目的:評價氯喹那多普羅雌烯陰道片對產后陰道黏膜修復及防治生殖道感染的作用。方法:對212例產后6～8周復診患者隨機分為實驗組92例和對照組120例。實驗組給予氯喹那多普羅雌烯陰道片陰道上藥,每日一片共18日;對照組僅給予溫鹽水清潔陰部。治療前后檢查兩組的陰道分泌物情況。結果:用藥前實驗組與對照組比較生殖道狀況均無統計學差異(Pgt;005)。用藥后實驗組生殖道狀況正常為80%,而對照組正常僅為36%,兩組比較差異有顯著性(Plt;005)。實驗組生殖道感染12例,無真菌和滴蟲感染,均為非特異性陰道炎,患病率1304%,有效率8695%。對照組生殖道感染84例,有效率3000%,患病高低順序依次為非特異性陰道炎4167%,真菌性陰道炎2083%,滴蟲性陰道炎 750%。結論:氯喹那多普羅雌烯陰道片能有效治療生殖道非特異性炎癥,真菌性、滴蟲性陰道炎,促進產后的陰道黏膜修復,防治產后生殖道感染。
Objective To investigate the development trajectories of kinesiophobia and their influencing factors in patients after total hip arthroplasty (THA). Methods Patients after THA from three tertiary hospitals in Wuhan from February to June 2023 were selected by convenience sampling method. The general situation questionnaire, Tampa Scale for Kinesiophobia, Self-Efficacy for Exercise Scale (SEE), Groningen Orthopaedic Social Support Scale, Generalized Anxiety Disorder, Patient Health Questionnaire, and Visual Analogue Scale (VAS) were distributed 1-2 d after surgery (T1), which were used again 1 week (T2), 1 month (T3), and 3 months (T4) after surgery, to evaluate the level of kinesiophobia and the physical and psychological conditions of the patients. The latent category growth model was used to classify the kinesiophobia trajectories of patients after THA, and the influencing factors of different categories of kinesiophobia trajectories were analyzed. Results A total of 263 patients after THA were included. The kinesiophobia trajectories of patients after THA were divided into four potential categories, including 29 cases in the C1 high kinesiophobia persistent group, 41 cases in the C2 medium kinesiophobia improvement group, 131 cases in the C3 low kinesiophobia improvement group, and 62 cases in the C4 no kinesiophobia group. Multicategorical logistic regression analysis showed that compared to the C4 no kinesiophobia group, the influencing factors for the kinesiophobia trajectory in THA patients to develop into the C1 high kinesiophobia persistent group were age [odds ratio (OR)=1.081, 95% confidence interval (CI) (1.025, 1.140)], chronic comorbidities [OR=6.471, 95%CI (1.831, 22.872)], the average SEE score at T1-T4 time points [OR=0.867, 95%CI (0.808, 0.931)], and the average VAS score at T1-T4 time points [OR=7.981, 95%CI (1.718, 37.074)], the influencing factors for the kinesiophobia trajectory to develop into the C2 medium kinesiophobia improvement group were age [OR=1.049, 95%CI (1.010, 1.089)], education level [OR=0.244, 95%CI (0.085, 0.703)], and the average VAS score at T1-T4 time points [OR=8.357, 95%CI (2.300, 30.368)], and the influencing factors for the kinesiophobia trajectory to develop into the C3 low kinesiophobia improvement group were the average SEE score [OR=0.871, 95%CI (0.825, 0.920)] and the average VAS score at T1-T4 time points [OR=4.167, 95%CI (1.544, 11.245)] . Conclusion Kinesiophobia in patients after THA presents different trajectories, and nurses should pay attention to the assessment and intervention of kinesiophobia in patients with advanced age, low education level, chronic diseases, low exercise self-efficacy, and high pain level.