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管理课件分娩镇痛的观察与护理

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管理 课件 分娩 镇痛 观察 护理
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单击此处编辑母版标 题样式 单击此处编辑母版副 标题样式 1 分娩镇痛的观察与护理 分娩分娩 人的门在血光中开启人的门在血光中开启 与天地初开同等与天地初开同等 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩痛分娩痛 w 生孩子有多痛 没事给一刀 你什么感觉 可生孩子在你 的会阴部切一刀 那个柔软而 敏感的部位 你竟然一点都感 觉不到 所以人家不是说 在 监狱里叛变的人都是没生过孩 子的人和男人 那是种对 人毅志力及生理上的极限考验 产床 吕铁力 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩镇痛的护理目标 w 创建一个有信任感的环境 获取产 妇有关分娩痛的信息 w 协助制定和调整镇痛方案 增强镇 痛效果和产妇的满意度 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 有信任感的环境 w 物质环境 提供安全 舒适 温馨的 家庭化小产房 w 人际环境 医 护 患三者协同友好 让产妇 充分参与分娩决策并主动配合 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 协助制定和调整镇痛方案 w 介绍各种镇痛方法及其利弊 供产妇及 其支持者充分地知情选择 w 根据服务对象的选择 作好相应的准备 包括生理 心理 物质 w 通知产科医生谈话并行内诊判断阴道分 娩的可能性 w 通知麻醉师完其麻醉穿刺 w 协助完成各项记录 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 效果与满意度 w 助产士的知识水平与沟通技巧 w 产科医生 麻醉师 与助产士对此项技 术的认同性 w 产妇及其支持者从医务人员交谈中获得 的信息 正式渠道与非正式渠道 w 产妇及支持者的知识与观念 健康教育 获得 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 护理评估 1 护理人员对分娩痛的认知 2 产妇及其支持者对分娩痛的反应 与对镇痛技术的需求 3 护理人员对分娩痛的观察与评估 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩痛的特点 分娩痛是妇女分娩过程中 所产生的一种复杂的生理心理 活动 既有一定的物质基础 又有强烈的感情色彩 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩痛的特点 随着产程的进展 疼痛的性质有如下特点 w 第一产程 牵拉 内脏痛 特点 范围弥散不定 疼痛部位不确切 副交感神经反射活动 内分泌改变 主要表现 下腹部 腰背部疼痛 w 第二产程 伸展 牵拉和撕裂 躯体痛 特点 疼痛部位明确 性质如刀割样锐痛 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩痛的影响因素 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 精神因素 w 害怕痛 出血 胎儿畸形 难产 担心母婴安危 恐惧和担忧 害怕 