目的 探讨积极综合护理措施对早期宫颈癌术后患者性功能、抑郁和主观幸福感的影响。方法 对我院收治的84例50岁以下宫颈癌患者的临床资料进行回顾性分析,将行常规护理的43例患者作为对照组、行综合护理的41例患者作为治疗组,治疗组除了常规护理内容,还采用幸福理论框架模型下（PERMA模型）的性健康管理多学科团队干预方案。分别在干预前、干预后3个月、干预后6个月采用女性性功能指数、抑郁自评量表评分和幸福感指数,对性功能指数、抑郁评分和幸福指数进行评估。结果 与对照组相比,治疗组干预3个月及6个月患者的性功能改善（F=91.08,P<0.001）。干预3个月及6个月后,治疗组抑郁评分低于对照组（F=1 092.59,P<0.001）,幸福感改善指数高于对照组（F=107.90,P<0.001）。Spearman相关分析结果显示,女性性功能指数同抑郁自评量表得分呈负相关（r_s=-0.918,P<0.001）,同幸福感指数得分呈正相关（r_s=0.844,P<0.001）。结论 综合护理在性功能、抑郁和主观幸福感方面均有明显改善。通过PERMA模式下性健康管理的多学科团队干预方案,可以提高患者的性生活质量,降低患者的抑郁程度,及改善患者的主观幸福感。

Objective To explore the effects of active and comprehensive care measures on sexual function,depression and subjective well-being of patients after early cervical cancer surgery．Methods The clinical data of 84 cervical cancer patients（under 50 years old）admitted to our hospital were retrospectively analyzed．There were 43 cases with conventional care in control group and 41 cases with comprehensive care group in treatment group．Besides the conventional care components,the comprehensive care group also adopted a multidisciplinary team intervention program for sexual health management under the framework model of well-being theory（PERMA model）．We used the female sexual function index,depression self-rating scale score and happiness index to assess the sexual function index,depression score and happiness index before,3 months and 6 months after the intervention,respectively．Results In comparison with the control group,the patients in the treatment group had a significant improvement in sexual function at 3 and 6 months of intervention（F=91.08,P<0.001）．After 3 and 6 months of intervention,the depression score was significantly lower in the comprehensive care group than in the control group（F=1 092.59,P<0.001）,and the happiness improvement index was significantly higher than in the control group（F=107.90,P<0.001）．Spearman’s correlation analysis showed that the female sexual function index was negatively correlated with the depression self-rating scale score（r_s=-0.918,P<0.001）and positively correlated with the well-being index（r_s=0.844,P<0.001）．Conclusions The comprehensive care group showed significant improvements in sexual function,depression,and subjective well-being．A multidisciplinary team intervention program for sexual health management under the PERMA model can improve the quality of patients’ sexual life,reduce their depression,and improve their subjective well-being．

目的 研究限制会阴切开及会阴不同切口对产妇产后出血、疼痛及性功能的影响。方法 选取我院2012年4月—2013年4月头位自然分娩产妇480例,抽签随机分为三组,每组160例,实施限制会阴切开的为限制组,实施会阴侧切的为侧切组,实施会阴正中切开的为正切组,比较三组产妇产后2 h出血量、产后住院时间、产妇会阴阴道裂伤率、产后疼痛程度和性功能满意程度。结果 产后2 h产妇出血量限制组(203.65±76.68)mL较侧切组(241.41±80.63)mL和正切组(239.15±85.19)mL少(P＜0.05);侧切组(1.64±0.87)d产后住院时间较限制组(1.37±0.64)d较长(P＜0.05);限制组会阴Ⅰ/Ⅱ°裂伤率为86.25%较侧切组1.25%和正切组6.88%较高(P＜0.05);侧切组2.50%和正切组3.13%会阴Ⅲ/Ⅳ°裂伤较限制组0%较高(P＜0.05);女性性功能指数限制组(22.69±2.65)分较侧切组(19.12±2.05)分与正切组(18.96±2.16)分较高(P＜0.05)。结论 实施限制会阴切开的产妇术后出血量少,会阴重度裂伤率低,保证了会阴完整性,产后性功能满意度高,值得临床上应用推广。