简介：孕产妇死亡率是代表卫生工作水平的重要指标之一。浙江绍兴地区对三级妇幼保健网络进行孕产妇死亡监测近20年来，孕产妇死亡率持续下降，围生质量大大提高。但近几年孕产妇死亡率有所回升，现就本地区1986年至2004年孕产妇死亡监测资料作一回顾性分析。

简介：AbstractAs a highly infectious respiratory tract disease, coronavirus disease 2019 (COVID-19) can cause respiratory, physical, and psychological dysfunction in patients. Therefore, pulmonary rehabilitation is crucial for both admitted and discharged patients of COVID-19. In this study, based on the newly released pulmonary rehabilitation guidelines for patients with COVID-19, as well as evidence from the pulmonary rehabilitation of patients with severe acute respiratory syndrome, we investigated pulmonary rehabilitation for patients with COVID-19 having complications, such as chronic pulmonary disease, and established an intelligent respiratory rehabilitation model for these patients.

简介：AbstractOutbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.

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简介：2009年4月30日《新商报》报道，大连19岁少女小欣，3年做7次人工流产手术，她到医院复诊后，竟还问医生，以后带朋友一起来。能不能优惠。

简介：目的：提高对脑梗死死亡病例临床特点的认识。方法：对19例脑梗死死亡患者的临床资料进行回顾性分析。结果：①患者多为年老、丧偶、伴有生活事件、合并脑卒中后抑郁，存在脑卒中的多种危险因素。②全部病例合并多器官功能障碍综合征（MODS）。③其中有15例合并血管性痴呆（VD）。④头颅CT或MRI存在严重的脑组织损害，表现多个病灶、重要部位的梗塞。15例VD患者中13例检出脑白质损害和脑室扩大，脑沟、回、裂增宽加深。结论：本组病例危险因素复杂，大多数患者合并VD、MODS，临床难以救治，重症病例的抢救不仅仅是原发病的救治，而是要针对整个机体多器官系统。

简介：目的：提高剖宫产手术后子宫疤痕妊娠的诊治水平。方法：收集2007—2010年本院收治的19例剖宫产术患者的临床资料，对19例患者进行剖宫产术后子宫疤痕妊娠分析。结果：19例患者均治愈出院（1例患者子宫切除），对患者进行随访无异常，化疗期间没有严重副反应。结论：提高剖宫产术后子宫疤痕妊娠的诊治水平有利于最大限度地保留患者的生育能力，提高患者的生存质量。

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简介：摘要目的通过分析已发表经同行评议的妊娠合并COVID-19的研究，总结COVID-19孕妇的临床表现、实验室检查及母婴结局，全面了解COVID-19孕妇的母婴情况，探索新型冠状病毒的宫内垂直传播证据。方法检索2019年12月1日至2020年4月9日PubMed、Embase、中国知网、中华全文数据库、万方数据库发表的妊娠合并COVID-19的文献，并在世界卫生组织COVID-19数据库和纳入文献的参考文献中进行补充检索，纳入新型冠状病毒核酸检测阳性、报告母婴结局或COVID-19孕妇继续妊娠并报告母胎情况的文献。分别通过阅读摘要和全文进行文献筛选，对最终纳入的文献提取并分析孕产妇临床表现、围产期结局及新生儿结局进行系统回顾。结果（1）最终纳入29篇文献中，146例病毒核酸阳性确诊孕妇，其中114例（2例双胎）孕妇分娩116例新生儿。8例（5.5%，8/146）重症孕妇，包括5例重型COVID-19，3例未明确分型但入住重症监护室治疗。69.9%（102/146）剖宫产，8.2%（12/146）阴道分娩，20.5%（30/146）继续妊娠，1例（0.7%，1/146）双向情感障碍发作中孕期（孕26周）引产，1例（0.7%，1/146）早孕期（孕6周）人工流产。发热（58.2%，85/146）、咳嗽（32.9%，48/146）是常见的症状；15.8%（23/146）入院时无感染相关症状；20.5%（30/146）产后出现感染相关症状或原有症状加重。实验室检查中，主要为淋巴细胞减少（49.6%，56/113）和C-反应蛋白升高（58.4%，66/113）。肺部CT以双肺多发斑片状毛玻璃影多见（79.7%，94/118）。（2）92.2%（107/116）新生儿结局良好。7.8%（9/116）新生儿有不同程度异常，其中6例有呼吸困难、发绀及呕吐等表现，包括1例进展为多器官功能障碍、弥散性血管内凝血死亡；1例生后36 h病毒核酸检测阳性；1例死产，死亡原因未述，但排除宫内垂直传播；1例病情较重孕妇剖宫产分娩的新生儿死亡。结论COVID-19孕妇重症比例低，妊娠结局良好，虽有新生儿不良结局报道，但缺乏宫内垂直传播证据。

