目的 探讨双管喉罩与气管插管用于全身麻醉妇科腹腔镜手术的安全性和可行性。 方法 2009年1月-5月择期妇科腹腔镜手术患者60例，ASAⅠ～Ⅱ级，随机分为喉罩组（P组）和气管插管组（T组）。记录入室基础值（T0），置罩（管）前（T1），置罩（管）后即刻（T2），置罩（管）后5 min（T3 ），拔除罩（管）即刻（T4），拔除罩（管）后5 min（T5）的收缩压（systolic pressure, SBP），舒张压（diastolic pressure, DBP），心率（heart rate, HR）和脉搏血氧饱和度（pulse oxygen saturation, SpO2），喉罩和气管插管控制呼吸时气腹前后不同时段的气道峰压（airway. maximum pressure, Pmax），潮气量（vital volume, VT）和呼气末二氧化碳分压（end tidal CO2, PETCO2）。记录插罩（管）成功率，及相关并发症。 结果 T2时T组SBP，DBP和HR显著高于P组（P＜0.05），两组术中通气均满意；Pmax，VT和PETCO2组间比较各时点无差异（P＞0.05）。气腹后Pmax和PETCO2组内比较均高于气腹前，差异有统计学意义（P＜0.05）。置罩（管）成功率组间比较差异无统计学意义，拔罩（管）期及术后24 h并发症，喉罩组明显低于气管导管组，差异显著（P＜0.05）。 结论 双管喉罩用于全麻妇科腹腔镜手术通气效果满意，安全可行。
ObjectiveTo systematically review the effect and influence of gum chewing on the recovery of gastrointestinal function in gynecological patients after operation. MethodsEBSCO, MEDLINE, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials of gum chewing on gastrointestinal function recovery in patients after gynecological surgery from inception to September 30th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. RevMan 5.3 software was then used to perform the meta-analysis. ResultsA total of 9 studies were included, involving 962 patients. Meta-analysis results showed that the time of first flatus (MD=–8.34, 95%CI –10.72 to –5.95, P<0.000 01), the time of first defecation (MD=–14.97, 95%CI –29.28 to –0.66, P<0.04), and the recovery time of bowel sounds (MD=–5.83, 95%CI –10.15 to –1.51, P=0.008) of gum chewing group was significantly shorter than that of the control group, and the incidence of abdominal distension was decreased after gynecological surgery (RR=0.24, 95%CI 0.08 to 0.74, P=0.01). According to the results of subgroup analysis, the time of first flatus of the gum chewing group was significantly shorter than that of the control group in laparoscopy (MD=–5.43, 95%CI –7.12 to –3.73, P<0.000 01), laparotomy (MD=–10.46, 95%CI –13.56 to –7.97, P<0.000 01) and abdominal surgery (MD=–10.64, 95%CI –13.01 to –8.26, P<0.000 01); the first defecation time after laparotomy (MD=–29.18, 95%CI –46.03 to –12.33, P=0.000 7), and abdominal surgery (MD=–14.24, 95%CI –24.27 to –4.21, P=0.005) in chewing gum group was significantly shorter than that in the control group; however, there was no significant difference in the laparoscopy group (MD=–2.97, 95%CI –12.94 to 7.00, P=0.56). ConclusionsThe systematic review and meta-analysis shows that gum chewing after gynecological surgery can shorten the time of first flatus, first defecation, and first bowel movement, and reduce the incidence of abdominal distension. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
Objective To investigate infertile inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010, so as to provide baseline data for further research. Methods According to diagnosis criteria of WHO, we collected demographical characteristics, disease cause and cost constitution of infertility inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010. The data of each patient were input into ACCESS database and SPSS 13.0 was used for statistical analysis. Results a) From 2008 to 2010, there were 1 452 infertile patients from 33 different areas of mainland China, 79.7% of which was from the north of China. b) The mean age was 31.2±4.3 years old. The percentage of patients aged 30 to 34 years accounted for the most (40.3%). Mental laborers (23.3%) were more than physical laborers (7.2%). 36.7% of patients received education from universities and 83.1% of patients had family income ranging from 20,000 yuan to 190,000 yuan. c) The mean age of the first sexual activity was 21.4±2.9 years old. 53.7% of patients had only one sexual partner and most couples had sexual activities twice every week. The mean age of husbands was 32.9±5.5 years old with the highest percentage of 30 to 35 years old (39.2%). The percent of intellectual work of husband was the highest (35.9%). 