全面二孩政策下已生育女性重复人工流产现状调查与分析

目的了解全面二孩政策下已生育女性重复人工流产的状况以及影响因素。方法收集2018年4月～12月就诊我院计划生育科门诊自愿要求终止妊娠行人工流产的已生育女性1 773例,其中既往有过至少1次人工流产史为重复人工流产组(1 095例),既往从未行人工流产者为对照组,即非重复人工流产组(678例)。比较两组社会人口学特征、既往生育情况、再生育计划、人工流产前后避孕情况。结果重复人工流产组者主要年龄段集中在35～<40岁(38.9%),而非重复人工流产组年龄段主要集中在30～<35岁(47.5%),差异有统计学意义(P<0.05)。与非重复人工流产组相比较,重复人工流产组大学以上学历、职业女性以及本地户籍所占比例更低,吸烟的比例更高,差异有统计学意义(P<0.05)。重复人工流产组中51.5%未来没有生育计划,显著高于非重复人工流产组(35.7%)(P<0.05)。与非重复性人工流产组相比较,重复性人工流产组人流术更倾向于选择长效可逆避孕方法(LARC),差异有统计学意义(P<0.05)。已生育1孩女性中重复人工流产组年龄≥35岁以上、吸烟者、本科以下学历、未来无再生育计划者、术后落实LARC者比例均显著高于非重复流产组(P均<0.05)。生育1孩高龄重复人工流产组中未来有生育计划的占20.1%,不确定是否再生育2孩占19.1%,显著低于非重复人工流产组(26.0%和24.0%)(P<0.05);重复人工流产组中无再生育计划占60.8%,显著高于非重复人工流产组(50.0%)(P<0.05)。结论已生育女性重复人工流产率高,高龄、仅生育1孩、无再生育计划者比例较高,人流术前避孕方法以避孕套为主,意外妊娠的原因主要是未避孕,人流术后LARC落实率较高。     

健康教育对非意愿妊娠妇女紧急避孕知识的影响

目的 探讨健康教育对非意恳妊娠妇女紧急避孕知识的影响.方法 将420例非意愿妊娠妇女随机分为对照组和观察组,各210例.对照组给予常规节育避孕教育;观察组在此基础上利用图片、宣传册、音像资料、专业人员讲解等形式进行紧急避孕知识的健康教育.健康教育1周后采用紧急避孕知识问卷进行调查.结果 两组干预前后知识水平和意愿差异显著(P＜0.05,P＜0.01);健康教育干预后两组紧急避孕知识水平和紧急避孕意愿比较,差异有显著性意义(P＜0.05,P＜0.01).结论 健康教育对非意愿妊娠妇女紧急避孕知识的掌握起到重要作用,而普及育龄妇女紧急避孕知识的健康教育势在必行.     

健康教育对非意愿妊娠妇女紧急避孕知识的影响

目的探讨健康教育对非意愿妊娠妇女紧急避孕知识的影响。方法将420例非意愿妊娠妇女随机分为对照组和观察组，各210例。对照组给予常规节育避孕教育；观察组在此基础上利用图片、宣传册、音像资料、专业人员讲解等形式进行紧急避孕知识的健康教育。健康教育1周后采用紧急避孕知识问卷进行调查。结果两组干预前后知识水平和意愿差异显著（P〈0.05，P〈0.01）；健康教育干预后两组紧急避孕知识水平和紧急避孕意愿比较，差异有显著性意义（P〈0．05，P〈0.01）。结论健康教育对非意愿妊娠妇女紧急避孕知识的掌握起到重要作用，而普及育龄妇女紧急避孕知识的健康教育势在必行。     

重复人工流产妇女的心理护理效果

目的探讨重复人工流产妇女的心理护理效果。方法将80例重复人工流产妇女随机分为2组,各40例。对照组行常规护理,观察组在对照组基础上联合心理护理。结果护理前2组妇女的SAS及SDS评分差异无统计学意义(P0.05)。护理后2组妇女的SAS及SDS评分均较护理前有所改善,其中观察组的改善程度明显优于对照组,差异有统计学意义(P0.05)。观察组术后VAS评分低于对照组,差异有统计学意义(P0.05)。出院后随访12个月,其间观察组未婚者重复人工流产率低于对照组,差异有统计学意义(P0.05)。结论对重复人工流产的妇女在常规护理的基础上联合心理干预,有助于改善其不良情绪及术后疼痛程度,提高其健康妊娠意识,并降低术后再次重复人工流产率。     