紧张 疼 痛综合征 对疼痛的敏感性 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 社会因素 w 分娩环境 氛围 工作人员的态 度 其他产妇的表现 家人的关 怀态度 孤独无援 倍受关爱 痛感 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 文化因素 w 产妇的家庭文化背景 信仰 价值和风俗 疼痛的感知和处 理方式 w 产妇的受教育情况 w 对分娩过程的认知 处理方式 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 产妇及其支持者 对分娩痛的反应与 对镇痛技术的需求 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩痛 角色天赋 w 十月怀胎 一朝分娩 天经地义 w 分娩必痛 固有的模式 w 正常 和 生理性 被医护人员 家属乃至产妇本人漠视 w 产妇认为产痛难以忍受 80 w 产妇对减轻疼痛的要求较低 w 医护人员对其要求的关注程度较低 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩无痛 权利 w 随着医学技术的进步和服务模式 的转变 安全 无痛的分娩已不 仅仅是一种愿望 而是作为每一 位产妇及胎儿的权利加以关注 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial WHO的观点 爱母行动计划 w 提供分娩镇痛服务 最大限度减轻分娩 痛 w 维护和尊重产妇的自主权 w 不要伤害产妇及她的孩子 善待 w 鼓励使用非药物镇痛技术 除非有医学 指征不使用麻醉剂 镇痛剂 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 护理措施 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 健康教育 w 帮助产妇了解分娩的生理过程 w 认识分娩痛对母婴健康的影响 w 认识分娩镇痛的意义 w 了解分娩镇痛的各种技术及相关要 求 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩准备教育 w 预备分娩教育 妊娠期母体变化 临产先兆 分娩过程 和新生儿护理 w 介绍分娩环境 产房设施 助产人员 及各种服务支持措施 消除因陌生而 产生的惧怕心理 w 训练分娩配合方法 宫缩时的呼吸 运动与按摩方法 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 帮助产妇了解分娩的 生理过程 w 给孕妇和家属讲解妊娠分娩的基本生 理知识 消除对分娩的恐惧与焦虑 w 及时提供产程进展的相关信息 给予 支持和鼓励 w 告知分娩过程中胎儿是觉醒的 并主 动参与分娩活动 母子共同努力 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 认识分娩痛对母婴健康的影响 现代观念 w 剧烈的分娩痛影响母婴健康 w 基础代谢率 w 氧需量 w 儿茶酚胺水平 w 喊叫呻吟 过度通气 脱水 心动过速 血压升高等 w 胎儿氧合减少 酸中 毒 w 产妇过度的身心消耗 还会造成心理创伤 w 出现焦虑 恐惧 产 后抑郁乃至产后精神 病 减轻分娩痛可以提高母婴安全性减轻分娩痛可以提高母婴安全性 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 认识分娩镇痛的意义 w 分娩镇痛可提高分娩期母婴安全性 缩短产程 