64.9% of patients had normal semen analysis results and 23.0% never took related examination. d) 29.9% of patients was primary infertility and 70.1% was secondary infertility, of which 57.6% had either induced or medical abortion. The mean duration of infertility was 5.2±3.5 years (range 1 to 21 year). e) 76.3% of infertile patients had pelvic adhesion and 88.6% suffered from tubal disease. Among the tubal infertile patients, 23.6% had uterine disease, 5.2% had ovarian disease, 5.0% had endometriosis, 6.7% had multiple problems, and 4.8% had unexplained infertility. In patients with tubal infertility, the incidence of distal fimbria atresia (45.8%) was higher than that of proximal block (32.9%). 24.7% of patients with fimbria atresia had hydrosalpinx and among of them, 21.1% had no hydrosalpinx. 15.2% had congenital tubal defects. f) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person. The percentage of material cost was 29.1% and that of drugs was 18.2%. Conclusion a) The total number of infertile inpatients was 1 452 in gynecology department of Pingjin Hospital of Tianjin from 2008 to 2010. 79.7% of patient was from North China. Most of them were 30 to 34 years old and 44.3% had no job. The percentage of patients had university education and that of low-middle family income was the highest. Sexual activity was relatively traditional. Most husbands were 30 to 35 years old and intellectual workers, and 23.0% of them had never taken an examination of semen analysis. More patients were secondary infertile, and the duration of infertility was 1 to 21 years. b) 76.3% of patients had pelvic adhesion and 88.6% had tubal disease. The incidence of distal tubal fimbria atresia was higher than proximal tubal occlusion. c) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person which was further lower than each cycle cost of assisted reproductive technology. The overall costs included materials and drugs (47.3%), which were mainly at patients’ own expense.
目的：探讨妇科癌症患者疼痛的护理措施。方法：60例妇科癌症患者随机分为常规护理、特殊护理，观察疼痛治疗效果。结果：特殊护理患者疼痛缓解明显。结论：护理干预能改善患者疼痛。
目的 探究妇科投诉纠纷发生的状况及原因，以改进工作方式减少投诉现象。 方法 对2005年1月－2010年12月妇科门诊和病房发生的投诉及医患纠纷资料进行收集，并对其原因进行分类统计分析，提出相关应对措施。 结果 6年间门诊及病房共发生投诉41例，纠纷8例。其医务人员技术水平不到位、服务态度差、沟通缺乏，就医环境差、收费不合理、患者自身因素等是投诉纠纷发生的主要原因。 结论 妇科是纠纷易发科室，但只要采用有效的控制措施，就能减少甚至避免医患纠纷的发生，提高患者满意度。
目的 探讨妇科化学治疗（化疗）患者自我管理效能感与焦虑抑郁的关系。 方法 2011年10月－2012年1月采用中文版癌症自我管理效能感量表和医院焦虑抑郁量表对110例妇科化疗患者进行问卷调查。 结果 共收回有效问卷106份。33例（31.70%） 患者焦虑阳性，43例（41.30%） 抑郁阳性，35例（33.70%） 焦虑抑郁均为阳性；自我管理效能感得分为（86.31 ± 27.06）分，并与焦虑呈负相关（r = −0.793，P = 0.000），与抑郁呈负相关（r = −0.753，P = 0.000）。 结论 妇科化疗患者自我管理效能感与焦虑抑郁密切相关，在以后的护理工作中应该重视妇科肿瘤患者自我管理项目的构建，提高患者的自我效能，从而改善其心理状况。
Objective To explore strategies to reduce the same-day cancellation rate of gynecological day surgery. Methods The same-day cancellation status of gynecological surgery in the Department of Day Surgery, West China Second University Hospital, Sichuan University from January to December 2021 (before improvement) was investigated. The causes of cancellation were analyzed from three aspects: patient-related factors, medical factors, and examination factors. Subsequently, management countermeasures were formulated for the controllable factors and continuous quality improvement was implemented. After improvement, the same-day cancellation rate of gynecological day surgery from September 2022 to January 2023 was collected and compared with that before improvement. Results Continuous quality improvement was implemented targeting three factors in day surgery, namely the short interval between patient’s visit time and pre-scheduled time, the irrational sequence of preoperative examinations for patients, and the non-standardized treatment of patients with abnormal vaginal discharge by physicians. The same-day cancellation rates of gynecological day surgery before and after the continuous quality improvement were 3.70% (156/4211) and 2.13% (30/1411), respectively, and the difference was statistically significant (χ2=8.231, P=0.004). ConclusionOptimizing the preoperative examination and admission process, effective preoperative education and physician-patient communication, establishing unified standards for the approval of vaginal discharge tests and standardized treatment protocols, and clarifying the responsibilities of the preoperative comprehensive assessment outpatient clinic along with the supervision system are effective measures to reduce the same-day cancellation rate of gynecological day surgery.