简介：摘要目的探讨紧张性木僵患者的护理体会。方法对2010年1月～2015年6月我院收治的19例木僵患者在安全护理、心理护理及生活护理方面的临床护理实践，进行回顾分析。结果所有病例无并发症发生，木僵状态得到缓解，均痊愈出院。结论加强安全护理、心理护理及生活护理是提高本病治愈率，降低复发率的关键。

简介：摘要As a highly infectious respiratory tract disease, coronavirus disease 2019 (COVID-19) can cause respiratory, physical, and psychological dysfunction in patients. Therefore, pulmonary rehabilitation is crucial for both admitted and discharged patients of COVID-19. In this study, based on the newly released pulmonary rehabilitation guidelines for patients with COVID-19, as well as evidence from the pulmonary rehabilitation of patients with severe acute respiratory syndrome, we investigated pulmonary rehabilitation for patients with COVID-19 having complications, such as chronic pulmonary disease, and established an intelligent respiratory rehabilitation model for these patients.

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简介：摘要目的系统分析2019新型冠状病毒肺炎（COVID-19）患者的凝血特征。方法计算机检索PubMed、Scopus、Web of Science、EMbase、中国知网数据库，搜集报道COVID-19凝血特征相关的文献，检索时限均为2020年1月1日至5月1日。由2名研究员独立筛选文献、提取数据并评价纳入研究的偏倚风险后，采用Stata12.0软件对不同疾病分型COVID-19患者的血小板计数、D-二聚体、凝血酶原时间（PT）、活化的部分凝血活酶时间（APTT）、纤维蛋白原（FIB）进行Meta分析。结果共纳入39个回顾性研究，共计6 994例COVID-19患者。Meta分析结果显示：（1）与重症患者相比，轻症患者的血小板计数较高［加权均值差（WMD）=20.11，95%CI 11.53~28.69，P<0.001］，APTT（WMD=1.30，95%CI 0.31~2.30，P=0.01）更长，D-二聚体（WMD=-0.41，95%CI-0.58~-0.24，P<0.001）、FIB（WMD=-0.58，95%CI-0.76~-0.39，P<0.001）较低，凝血酶原时间（PT）（WMD=-0.51，95%CI-0.92~-0.10，P<0.001）更短；危重患者血小板计数较低（WMD=-14.75，95%CI-29.73~-0.23，P=0.044），D-二聚体较高（WMD=1.06，95%CI 0.65~1.47，P<0.001）。（2）与存活组相比，死亡组患者血小板计数较低（WMD=-36.40，95%CI-63.23~-9.58，P=0.008），D-二聚体较高（WMD=6.86，95%CI4.15~9.57，P<0.001），PT（WMD=1.37，95%CI0.73~2.02，P<0.001）更长。结论凝血功能紊乱在重症、危重症和死亡的COVID-19患者中较常见。血小板计数、D-二聚体和PT值与病情严重程度相关，可作为住院期间病情恶化的早期预警指标。

简介：摘要After severe COVID-19 disease, many patients will experience a variety of problems with normal functioning and will require rehabilitation services to overcome these problems. The principles of and evidence on rehabilitation will allow an effective response. These include a simple screening process; use of a multidisciplinary expert team; four evidence-based classes of intervention (exercise, practice, psychosocial support, and education particularly about self-management); and a range of tailored interventions for other problems. The large number of COVID-19 patients needing rehabilitation coupled with the backlog remaining from the crisis will challenge existing services. The principles underpinning vital service reconfigurations needed are discussed.