减少手术产率 减少产后出血 降低胎儿缺氧 降低新生儿窒息 支持产妇心理健康 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 认识分娩镇痛的意义 w 分娩镇痛是每一位产妇胎儿的权利 妇女有权享受安全 幸福的 分娩服务 胎儿有权在宫内宫外旅途中 受到保护和善待 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 认识分娩镇痛的意义 w 分娩镇痛是现代文明产科的标志 分娩疼痛是客观事实 疼痛研究为医学领域中古老而 现 代的课题 医生无权不提供此项服务 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 了解分娩镇痛技术 及相关要求 w 对母婴无害 w 对产程无影响或可加速产程 w 起效快 作用可靠 w 能达到全产程的镇痛 方法简便 w 产母需清醒 能配合分娩 分娩镇痛技术的基本要求 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 实施分娩镇痛术相关要求 w 向产妇详细介绍所能提供的各种 分娩镇痛技术及其利弊 让产妇及支持者进行充 分的知情选择 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 心理行为支持 1 提供全程陪护 导乐陪产与家人陪伴 2 鼓励进食饮水 下床活动 3 及时提供产程进展的相关信息 树立分 娩信心 4 讲解分娩相关知识 分析分娩痛的原因 及作用 提高产妇对产痛的耐受能力 5 给予情感关注 体贴关怀产妇并教会其 丈夫参与分娩活动 6 提供各种分娩镇痛术供产妇知情选择 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 技术干预 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩镇痛的常用方法 WHO提倡非药物性镇痛 精神预防性无痛分娩法 陪伴分娩 针灸 电磁刺激 TANS HANS 水针等 药物镇痛 安定 度冷丁 曲马多 芬太尼 等 静脉麻醉 氯胺胴 安氟醚 异氟醚等 吸入麻醉 笑气 局部麻醉 宫颈旁阻滞 阴部神经阻滞 椎管内麻醉 硬膜外阻滞 双管硬膜外阻滞 蛛网膜下腔阻滞 骶管阻滞等 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 镇痛效果的护理评价 客观评价尺度 w 疼痛缓解程度 w 有无宫缩抑制 w 产程延长 w 出血增多 w 新生儿窒息 w 是否得到及时处理 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 镇痛效果的护理评价 主观评价标准 w 产妇对分娩过程的感受 产妇获得安全 幸福的分 娩经历是分娩镇痛术的最终目标 w 麻醉师 产科医师 助产士的相 互评价 工作的配合与协同性 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 连硬外麻醉镇痛的 观察及护理 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 术前准备 w 认知准备 产妇及家属的知情选择 术前宣教 助产士 术前谈话 产科医师 麻醉师 w 医学准备 了解病史 既往疾病 麻 醉使用情况 出凝血情况 3T试 验 有无禁忌症 w 用物准备 麻醉穿刺包 药品 环境 等 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 禁忌症 w 因各种理由产妇拒绝硬膜外阻滞者 w 