300例已婚育龄妇女人工流产的临床分析

目的对本站300例已婚育龄妇女行人工流产的情况进行分析，为减少人工流产的发生，保护已婚育龄妇女的健康提出对策。方法对2012年1月至2013年3月在本院实行人工流产的300名已婚育龄妇女进行调查，分析已婚育龄妇女意外怀孕的原因并制定预防对策。结果300名中已婚育龄妇女中两次或者两次以上的人工流产史208例。有150例由于未采取避孕措施引起．15例对避孕知识略知道或一无所知，不知道人工流产的严重后果，占人工流产总数的6．7％；有21例违反计划生育政策，占人工流产总数的7％：5例因为胚胎发育异常而采取人工流产措施。109例的已婚育龄妇女避孕失败引起，占人工流产总数的36．33％；其中IUD移位脱落60例，避孕套滑脱或者破裂21例，输卵管结扎失败6例、漏服避孕药5例，输精管结扎失败5例，安全期避孕2例，外用药膜1例。结论应加强在已婚育龄妇女中的宣传教育工作，对避孕节育知识进行传播，定期对宫内节育器的妇女进行检查，提高已婚育龄妇女的避孕和生殖保健意识，提高已婚育龄妇女的生殖健康水平，避免意外妊娠的发生，减少人工流产对已婚育龄妇女的损害，保障广大育龄妇女的身体健康，促进家庭和睦．社会和谐。     

人工流产术后口服妈富隆的临床观察

目的观察人工流产术后立即口服妈富隆的临床效果。方法将200例拟行人工流产的健康女性分为2组,各100例。2组术后均常规口服抗生素3 d,益母草膏(10 m L/次,3次/d)6 d。观察组于术后当日加服妈富隆片,1片/次,1次/d,连服3周。观察2组术后阴道流血持续时间及流血量、月经恢复时间、避孕效果及观察组妈富隆的用药不良反应。结果观察组术后阴道流血持续时间及流血量,月经恢复时间、避孕效果等指标优于对照组,差异有统计学意义(P0.05)。且妈富隆用药物不良反应轻。结论人工流产术后立即口服妈富隆,可减少术后出血时间,促进月经恢复和维持正常月经周期,降低生殖道感染和重复人工流产率,且不良反应轻。     

育龄妇女避孕知识、态度、行为及影响因素的研究

目的了解育龄妇女的避孕知识、态度及行为状况,并分析其影响因素,为促进育龄妇女有效避孕提供依据。方法采用目的抽样方法对120例育龄妇女进行问卷调查。结果育龄妇女避孕知识得分为6.72±1.92,处于中等水平,获取避孕知识的前4位途径是报刊杂志(66.7%)、家人朋友(38.3%)、卫生保健人员(31.7%)和网络媒体(30.0%);育龄妇女避孕态度较积极,得分为21.97±2.91;其避孕行为得分为13.24±2.71,处于中等水平。育龄妇女的避孕知识和态度、避孕态度和行为、避孕知识和行为呈正相关(r分别为0.24、0.19、0.19,均P0.05);育龄妇女的避孕知识受其文化程度和性伴侣文化程度的影响(均P0.05);避孕态度受其年龄、文化程度、婚姻状况、职业、避孕工具的可及性的影响(P0.05,P0.01);而避孕行为受其年龄、婚姻状况、文化程度、性伴侣文化程度、流产次数及避孕工具的可及性的影响(P0.05,P0.01)。结论尚需通过多种途径促进育龄妇女对避孕知识的掌握,并充分调动性伴侣参与避孕的责任和意识,鼓励育龄妇女采取高效的避孕措施以提高避孕效果,减少意外妊娠和不必要的人工流产,促进妇女的身心健康。     

