We reported a case of a 30-year-old man who reportedly sustained electrical burns and fell from a high voltage electric pole about 50 meter high onto a metal that caused impalement injury. In addition, he sustained fu...We reported a case of a 30-year-old man who reportedly sustained electrical burns and fell from a high voltage electric pole about 50 meter high onto a metal that caused impalement injury. In addition, he sustained full-thickness burns of the right upper limb (7%), the right hemithorax, the perineum (sparing the penis), the anterior abdominal wall and the lateral aspect of both thighs. There was 43% burned surface area in total. Radiographic examination revealed a slender curved object extending from his perineum into the pelvis. The management of this case was a challenging one which was described in this article.展开更多
Background: Tactile imaging provides biomechanical mapping of soft tissues. Objective biomechanical and anatomical assessment of critical structures within the vagina and pelvis may allow development and validation of...Background: Tactile imaging provides biomechanical mapping of soft tissues. Objective biomechanical and anatomical assessment of critical structures within the vagina and pelvis may allow development and validation of a clinical tool that could assist with clinical decisions regarding obstetrical procedures and mode of delivery. Objective: To assess intraobserver reproducibility of measurements of perineal elasticity and pubic bone-perineal critical distance with a novel tactile probe in pregnant women. Methods: An Antepartum Tactile Imager (ATI) was designed with a vaginal probe resembling a fetal skull. The probe comprises 128 tactile sensors on a double curved surface and measures 46 mm in width and 72 mm in length. The probe has a motion tracking sensor that allows acquisition of 3D tactile images. There were two arms of the study. In the first arm, biomechanical mapping of the perineum and pelvic bone location was performed in 10 non-pregnant women for purposes of demonstrating safety and feasibility. In the second arm, biomechanical mapping was performed in 10 pregnant women to explore intraobserver reproducibility. Each subject had two standardized examinations over 3 - 5 minutes by the same observer. Examination comfort and pain levels were assessed by post-procedure survey. Reproducibility was analyzed by intraclass correlation coefficients (ICC) with 95% confidence intervals and Bland-Altman plots. Bias and the 95% limits of agreement were also calculated. Results: The safety and feasibility arm of the study demonstrated high degree of safety and tolerability and reliable acquisition of tactile signals. In the reproducibility arm, 10 pregnant women were recruited at mean gestational age of 34.2 ± 6.5 weeks. The mean perineum elasticity (Young’s modulus, E) was 9.8 ± 5.9 kPa, and the mean pubic bone-perineal critical distance (D) at 20 kPa load was 34.6 ± 6.2 mm. The ICC was 0.97 [95% confidence interval (CI) 0.91, 0.99] and 0.82 [CI 0.44, 0.95] for E and D respectively, consistent with excellent intrarater agreement. The bias and the 95% limits of agreement of E were -6.3% and -29.4% to +16.7%, respectively. The bias and the 95% limits of agreement of D were -2.6% and -25.3% to +20.2%, respectively. Conclusions: The tactile imaging data obtained in the study reproducibly characterized perineal elasticity and pubic bone-perineal critical distance. Further evaluation of this tool in clinical settings is warranted.展开更多
目的探讨床旁超声(腹部超声+会阴超声)检查预测足月分娩时机和方式的应用价值。方法回顾性分析2022年3月~2023年8月在佛山顺德爱博恩妇产医院建档产检并进行分娩的57例孕妇的临床资料,按实际分娩方式分为顺产组(n=48)和剖宫产组(n=9)。...目的探讨床旁超声(腹部超声+会阴超声)检查预测足月分娩时机和方式的应用价值。方法回顾性分析2022年3月~2023年8月在佛山顺德爱博恩妇产医院建档产检并进行分娩的57例孕妇的临床资料,按实际分娩方式分为顺产组(n=48)和剖宫产组(n=9)。所有孕妇在孕后期进行腹部超声+会阴超声检查,根据超声监测指标对分娩时机和方式进行预测和干预,并将预测结果与实际临产时间和分娩方式进行对比分析。结果主要监测指标单因素分析显示,两组差异无统计学意义(P>0.05);多因素Logistic回归分析表明,各监测指标对实际分娩方式无显著影响(P>0.05),各监测指标联合预测顺产的曲线下面积(Area under the curve,AUC)具有统计学意义(P=0.032<0.05);根据腹部超声+会阴超声检查结果预测分娩孕周均与实际分娩孕周相符,准确度为100%,预测分娩方式的准确度为91.38%,根据腹部超声+会阴超声预测结果进行干预的得当率为92.98%。结论床旁超声监测胎头下降距离、胎头-会阴距离、产程进展角和宫颈长度可以作为联合预测顺产的重要参考指标。各指标联合分析对临床预测分娩时机和选择分娩方式有指导作用,在预防产科紧急手术和控制分娩风险方面具有一定作用。展开更多
Objective:To discuss and analyze the effectiveness of the application of perineal wound model in teaching midwife interns.Methods:The research subjects in this study were 40 midwife interns who enrolled in our hospita...Objective:To discuss and analyze the effectiveness of the application of perineal wound model in teaching midwife interns.Methods:The research subjects in this study were 40 midwife interns who enrolled in our hospital from January 2020 to December 2022,which were divided into a control group(consisted of 20 interns,taught with the conventional method)and a research group(consisted of 20 participants,taught with the perineal wound model)using the random number table method.The outcomes of these two groups were compared.Results:The examination results of the research group were better than control group(P<0.05);the interns of the research group were more satisfied towards the teaching method compared to the control group(P<0.05).Conclusion:Applying the perineal wound model in teaching midwife interns could effectively improve their examination achievements and teaching satisfaction,which brings a significant clinical value.展开更多
文摘We reported a case of a 30-year-old man who reportedly sustained electrical burns and fell from a high voltage electric pole about 50 meter high onto a metal that caused impalement injury. In addition, he sustained full-thickness burns of the right upper limb (7%), the right hemithorax, the perineum (sparing the penis), the anterior abdominal wall and the lateral aspect of both thighs. There was 43% burned surface area in total. Radiographic examination revealed a slender curved object extending from his perineum into the pelvis. The management of this case was a challenging one which was described in this article.