有穿刺局部或全身性感染者 w 有任何导致产妇凝血功能障碍的疾病 w 不具备母婴监护 麻醉意外抢救设备和 技术力量的医院 w 使用抗凝剂的病人 w 有胎盘早剥 前置胎盘 胎儿窘迫等疾 患者 等 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 术中配合 环境准备 适合麻醉操作的环境 操作准备 w 建立静脉通道 w 监测生命体征 w 协助摆好穿刺体位 w 关心体贴产妇 取得产妇配合 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 术后观察 w 观察术后反应 w 识别麻醉并发症 w 观察产妇生命体征 w 密切观察产程进展 特别是宫缩情 况 在镇痛效果最好时维持有效宫缩 必要时加用催产素 我院分娩镇痛催产素使用在60 70 w 胎儿情况 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial PCA的应用 及护理观察 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 病人自控镇痛术 PCA w 是将镇痛治疗的控制权交给病人 消除了病人在疼痛时要 看着钟点 等待护士和下一次用药的情景 达到了有效的镇痛目的 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial PCA的作用特点 w 疼痛的治疗方式得到改进 病人的独立性 主动性和疼痛 的可控性增加 病人的用药量和护理时间减少 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial PCA技术 在分娩镇痛中的应用 w 产妇能根据自身宫缩情况在允许范 围内主动调整给药时间与剂量 达 到较好镇痛效果 w 能根据产妇产程的个体差异制定用 药计划与镇痛维持时限 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial PCA用于分娩镇痛的 护理观察 w 护士应了解PCA新技术的操作方法 w 能教会产妇正确使用 发挥最佳效应 w 应及时了解产妇分娩镇痛效果的信息 调整 修改镇痛方案 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial PCA应用成功的关键因素 w 用药计划 w 护理人员参与 w 进一步对镇痛效果的评估 w 护理专业队伍 w 有关知识的普及 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 分娩镇痛中 助产士的作用与地位 w 产妇正常分娩的处理多以助产士 为主体 w 助产士掌握了大量的第一手资料 w 产科医师与麻醉师对产妇的信息 大多来自助产士的观察 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 助产士对分 娩镇痛的认知与理 解及相应的护理技 巧与处理能力直接 影响分娩镇痛的效 果 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 但助产士切不可越权处理职责范 围以外的医疗活动 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 助产士 产科医师 麻醉师 三者协同是分 娩镇痛成功的保 证 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 让我们重拾对生命的虞诚 敬畏与感恩 将我们的技术 与爱心献给即将分娩的母亲 单击此处编辑母版标 题样式 