溧水县农村育龄妇女人工流产原因分析

目的探讨溧水县农村育龄妇女人工流产原因。方法采用回顾性统计调查方法,对2010年1～12月在溧水县计划生育指导站行人工流产的育龄妇女资料进行统计和分析。结果人工流产对象年龄主要集中在21～30岁、31～40岁两个年龄段,分别占42.84%和44.74%;既往有人流史者占58.5%,最多达7次;人工流产原因有34.68%是由于未采取避孕措施所致,避孕套避孕失败占43.74%,放置IUD避孕失败占18.46%,其他方法避孕失败占3.13%。结论应加强避孕知识的普及和宣传,积极倡导使用长效避孕措施,规范做好随访服务工作,提高农村育龄妇女避孕措施的使用率和有效率,避孕反复人工流产发生,降低人工流产率。     

心理护理在人工流产术中的应用

目的探讨心理护理在人工流产术中的应用效果。方法将126例实施人工流产者随机分2组,每组63例,对照组实施常规护理,观察组在常规护理基础上,实施心理护理干预。根据焦虑自评量表(SAS)和自制护理调查问卷,比较2组患者手术前后的心理状况变化和护理满意度。结果护理后观察组SAS评分明显低于对照组,2组比较,差异具有统计学意义(P0.05);护理满意度观察组96.83%(61例),对照组85.71%(54例),2组比较,差异具有统计学意义(P0.05)。结论对人工流产患者实施心理护理干预,能明显缓解患者焦虑状态,提高护理满意度。     

超声引导下微创无痛人工流产术应用体会

目的探讨超声引导下实施无痛人工流产术的临床效果。方法将92例早孕者随机分为2组,每组46例。对照组采用常规无痛人工流产术。观察组采用超声引导微创无痛人工流产术。观察并比较2组手术效果。结果 2组完全人工流产率比较,差异无统计学意义(P0.05)。观察组术中出血量、人工流产综合征等发生率均少于或低于对照组,手术时间及术后出血持续时间均短于对照组,2组比较,差异均有统计学意义(P0.05)。结论超声引导微创无痛人工流产术,术中出血量少、恢复快、并发症发生率低、安全性高。     

Importance of echocardiography in prognosis of surgical outcomes in cholecystitis in elderly patients

The authors propose to use more often echocardiography (EchoCG) in examination of elderly (over 60 years) of age patients with cholecystitis that permits to increase surgical activity to 92.4%. Left ventricular ejection fraction is the most informative. When this fraction is lower than 45% surgery must be recommended on vital indications only. EchoCG was used in 155 patients with cholecystitis, 131 of them were operated. 2 (1.52%) patients died due to acute cardio-vascular insufficiency and pulmonary artery thromboembolism.     

杭州健康女性定量骨超声测定原发性骨质疏松

目的 评价杭州健康女性骨超声速度(SOS)值随增龄减少和骨质疏松患病率，建立杭州地区女性骨超声速度值参考数据库。方法 定量超声法测定1208例杭州地区健康女性桡骨远端(RAD)，第3指骨近节(PLX)，第V跖骨(MTR)和胫骨中段(TIB)的超声速度值。结果 RAD、PLX、MTR和TIBSOS峰值(Peak of SOS)均出现在40-45岁，TJB的SOS峰值出现在35—40岁，此后随年龄增长而下降。绝经后妇女在绝经后早期和晚期各有1个SOS快速减少期，前见于桡骨近端，平均年减少率为2．4％，后见于胫骨中段，平均年减少率为1．8％。各部位骨SOS累积减少率随年龄增长而增加，到85岁4部位累积减少为13％-18％。60岁以后骨质疏松性症(OP)检出率为45％-70％，OP检出率以桡骨远端最高，60-70岁平均为67％，第3指骨近端次之约50％，胫骨中段最低为36％；75岁以后分别为70％，65％和45％。结论 全身各部位骨超声速度值到达峰值的年龄不同，峰值也各有差异。绝经后妇女骨超声速度值随年龄增加减少较快，应予激素和补钙治疗，桡骨远端为本地区SOS检测和OP检出的敏感部位。     