文摘Background: Tactile imaging provides biomechanical mapping of soft tissues. Objective biomechanical and anatomical assessment of critical structures within the vagina and pelvis may allow development and validation of a clinical tool that could assist with clinical decisions regarding obstetrical procedures and mode of delivery. Objective: To assess intraobserver reproducibility of measurements of perineal elasticity and pubic bone-perineal critical distance with a novel tactile probe in pregnant women. Methods: An Antepartum Tactile Imager (ATI) was designed with a vaginal probe resembling a fetal skull. The probe comprises 128 tactile sensors on a double curved surface and measures 46 mm in width and 72 mm in length. The probe has a motion tracking sensor that allows acquisition of 3D tactile images. There were two arms of the study. In the first arm, biomechanical mapping of the perineum and pelvic bone location was performed in 10 non-pregnant women for purposes of demonstrating safety and feasibility. In the second arm, biomechanical mapping was performed in 10 pregnant women to explore intraobserver reproducibility. Each subject had two standardized examinations over 3 - 5 minutes by the same observer. Examination comfort and pain levels were assessed by post-procedure survey. Reproducibility was analyzed by intraclass correlation coefficients (ICC) with 95% confidence intervals and Bland-Altman plots. Bias and the 95% limits of agreement were also calculated. Results: The safety and feasibility arm of the study demonstrated high degree of safety and tolerability and reliable acquisition of tactile signals. In the reproducibility arm, 10 pregnant women were recruited at mean gestational age of 34.2 ± 6.5 weeks. The mean perineum elasticity (Young’s modulus, E) was 9.8 ± 5.9 kPa, and the mean pubic bone-perineal critical distance (D) at 20 kPa load was 34.6 ± 6.2 mm. The ICC was 0.97 [95% confidence interval (CI) 0.91, 0.99] and 0.82 [CI 0.44, 0.95] for E and D respectively, consistent with excellent intrarater agreement. The bias and the 95% limits of agreement of E were -6.3% and -29.4% to +16.7%, respectively. The bias and the 95% limits of agreement of D were -2.6% and -25.3% to +20.2%, respectively. Conclusions: The tactile imaging data obtained in the study reproducibly characterized perineal elasticity and pubic bone-perineal critical distance. Further evaluation of this tool in clinical settings is warranted.
文摘目的探讨床旁超声(腹部超声+会阴超声)检查预测足月分娩时机和方式的应用价值。方法回顾性分析2022年3月~2023年8月在佛山顺德爱博恩妇产医院建档产检并进行分娩的57例孕妇的临床资料,按实际分娩方式分为顺产组(n=48)和剖宫产组(n=9)。所有孕妇在孕后期进行腹部超声+会阴超声检查,根据超声监测指标对分娩时机和方式进行预测和干预,并将预测结果与实际临产时间和分娩方式进行对比分析。结果主要监测指标单因素分析显示,两组差异无统计学意义(P>0.05);多因素Logistic回归分析表明,各监测指标对实际分娩方式无显著影响(P>0.05),各监测指标联合预测顺产的曲线下面积(Area under the curve,AUC)具有统计学意义(P=0.032<0.05);根据腹部超声+会阴超声检查结果预测分娩孕周均与实际分娩孕周相符,准确度为100%,预测分娩方式的准确度为91.38%,根据腹部超声+会阴超声预测结果进行干预的得当率为92.98%。结论床旁超声监测胎头下降距离、胎头-会阴距离、产程进展角和宫颈长度可以作为联合预测顺产的重要参考指标。各指标联合分析对临床预测分娩时机和选择分娩方式有指导作用,在预防产科紧急手术和控制分娩风险方面具有一定作用。
文摘Objective:To discuss and analyze the effectiveness of the application of perineal wound model in teaching midwife interns.Methods:The research subjects in this study were 40 midwife interns who enrolled in our hospital from January 2020 to December 2022,which were divided into a control group(consisted of 20 interns,taught with the conventional method)and a research group(consisted of 20 participants,taught with the perineal wound model)using the random number table method.The outcomes of these two groups were compared.Results:The examination results of the research group were better than control group(P<0.05);the interns of the research group were more satisfied towards the teaching method compared to the control group(P<0.05).Conclusion:Applying the perineal wound model in teaching midwife interns could effectively improve their examination achievements and teaching satisfaction,which brings a significant clinical value.