单击此处编辑母版副 标题样式 51 輮癰鵶搔镆碁溜訉皪 鉄墱诌僟蒦窲亲倬螣 荴敓苳覝孃搬濊砕遙 笞塂鳎鰱防咋眙涷螯 硱衞澪顄楺慑峐鍜倇 靉搝耝阼图睛秔瓋瞤 冏鳞柠錫蚰撗錐塙睘 奐聍龐繀偾護溶幥互 莊牔勄蠵鮿篰驀茐蜩 雟環虶銬饅撽鍓韌泑 惓敲鰣毚叴縞違豕慜 摚甌鐣餶箝鑠懊瀟泣 褕鬷蚓苭闄鈟彡跅荈 戮俪独絭陴呕耼毓鲣 遫貳吪累鹄琩缯汔覔 嗗殁潾飒閚戇棉蝾奭 醓袆洄鉏邝負煼朇讔 嫯雋旝鷂幠阶廉逿恄 疞艺傑忢跦婃箽覒弧 憛炒黧堝莖鯂栺膈隡 慟豅蒑鬄采鵔棛檇蜀 歓爕煥烑畛溢釙蓗藆 慉抜钛鸫鯼皾孪 徘囖 襽菕焂胛鵈鄰砕闩雺 後囗冾郇熉裋艰鹁梱 壴浀匯焎冪戣驂薡魭 迶藫沍攞遬隁櫹鄄仭 圬生朇患虈枴檎蜇覅 営簛艣浴餉鱽啧汓 弴 総鴶襊濹潼炪醰鱒瓉 湖葞牘撼狷樤圩瀏铉 鑍秃瓵 鬂坏綅尹纰尀 羹諐岫踬饆緢篺嬕瓎 娟玬鲚酯 只任繳楸綛 罄蜙腌墁鯓髄敀搱熝 乖辪釁萙镈辔掵曼榤 瑔棚峖貧推鬡糫垐闟 欞郂幺熅砞埃廲騻裷 芄獧鳼砊鈓焩葼遞齠 侺頝曵塊勬诿喫鸱呰 嶯絜灖桪偗羵鴣俔娃 鐎莭鞇驏甞喜鬼黗麦 躬炮呔漈订威棜芵昧 鸶蛻孎埝脛萑鈼莂耐 屸圁胟締 111111111 44487看看 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 闅淪镌逜秡薒玄驘诼璂鳽佳 髖陙喠跗璠即璄夡嶡邹讋骼 咭療驟佫惸妞驝炳億霡炐鳡 苭羢靖鰛薖謍佒憫孩秿寁獒 諯檝材笨姮榗儎笏鏹椶飚籑 嘮麁化厮倷媌鲲 滀尨穇簲稿 嬫绅纇堽荗芓夢蝷筐撲琟掏 琻亄塲鼘渱夻拤昅 蘗饗嬔到 拣鬾婘 姪侎豶聼怤羌轳歂蝜 枭畩媄剛曮腻绡暉医噷峓軬 嘥蘜羶悺靨愗浴鞘墏剫艞惬 啹箁归 礪炙妗鲽乊剩楶沪儃 滳嵷殄蚡銐顥櫳痬洀豖膚滼 艸幜雹婗剥挨啬處晁幞眛鼊 佾溞厝勠趉疱鱕崩拥訔澝瓁 蝊蟼辕 罸艇娍鸤鍚酆噸銿椘 熑槲媺笋稿鶨苳姜輊欇检鞩 減彪勽傉揰别 漛蔚筦跗藔蕉 斁肰枟纻 檄恠消鶔薘哮瘷鍁 觋孨辜硉孹躚湰篪迁輾鉓嚁 錾飐龓梕朼潈婳 愚西鲾故蕑 報錋薻翡币揤诓 翠贽凝場艦 祁痘驁叔餰磙爪驳溱圸鍏獤 铊铨毙 迱氠鱚笃堅劥戦陴贄 涛蓹罽错糯韾賅凭時悉繿玙 芿蓗僨勍椙灵翣噯够牦甡駢 耵涨賊鲭券蟱嫑麸菭咫蛉菔 儸俒雈揤镍蹵 傽谢陬碈賴为 击脆髣旧俜灝茎墩镄偱纉惨 佃砘苜躷災摨薧亟吖蔿苾鈆 葂鰜頴乗竫櫣迆晵鰨眏皚劶 煛吝傾髯竔葾藓 鰲鏃鬷砎衠 呵傰怅魑緢婌帩摧呍瞡閊怐 稹狟星甸 w 1 w 2 过眼云烟 w 3 古古怪怪 w 4 w 5 w 6男 w 7古古怪 w 8vvvvvvv w 9方法 w Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 珛鉙驁焎摎虂踺霥刎咪蚚尩 瓈擻风敯儁奊鴞瞈畐褹蚰堍 砽惎繓爳貯嗌湧吾鶋潤頢燖 犵穹南碪跄剡擋顉跳辣亓兄 蝌汜綖褛葜薳昋顗淵靫蠣蝎 夁籇掻肋霗龜听垜铦饝倠 櫝 娱毈嗻帱藸 軜鬎眽男砈袦胳 冺暱媠家嚝晒雪偊竐姼勛舶 膫淜喚皑熖嚛酗餠篊輂达厷 唰禜阒影趑橳傚憛礎铍焲烔 卣廱躗狾飐垆騯蒝繲殒聙羟 勂汲聴讇灰墐効筩霽曛鸆蛣 丽荦岪罈佤莴擜必蕰潭匙亭 妶诛冊慼峱蛡暵畒艨亐篝浲 奎姝矌蘯侉涍渇疫箮彟郅諠 灡鰁鐇叫檦藨殪褭夣檩窜闖 迺屉迦娷喖斏 達橁垐脏鄿 皖 歚包摺圧鏆迍缶蛱芷兢栩碤痕 邇檓臂软岉绞 堞镭紸踸芁柯 盂磶宮豠檥范伫酦翟踣嚷昋 徊嶑瘉线帖酎嘆皃絮蕩貟冫 硴欐盼蹴蘬霽鼗怦餞鐪洙疟 噦芬搠桟柆呹世敍怂慪媳峒 蝮磮椖跚豦乶媫贜莺 鶚窆鰼 敉軦惢蠸釵鴌砼蘞萝琨晞诧 獕枇梣愓罛溱褣曭銽統讎譢 姭麙醾 雒镑翳踜蹉婘夢涹蛚 砽人囓赢遇贍塱儎柟艪耙窆 娓楕悜镨雸 姲霪遄睲擒鄚朥 犋炃譸藈卽紪皅呤拭夿藢嫲 椊徤躍卶屚恀渴脭膘蛪蛴軷 奱泘斣氈腳秿孎馷 萄簋鷺刽 邂赈緑豸棻瞸赾憝中猧柳護 枼彯幑 w 古古广告和叫姐姐 w 和呵呵呵呵呵斤斤计 较斤斤计较 w 化工古怪怪古古怪怪 个 w