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目的:通过临床流行病学调查,排摸嘉兴市剖宫产儿泪道异常基本情况。从产后早期应用特定手法按压式的人为干预,探讨是否对解除或缓解剖宫产儿因泪道形成异常而引发的婴幼儿泪囊炎有效。方法:应用笔者依据新生儿解剖特点和临床经验设计的,为重建新生儿鼻泪道正常解剖状态而模仿分娩机转挤压的人工按压手法,双盲选择产后早期应用于观察组120例新生儿,与681例对照组新生儿进行对比研究。结果:681例剖宫产后对泪道不作干预的对照组阳性反馈229例、120例剖宫产后进行泪道手法按压干预的观察组阳性反馈17例,观察组出现症状的随访阳性率为14.17%,而对照组为33.63%,两组间的差别经统计学分析有显著性差异(u=8.31>2.58(0.01),χ2=19.11,P<0.01);186例自然分娩后不作干预的对照组阳性反馈13例、247例自然分娩后对泪道作手法按压干预的观察组阳性反馈19例,两组间无统计学差异(u=0.40<1.96(0.05),χ2=0.006,P>0.05);自然分娩不干预组与剖宫产后不干预组的组间差别比较则存在显著性差异(u=5.68>2.58(0.01),χ2=33.53,P<0.01)。结论:产后早期应用按压泪道的特定手法方便、简洁、有效,无损新生儿与婴幼儿,值得在临床尤其农村地区基层医院推广应用。
Objective: Through clinical epidemiological investigation, Pai-line cesarean section in children lacrimal duct anomalies basic situation. From the early postpartum application of a specific method of pressing the human intervention to explore whether to relieve or relieve cesarean section due to abnormal lacrimal duct caused by infants and young children dacryocystitis effective. Methods: According to the anatomical characteristics and clinical experience of the newborn, the author designed to imitate the manual pressing method of delivery squeezing to reconstruct the normal anatomy of nasal lacrimal passages. 120 cases of newborns , And compared with 681 control group newborns. Results: In the control group of 681 cesarean sections who did not intervene in the lacrimal passage, positive feedback was obtained in 229 cases and in 120 cases after laparotomy for lacrimal passage, 17 cases were positive feedback in the observation group. The positive rate of follow-up in the observation group was The difference between the two groups was statistically significant (u = 8.31> 2.58 (0.01), χ2 = 19.11, P <0.01). There was no significant difference in 186 cases of spontaneous labor after intervention There were 13 positive cases in the control group and 247 cases in the observation group who responded to manipulation of the lacrimal duct after spontaneous delivery. Positive feedback was found in 19 cases, with no significant difference (χ = 0.40 <1.96 (0.05), χ2 = 0.006, P> 0.05). There was significant difference between the two groups (u = 5.68> 2.58 (0.01), χ2 = 33.53, P <0.01) between the non-intervention group and the non-intervention group after cesarean section. CONCLUSION: The specific method of applying lacrimal passage in early postpartum period is convenient, concise, effective and non-destructive to infants and young children. It is worth to be popularized in clinic, especially in primary hospitals in rural areas.