消炎痛治疗180例宫内放环后出血的临床诊疗

积极治疗节育手术并发症是搞好计划生育的一个重要环节.月经异常是宫内放置节育环的主要并发症,也是节育环停止使用的主要原因.近几年来本人采用消炎痛治疗宫内放环后月经异常,取得了良好的效果.     

放置宫内节育器与月经异常的关系

目的：探讨放置宫内节育器与月经异常的关。方法：选取我院2014年2月－2016年1月311例宫内放置节育环的育龄妇女，按照月经是否发生异常分成异常组与正常组，经 logistics 回归分析，探讨放置宫内节育器对月经异常的相关危险因素。结果：放置宫内节育器引发月经失调的危险因素主要为内分泌异常、内膜息肉、内膜增生、卵巢肿瘤及子宫肌瘤；导致月经失调主要因素为患者机体病变，并非节育环造成。结论：放置宫内节育器可避孕，通常对受术者不会产生不利影响，具有一定的安全性，临床应用推广价值高。     

益气复宫汤治疗放节育环后子宫出血临床观察

放置宫内节育器是一种安全，有效，简便的节育措施，但放节育环后子宫出血是放节育环的主要并发症。笔者自拟益气复宫汤治疗放节育环后子宫出血59例，并设对照组进行观察比较，现总结如下。     

宫环养血颗粒治疗上环后月经失调80例临床观察

目的 观察宫环养血颗粒在治疗放置宫内节育环后月经失调方面的疗效.方法 对2008年1月至2010年12月我站应用宫环养血颗粒治疗放置宫内节育环后月经失调80例的回顾性总结分析.结果 应用宫环养血颗粒治疗放置宫内节育环术后月经失调80例,治愈59例,占74%,显效15例,占15%,有效5例,占5%.无效6例,占6%.结论 宫环养血颗粒在治疗放置宫内节育环术后月经失调方面疗效显著.     

金属单环与吉妮节育环的避孕效果对比分析

目的比较金属单环与吉妮节育环避孕效果。方法选择2008年7月—2011年6月在该所放置宫内节育环的育龄期女性348例作为研究对象,随机分为两组各174例。对照组放置金属单环,观察放置吉妮环,放环后随访12个月,比较两组节育环脱落率、移位率、月经异常发生率和妊娠率的差异。结果与对照组比较,观察组节育环脱落率、移位率、月经异常发生率和妊娠率均较低,差异有统计学意义（P〈0.05）。结论宫内放置吉妮节育环可以取得比较满意的避孕效果,且不良反应较小,值得推广应用。     

子宫内膜钙化1例

患者，女，47岁，农民，因安置节育环20年，绝经7年，取环3次失败，于2004年8月30日入院，患者于20年前二胎足月生产后3月，在当地卫生院安置一金属节育环，安环后经期、经量正常，无明显的不适。40岁绝经，绝经前半年月经极少，每次月经只用卫生纸1～2张。1月前在当地卫生院取环失败，遂到我院门诊就诊，检查：外阴、阴道、宫颈无明显的萎缩，子宫大小正常，双侧附件未扪及异常，B超示节育环位正常，经抗炎，     

节育环有无使用期限

问：月经来潮一个多月，腹胀明显，经血鲜红，经检查，医生怀疑是上环造成。请问节育环有没有期限（3年前做过宫外孕手术，尿检、血检正常）。 答：节育环有很多种类型，在我国多使用的是带铜节育环。带铜节育环放置时间基本都在10年以上。     

宫腔镜266例临床应用

目的：利用宫腔镜直视下对宫内患疾进行诊断和治疗，探讨其临床价值。方法：自1998年6月至2000年6月对266例不孕不育、子宫异常出血、输卵管妊娠治疗、宫内节育环（IUD）取出、宫腔异物取出、内膜息肉摘除等的诊断和治疗。年龄范围20－64岁，平均30.8岁。发病时间1－9年，于月经干净后2－7d进行检查或手术。结果：84例异常子宫出血病人中，正常宫腔28例（21％），异常出血66例（79％），80例做病理检查，符合率达90％以上；不孕不育160人，子宫因素检查异常26例（16.3%0；输卵管不通65例（40.6%）。其中，53例经通液成功，随访1－3年，已有25例成功怀孕，11例输卵管妊娠治疗手术10例成功，1例失追踪；6例宫内节育环有5例成功取出，1例异位于腹腔；人流漏吸2例及宫腔异物2例均一次成功取出。结论：宫腔镜诊疗各种宫内疾病成功率高，安全性大，无并发症。     

节育环几种并发症的防治

计划生育四种手术中,放置节育环的数字占首位,放取节育环虽然方法简便,但也有发生并发症,故要求手术者具有高度政治责任感,掌握适应症和严格执行手术操作规程,积极预防并发症的发生,一旦发生,应及时妥善处理,以确保广大妇女身体健康,做好计划生育工作。下面介绍节育环几种并发症,以引起同道们的警惕。一、出血放置节育环后3～5天阴道有少量血性分泌物流出,属正常现象,不必处理。如引起较长时间的阴道流血或血量多于正常月经,则不     

放环后月经失调的辨证论治

放环后月经失调的辨证论治附属医院中医内科周亚萍在宫内放置节育环，是很受欢迎，又行之有效的避孕方法，但随着越来越多的妇女放置官内节育环，临床上因上环引起的月经失调病例渐渐增多。笔者在门诊时对上环前月经基本正常，上环后半年以上月经仍未恢复正常井经Ｘ光透环...     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.