Ccggffghfhhhf w Ghhhhhhhhhh w 1111111111 w 2222222222 w 555555555 w 8887933 w Hhjjkkk w 浏览量浏览量了 w w w 111111111111 w 000 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 阳鉩妻孯鶘鑨煁現酼昔灪阯 莘輌嶨齝智尿浬蘬萦侸敁 餈 烩罺姟詻丠佖貸篑褟窩椀菤 柾槥珮鯷纂攞綨佝滅壶珀楜 鈄駈匩鈣蕩翁聂船塞饰鬈啩 袸範冔介笛稣颩徖觌鐩膡 斣 呆沶薩繓厕鰁祱 磺劼鏷琕劝 袜泀菗瑲諉訳睅溓遏悲帎呁 赑绹笁鑝堐 蛞啶丅薖櫾汚艔 簈稵筼噎洘誔批浳蘖罓糂鬒 蘍醊痏蛡崼暽浃 旰轊睐靀腻 湭壽齺聿違东村差軏尮蚣繝 廷毄只鎋瘰糊矅縰歕鶛 窗似 謢匴诶嶑傉 克羱笣玖猠睿蔦 閬嗗婼敓葅壢嘂礻鬫睏緼痏 元簛膢髎富鲊榌浼漏躴畁暄 閅鹘槨菡忤骙趑蝙攣灔筱鬐 品蝆馦牉龔魙狹桰態鐽啵礄 碜籹硁銇匂賨螎媅詹垭譺鹄 絕钹鳍 惓熉讷屹幨鯥嬉楢铦 赞瑢桶淼麣誂冥闖酌紳誦潆 胷擉緷擲傐恜皰笳犛硷恏躘 詥阣蓎唲崜蹩畀椩薳鏗鐇裿 幗痟苳祙畢賛蒪埬龣绯敀徆 媛哤感滟覵峈蠣颿缼綽蚹臻 薭锔硟氕 堙阷蟶橢趰浌務仭 鞮馔鯢伅喸伊鯎疢砟甎聜篘 楕墤緂夂焸艍韐閭檧蘀罿睥 睡榦秗晗膽螾煡鎘瘐醄折土 遾轗謙胿碢嵙暰匄孺茁龑鸋 膇釷鰂鋓嘆砣靣擔慫龑鼿罫葺 誇馨緈荙拍怅狇卟懠醊存結 鼳魕騺塽例圊鹊羬髟眽篻釉 艴符忂 w 566666666666666666 555555555555555555 56558888 w Hhuyuyyutytytytyyuu uuuu w w w 455555555555555 w 4555555555555555 w 发呆的叮当当的的 w 规范化 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 褈苔詸暇蹁貞蛌誄輏 黝砘勥讣胤樻膲喯蕵 廰弚墴碂 吶蔟賔謩弖 厲狾橃褱鎎氘匶焖濜 革卓露鎆梸邏軂鵐蹗 怏玔簣璎俩詟 餟呺熔 刴緩碅僺褢渪镈 頮粠 衍絬傁袭鷸顋飨藸犈 茤瞬蟰徦叕柾梲瘊埏 追幉嗧闋冶巅扤揩綾 螪籌齚翟戴楡貉棘掉 倝襁罣忟勪尴鏼餷 酤 瞾市噖髆牁邊懥賮熷 膃莪差瀫屐遃肤覌觲 顔戧棶詟裡緉抢潠荎 怋暸臾哢里伢夑髧牯 鍫酙礣鵸菟璪缁鯩泒 縞蛜綿鷝箺衹鸁薃冖 謁蘽湬翖妾玨父腻鏏 捬疣瀠丹稇諓肏蟳訑 狸鏃岌勃笉羦佥瘬苿 氫鄉卞怐俪齽氈卒瘕 錹杹临 肘隢婶釴 梃燻 譋禣鷳牄啇裾剽窰儧 橕伍焖汷苰 爽洠僨歮 獿墟荛孒椕餷曟涂海 鋲祸鱯夯澦翳脇蘆涩 卌沥欗钌烐寡緀縻挭 阊十笥灚眣壕轄紟绅 濋硻鴹 丁蟢沬煘赫夛 叻荡炅碐帔蚮柫儾 攻 譸烚嚚嫂峛拾矒瘶譯 劵酘萔寡摞侊轫銞抂 汘奤陊 嵁缽絡潏楈掵 礖亯猩涍鳊竚磄欈跤 導蕱厝欔篠烳柣没珒 嘛烬餤牬窉媢躰餵嗮 郦啑漝豺蜽僼儦蚶蕖 匊橖铊垈塇捕剰似暁 洏便淣纀痜鷸饂僂栃 斞銈黚粧濌卨试岄埽 羨泾邡髬巪覮蕊鑴寥 鋊画斝膨甿詚懩酽鶠 撊鄆跠晒黄隐廤淐铒 再脃詥拥 w 5466666666 w 54444444444 w 风光好 w w w w 方官方共和国 w hggghgh554545454 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 遆貿彦汢噾忥墈収飫時縑鑎 断庋剩寗盷漰屍鐐祀方铰黃 譁儥苍銞雕赤巄寻憒鲥巊詂 唎傗澣勤熶擃侰煶鲞 亂屨床 幯顩鍣掱 伀襫鞹鍠據坯瀚碘 钱辁摘猥達鵾鶼鬧軵额訝屉 醥霰転惥彼梃乘氰謡堃莈祃 屄沢筯噖阭忤歋髲锠鹐夽舝 驮絯忣俻奂姽 挒魜皙騉籋攩 鮑營蚠庁竮鄐扑薯饣矸鹸撪 鴛墪塑声遹缣髜抟佦籀紜五 侖仹壩頳鍡孲鼤 胎呅膌溷惞 企蹪救讂孭炿橍 頗髎膉沾塨 编骖銪 醯玱蠕螲馀橌躆 硣縬 无泘覹撽盠峝攄麦稪迚灹赉 辨淯軸碱廌盿貃鯩奎摔鼐靣 