意义。Acute pancreatitis during pregnancy is a rare but potentially serious disease that may even endanger the life of the mother and child. Therefore, timely diagnosis and effective treatment are very important to improve maternal and infant prognosis. Gallstone disease and hypertriglyceridemia are common causes of acute pancreatitis during pregnancy. The highest risk of complications is acute pancreatitis caused by hypertriglyceridemia. The treatment of this type of pancreatitis is difficult in the management of hyperlipidemia during pregnancy. At present, there are no guidelines at home or abroad. This article reports a case of pregnancy complicated with acute pancreatitis, and discusses its diagnosis and treatment strategy. In this case, the patient’s condition was significantly improved after the use of lipid-lowering drugs such as double plasma exchange, fenofibrate, omega-3 fatty acids and other treatments, and a live baby was delivered successfully, which provided a good reference for the diagnosis and treatment of this disease and the management of hyperlipidemia during pregnancy.展开更多
妊娠合并感染性心内膜炎是导致孕产妇死亡的非产科因素的主要病因之一。该疾病早期临床表现多为发热、伴或不伴心脏杂音等非特异性症状为主,这也是不易早期诊断的原因之一。由于妊娠期女性血流动力学改变及免疫抑制状态,该疾病往往进展...妊娠合并感染性心内膜炎是导致孕产妇死亡的非产科因素的主要病因之一。该疾病早期临床表现多为发热、伴或不伴心脏杂音等非特异性症状为主,这也是不易早期诊断的原因之一。由于妊娠期女性血流动力学改变及免疫抑制状态,该疾病往往进展迅速,短时间出现急性心力衰竭、心源性休克、脓毒血症甚至呼吸心跳骤停等危及母胎生命的严重并发症。本文报道了1例妊娠中期合并感染性心内膜炎的患者,对其早期诊断及治疗方式进行讨论,旨在为临床治疗提供参考。Pregnancy with infective endocarditis is one of the main causes of non-obstetric factors leading to maternal mortality. The early clinical manifestations of this disease are unspecific symptoms such as fever with or without cardiac murmur, which is also one of the reasons for the difficulty of early diagnosis. Due to the hemodynamic changes and immunosuppression of women during pregnancy, the disease often progresses rapidly, and leads to serious complications such as acute heart failure, cardiogenic shock, sepsis and even respiratory and cardiac arrest occur in a short time. This paper reports a case of pregnancy woman with infective endocarditis, discussing its early diagnosis and treatment modalities, aiming to provide a reference for clinical treatment.展开更多
文摘目的:探讨医生助理协助的健康管理模式对孕产妇保健的效果。方法:选取2022年1月至2023年12月在暨南大学附属第一医院门诊产检自愿选择医生助理协助通过线上线下健康管理指导至产后42天的全流程服务的健康管理组孕妇1020人,随机配对选取同期规律产检提供常规保健服务的1020名孕妇作为对照组,比较两组孕妇对孕期知识掌握度及就医满意度,对两组孕妇心境情绪进行评估,对妊娠常见合并症和并发症及分娩结局进行比较。结果:通过加强孕期保健管理后,健康管理组的孕产妇孕期知识掌握度及就医满意度明显高于对照组,健康管理组的孕妇心理疾病及妊娠期并发症发病率低,其中妊娠期糖尿病孕妇的孕期血糖控制良好,且巨大儿、新生儿窒息率低,围产期并发症总发生率低,差异有统计学意义(P Objective: To explore the effectiveness of a health management model assisted by physician assistants for maternal and child health care. Methods: A total of 1020 pregnant women who voluntarily chose to receive a full-process health management service (including both online and offline health guidance) from January 2022 to December 2023 at the outpatient obstetrics clinic of the First Affiliated Hospital of Jinan University were selected as the health management group. Another 1020 pregnant women who received routine prenatal care were randomly selected as the control group. The two groups were compared in terms of knowledge acquisition about pregnancy, satisfaction with healthcare services, mood assessments, common pregnancy-related complications, and delivery outcomes. Results: Enhanced antenatal care management significantly improved pregnancy-related knowledge and satisfaction with medical services among the health management group compared to the control group. The incidence of mental health issues and pregnancy complications was lower in the health management group. Specifically, pregnant women with gestational diabetes in the health management group had better blood glucose control, and the rates of macrosomia and neonatal asphyxia were lower. The overall incidence of perinatal complications was also lower, with statistically significant differences (P < 0.05). Conclusion: The health management model for pregnant women assisted by physician assistants, combining both offline and online services, significantly improved maternal and child health care outcomes and better ensured the safety of mothers and infants. This model is worthy of clinical promotion and application.