简介：Herpeszosterisanacutedermatosiscausedbychlckenpoxvirusinflammationandmarkedmainlybyviolentpainandcord-likeherpesontheskinsurface.IntraditionalChinesemedicine,itistermedas"SheChuanChuang"(蛇串疮).Theintolerablepainexitsinthewholeprocessofthediseaseevenafewweeksormonthsafterdisappearanceoftheherpes,causingthepatienttosufferalot.FromAprilof1997toJuneof2002,theauthoradoptedacupoint-injectionandacupuncturetherapiestotreat19casesofherpeszosterandachievedsatisfactoryresults,hereisthereport.

简介：低钠血症是临床常见的电解质紊乱，但重度低钠血症可因血钠下降后脑细胞水肿导致低钠性脑病。现将近年来在临床工作中收治的低钠性脑病患者19例谈谈自己的治疗体会。

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简介：摘要The global outbreak of coronavirus disease 2019 has created an unprecedented challenge to the society. Currently, the United States stands as the most affected country, and the entire healthcare system is affected, from emergency department, intensive care unit, postacute care, outpatient, to home care. Considering the debility, neurological, pulmonary, neuromuscular, and cognitive complications, rehabilitation professionals can play an important role in the recovery process for individuals with coronavirus disease 2019. Clinicians across the nation′s rehabilitation system have already begun working to initiate intensive care unit-based rehabilitation care and develop programs, settings, and specialized care to meet the short- and long-term needs of these individuals. We describe the anticipated rehabilitation demands and the strategies to meet the needs of this population. The complications from coronavirus disease 2019 can be reduced by (1) delivering interdisciplinary rehabilitation that is initiated early and continued throughout the acute hospital stay, (2) providing patient/family education for self-care after discharge from inpatient rehabilitation at either acute or subacute settings, and (3) continuing rehabilitation care in the outpatient setting and at home through ongoing therapy either in-person or via telehealth.

简介：摘要目的探讨阴道分娩时造成会阴Ⅲ度裂伤原因及防治措施。方法通过对1９84年１月-２０10年1月我院发生的19例会阴Ⅲ度裂伤进行回顾性分析总结，其中4例合并直肠粘膜损伤；产钳助产1例,胎吸助产1例,臀位助产1例,肩难产1例,7例合并外阴、阴道炎；3例会阴发育差、组织脆硬；3例为急产；巨大儿1例；所有病例均及时修补。结果17例会阴伤口甲级愈合，1例伤口愈合不良、1例合并直肠阴道瘘，均行二期缝合后痊愈，肛门括约肌功能恢复，远期随访无异常，2例出现医疗纠纷。结论正确处理产程,加强预防措施可避免会阴三度裂伤，一旦发生裂伤应及时修补缝合，并重视及与病人及家属的沟通,可有效减少医疗纠纷。

简介：摘要目的新型冠状病毒肺炎(COVID-19)是由引起严重急性呼吸综合征的2019新型冠状病毒(2019-nCoV)导致的全球流行性疾病，能否为COVID-19的危重患者进行探索性、抢救性的肺移植手术在移植学界引起了广泛讨论。到目前为止国内有报道COVID-19危重患者接受了肺移植，对于这类探索性、抢救性肺移植手术，移植术后相关治疗及预后情况尚无结论。本文主要从相关肺移植与病毒感染指南、肺移植适应证、术后并发症、伦理、卫生经济学等方面阐述这一争论，并思考COVID-19肺移植手术在未来的发展方向。