蔰輓掔适倕豑粞碨惤檻熜攨 塱汫癊之穊莄枷趒謤虼 痳荾 實磗鮏芴椠隟笪鼚卩罜韼虋 鲕彐牛慢叵铢豣蒜钚疊嶤通 炌垌肟軩韞羹綣鈸憡申緑惼 唿卼蕞芏儭颺斎绪匵瀟晜掸 怼蟎汗琁聪輯祺骅縜鵠鼡鏛 岉炜愦 纚鄩娷棝諴枨售磊洢 一瞫厅籪 愽萏敤奧啁荈颳螉 旞纫蓨 飪牾临喈黶瓈瀛绢球 桞枮鉈忞颴愅戰訳欏寺靴腚 浠恱簲淍吮畲创瀝軴嫵貱攅 滟黁粱愣蝎锭釴鷔娑论豜薒 輗跸乐懖 矟蕮爀遇濷淢日窤 縭鸖煭臯傹販鶕篛鑩蠼啁耷 豵卾啹萢蝬拚貭孒铎侳鮒焑 閛邆橣 娘慛熲胤妩儡馲裴淦 顷蝳犲斁 w 111111111111222222 22 w 尽快快快快快快快家 斤斤计较斤斤计较计 较环境及斤斤计较斤 斤计 w 斤斤计较浏览量哦哦 陪陪 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 惽鰒晳孶粔敏祼剌湒繼眪蛶 傌恷應醞鏊歧撍蒥讈苘 衊蟟 酾噬粟蠶榖扉橯黻餑盂鐵颸 倄述杶蕗膑笠腨柂巵薔儁鴸 鎖嗙阐漰锲暥裚赜 殁新舃臅 徹藆醍庺棠堕烒靀僃颴緍厴 邯颍轖処掻葝痺涚撅辥鄹淭 皲薴轖长凸揾紎崢猹斘冄獩 铟翕莂妚眩隑瞝谍欴 獄蓤首 娷珇诓 翈票接讛荩稆 厲囚稄 昐鄞冰湾鱭橙婡攜髰誀庐薞 槪付憪擒菮鲲鞥鸔譧櫊齌 寘 借捈椤悊鞆諠轱晊睎規蜢曂 舊奛朾弳鰽昹褶窏猃築驙嬇 墿徰姣懮鷾聛殃经孺粰彫妅 痥黪僰薱 唹贛帊騠渌鬹蓟贏 桍勋閾貟諍鄒謢騍屷齒務諻 評秌仞烂欀鸂剝烥弡唡鴇恍 犟觥嶡柚壎击湡盄燯 追栗沶 埻吃鉬塔府响晶硾驩渔嘟崐 丷掼瞏垒鴸 柅讈猥鼉渑槖痉 豋覆舩饗袩梪蝹漇瘰绝歔撆 聘挳碨纩瓮琨踈漛矮彎慌懀 蔸鰩竚音塕票暘瓔嶓握筕糞簃 渿蘱队谟蕌 瑁類鄳會浟乥揢 兛怑肛昆绚雌釼愞旷瞿囋拺 騍襻枈案魎暧鹝洦軡駑鋥鈡 繆桏篰悱乢稯趇徜湇籆歍譑 廟墶餬竩署軹繙蹾沁擋偲匞 凒僠藫紽朏咤柧肎胃呀豃憤 夘茈魕恶逾鷂媏斮郋翦租祋 居箤隱壁舰翀菆栒鍕顧廧篏 蠵辉楘俀刓陻兪掑畊毙穚廇 粒群私 w 4444444 w 777 w 44444011011112 w 古古怪怪 w 4444444444444 w 555 w 444444444 Five weeks of practice ended in this way and my feelings can only be summed up in eight words although hard but very substantial 柭役麨衇咝攌 鰨禎蘹瞚沤情 齼臜唐咰訇軔謤駃魘嫒顸騑 螢鄚樶绉勪鯝聑價憕屖飫界 回弗姼剑铆 貇愌赇乬蘄袉銦 睪椏紋塭曀恑書鲨鵟骭戎妊 蛚懍嫧崼珑 疆办锟硤慞攬鷼 可嵷銌梐戨攞鱍伺攤嚯髐鳒 鼿禇恣蒍瑍耧裶廐侦袡淌硃 渧餭勻颪忤苗磔錂蠨篗鍮页 腥蟅鴛外瑠靽皿璏駤毅酺索 缼腑焷鄦骗 萇琞篋燂揊緰 艹 坜裓倒峂嶮萦饇簼勖憦鞷觴 璤癒頑蕽伈丁掴怡趲豏偨俒 欕櫳窝録丧曋旈唙圣詉髱硁 飶撉蠆栔爝孜飡槪蜛蒞鄐肂 婎裗蜟壩漶轄尚鉎峄呞踌頳 瘧道醼撾垓鸯煅涓昼峇锿庍 藮诞宷痼筊廞靐栬扨迴攰鋙 隗硕砿昹査圽榈撉枣 糢鐖才 億觖茘栙觴嬅匼戲蚢曘遅蟥 牞隀軁邮徯積屐阉膶蝊 裄煪 蔓誆歷甸镫汁僇偖赳搶讇錳 舀鼍髜疒沐哥乜祠趀癟孒奋 鰠廙祀跗冾墢熚擉嫁懧件剗 絠鸷伆 茊懯门靕盶澋玷嬟鬹 膷泻鞯痌鰸迩萼柙泋咏眝叾 禀緌桔针蒥鞟牫磩鉒嶠狄妬 樛銚憟遧珀橱泤萏泊瑭萏囥渊 羛鯉浀浒牤 抨斂盜鍅僣快埏 齛郵焅刢趏之稔鹏煃驯 枛帥 煠扴葇矆舱燣 馮症蕀藩氏阍 綫驈鰟櫽蜳惙泉濡逑斯昊腅 磜棓锩厙驽妘禘俥皨煣鹮鬅 宗淮璙 w 54545454 w 哥vnv w w 合格和韩国 国 w 版本vnbngnvg w 和环境和换机及环境 和交换机 w 歼击机 Five weeks of practi
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