文摘本文报道一例孕中期先兆流产伴多重耐药菌感染患者,通过有效抗感染及保胎治疗,为有生机儿争取到了宝贵的促胎肺成熟时间、更大的出生体重以及更高的存活几率。妊娠期生殖道感染可造成不良妊娠结局的发生,个体化的治疗方案,尤其是药物种类、剂量和治疗周期的选择,对改善妊娠结局十分重要。This paper reports a case of a patient with threatened abortion with a multi-drug-resistant bacteria infection in the second trimester. Through effective anti-infection and fetal protection treatment, it gained valuable lung maturity time, greater birth weight and a higher survival rate for vigorous children. Reproductive tract infection during pregnancy can cause adverse pregnancy outcomes. A personalized treatment plan, especially the choice of drug type, dose and treatment cycle, is very important to improve pregnancy outcomes.
文摘卵巢是转移性肿瘤的好发部位,继发性卵巢肿瘤常来源于胃肠道(最常见)、乳房和泌尿生殖道。近年来肠来源继发性恶性肿瘤有逐渐上升趋势,其临床症状与影像学多无特异性表现。本研究以一例继发性卵巢肿瘤为例,通过讨论病史、疾病临床特征、手术与化疗方案及护理的影响,进一步指导患者诊疗及护理。The ovary is a common site for metastatic tumors, and secondary ovarian tumors often originate from the gastrointestinal tract (most commonly), breast, and urogenital tract. In recent years, secondary malignant tumors of enteric origin have been on the rise gradually, and their clinical symptoms and imaging findings are mostly non-specific. In this study, a case of secondary ovarian tumor was taken as an example to further guide the diagnosis, treatment and nursing of the patient by discussing the history, clinical features of the disease, the influence of surgery and chemotherapy and nursing.
文摘目的:调查孕晚期妇女睡眠状况与妊娠期营养和情绪的关系,为通过饮食干预改善孕期睡眠质量、降低围产期心理疾病提供依据。方法:选取2023年1月至2023年12月于暨南大学附属第一医院产检的245名孕晚期(孕周 ≥ 28周)孕妇进行横断面调查。使用匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index, PSQI)量表评价孕妇的睡眠质量,采用抑郁量表(Patient Health Questionnaire, PHQ-9)和焦虑量表(Generalized Anxiety Disorder-7, GAD-7)评估孕妇的抑郁和焦虑情绪。通过食物频率问卷(Food Frequency Questionnaire, FFQ)收集孕妇对29种营养素和12种食物种类的摄入量,同时记录其不同社会人口学资料、产科资料及心理学资料。结果:调查显示245名孕妇中有89例(36.33%)存在妊娠晚期睡眠障碍,156例(63.67%)无睡眠障碍。膳食纤维摄入量、坚果类食物摄入量、GAD-7评分和PHQ-9评分均与孕妇妊娠晚期睡眠障碍有关(P Objective: To investigate the relationship between sleep status and nutrition and mood during pregnancy in women in late pregnancy, and to provide a basis for intervening in sleep quality during pregnancy through diet and reducing perinatal mental illness. A cross-sectional survey was conducted on 245 pregnant women in late pregnancy (gestational age ≥ 28 weeks) who received prenatal check-up at the First Affiliated Hospital of Jinan University from January to December 2023. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of pregnant women. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) were used to assess whether pregnant women had depression and anxiety, respectively. The intake of 29 nutrients and 12 food types of pregnant women was collected through a food frequency questionnaire (FFQ), and the relationship between various nutritional components in the diet of pregnant women with different sociodemographic, obstetric and psychological data and sleep disorders in late pregnancy was recorded. Methods: A total of 245 pregnant women were investigated, 89 cases (36.33%) had sleep disorders in late pregnancy, and 156 cases (63.67%) had no sleep disorders. Dietary fiber intake, nut food intake, GAD-7 score, and PHQ-9 score during pregnancy were all associated with sleep disorders in late pregnancy (P < 0.05). Logistic regression analysis showed that depression (OR = 0.089, 95% CI = 0.048~0.165) was an independent risk factor for sleep quality in late pregnancy (P < 0.05). The dietary fiber (13.28 ± 9.02 g/day) and nut intake (10.69 ± 14.73 g/day) of pregnant women in the sleep disorder group were lower than those in the non-sleep disorder group (18.18 ± 11.09 g/day;19.28 ± 38.86 g/day), which was statistically significant (P < 0.05). Compared with the sleep disorder group, the proportion of depression and anxiety in the non-sleep disorder group was also lower (P < 0.05). Conclusion: Sleep disorders in women during late pregnancy may be related to insufficient intake of dietary fiber and nuts. Targeted dietary intervention may improve mood during pregnancy by regulating maternal sleep.