中脑导水管周围灰质小胶质细胞活化在大鼠神经病理性痛中的作用

目的 评价中脑导水管周围灰质小胶质细胞活化在大鼠神经病理性痛中的作用.方法 雄性SD大鼠176只,体重200 ～ 250 g,9周龄,采用随机数字法,将其分为4组:假手术组(S组,n=40)、神经病理性痛组(NP组,n=40)、生理盐水组(NS组,n=48)和米诺环素组(M组,n=48).NP组、NS组和M组采用慢性坐骨神经缩窄性损伤法制备大鼠神经病理性痛模型;S组仅暴露坐骨神经,而不结扎.术后第7天时,NS组和M组分别于中脑导水管周围灰质的腹外侧区注射生理盐水或米诺环素0.5μl.取8只大鼠,分别于术前1 d(T0)、术后第3天(T1)、第7天给药前30 min(T2)、第7天给药后30 min(T3)、第14天(T4)和第21天(T5)时测定机械痛阈.于T1-5时各处死8只大鼠,取脑组织,行小胶质细胞计数.结果 与S组比较,NP组、NS组和M组T1-5时机械痛阈降低,小胶质细胞计数升高(P＜0.05);NP组和NS组各时点机械痛阈和小胶质细胞计数差异无统计学意义(P＞0.05);与NP组和NS组比较,M组T3时机械痛阈升高,小胶质细胞计数降低(P＜0.05).结论 中脑导水管周围灰质小胶质细胞的活化参与了大鼠神经病理性痛中的形成与维持.     

沈阳男性髋部骨折多于女性原因探讨

为找出沈阳地区髋部骨折发生男性多于女性的原因，探索该病在不发达国家或地区的流行特点，我们再次通过查阅病例记录，对沈阳市１９９４年５０岁以上人口的部分髋部骨折病发生的原因进行了较详细的调查分析。共调查分析２６６髋部骨折病例，其中男１６３例，女１０３例。损伤原因记为单纯摔倒（滑倒或绊倒）、骑自行车摔倒、自行车撞倒、机动车事故和高位跌下（滚楼梯或从较高位置掉下）。结果表明：男女在髋部骨折伤因构成上有差别（Ｐ＝０．００４）。女性髋部骨折的大多数（７０％）是由单纯摔倒引起，而在男性则不足一半（４９％），即男性髋部骨折的一半以上不是由于单纯摔倒而是由各种意外事故造成的（Ｐ＝０．０００８）。在各种意外事故中，男性骑自行车摔倒引起骨折的频率（２８％）明显高于女性（１０％）。除了骑自行车摔倒外，男性由自行车撞倒和高位跌下引起骨折的频率稍高于女性，但无太大差别。机动车事故造成骨折的频率男女基本一致。此结果在一定的程度上说明，１９９４年沈阳５０岁以上的男性髋部骨折发病率高是由于男性发生的各种意外事故多，尤其是骑自行车引起的事故造成的。     

脊髓胶质细胞在大鼠炎性痛形成中的作用

目的 评价脊髓胶质细胞在大鼠炎性痛形成中的作用.方法 清洁Ⅱ级成年雄性SD大鼠,体重180～220 g,取蛛网膜下腔置管成功的大鼠65只,随机分为5组(n=13),生理盐水组(NS组):右后肢踝关节外侧皮下注射NS 50μl;炎性痛组(IP组):采用右后肢踝关节外侧皮下注射完全弗氏佐剂50μl的方法制备炎性痛模型;氟代柠檬酸组(FC组):经蛛网膜下腔导管注射FC 1 nmol/10 μl,15 min后右后肢踝关节外侧皮下注射NS 50 μl;NS+IP组:经蛛网膜下腔导管注射NS 10 μl,15 min后制备炎性痛模型;FC+IP组:经蛛网膜下腔导管注射FC 1 nmol/10 μ,15 min后制备炎性痛模型.于模型制备前2 d(T_0)、皮下注射药物前(T_1)和注射药物后2、4、6、8、10、12、24、26 h(T_(2～9))时测定机械缩足阈值(MWT)和热缩足潜伏期(TWL).皮下注射药物后8 h时采用免疫组化法测定脊髓背角星形胶质细胞标记物(GFAP)和小胶质细胞标记物(OX-42)的表达水平.结果 与NS组比较,IP组和NS+IP组T_(3～9)时MWT和TWL降低,FC+IP组T_(3～9)时MWT降低,T_(8,9)时TWL降低,IP组、NS+EP组和FC+EP组脊髓GFAP和OX-42的表达水平均上调(P<0.05);与IP组比较,FC组T_(3～9)时MWT和TWL升高,FC+IP组T_(3～7)时MWT和TWL升高,2组脊髓GFAP和OX-42的表达水平均下调(P<0.05或0.01).结论 脊髓胶质细胞的活化参与了大鼠炎性痛的形成.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.