文摘妊娠合并急性胰腺炎是一种少见但潜在严重的疾病,甚至可能危及母婴生命。因此及时诊断和有效治疗对改善母婴预后十分重要。胆结石疾病与高甘油三酯血症是妊娠合并急性胰腺炎的常见病因。其中并发症风险最大的是由高甘油三酯血症引起的急性胰腺炎。此种类型胰腺炎的治疗重难点在妊娠期高脂血症的管理。目前国内外尚无指南。本文报道了一例妊娠合并急性胰腺炎的患者,并探讨了其诊断和治疗策略。本案例患者在使用双重血浆置换、非诺贝特、omega-3脂肪酸等降脂药物及其他治疗后病情得到显著改善,顺利分娩一活婴,为该疾病的诊治和妊娠期高脂血症的管理提供了很好的参考意义。Acute pancreatitis during pregnancy is a rare but potentially serious disease that may even endanger the life of the mother and child. Therefore, timely diagnosis and effective treatment are very important to improve maternal and infant prognosis. Gallstone disease and hypertriglyceridemia are common causes of acute pancreatitis during pregnancy. The highest risk of complications is acute pancreatitis caused by hypertriglyceridemia. The treatment of this type of pancreatitis is difficult in the management of hyperlipidemia during pregnancy. At present, there are no guidelines at home or abroad. This article reports a case of pregnancy complicated with acute pancreatitis, and discusses its diagnosis and treatment strategy. In this case, the patient’s condition was significantly improved after the use of lipid-lowering drugs such as double plasma exchange, fenofibrate, omega-3 fatty acids and other treatments, and a live baby was delivered successfully, which provided a good reference for the diagnosis and treatment of this disease and the management of hyperlipidemia during pregnancy.
文摘妊娠合并感染性心内膜炎是导致孕产妇死亡的非产科因素的主要病因之一。该疾病早期临床表现多为发热、伴或不伴心脏杂音等非特异性症状为主,这也是不易早期诊断的原因之一。由于妊娠期女性血流动力学改变及免疫抑制状态,该疾病往往进展迅速,短时间出现急性心力衰竭、心源性休克、脓毒血症甚至呼吸心跳骤停等危及母胎生命的严重并发症。本文报道了1例妊娠中期合并感染性心内膜炎的患者,对其早期诊断及治疗方式进行讨论,旨在为临床治疗提供参考。Pregnancy with infective endocarditis is one of the main causes of non-obstetric factors leading to maternal mortality. The early clinical manifestations of this disease are unspecific symptoms such as fever with or without cardiac murmur, which is also one of the reasons for the difficulty of early diagnosis. Due to the hemodynamic changes and immunosuppression of women during pregnancy, the disease often progresses rapidly, and leads to serious complications such as acute heart failure, cardiogenic shock, sepsis and even respiratory and cardiac arrest occur in a short time. This paper reports a case of pregnancy woman with infective endocarditis, discussing its early diagnosis and treatment modalities, aiming to provide a reference for clinical treatment.
