妊娠高血压孕妇的发病因素与干预

目的:探讨孕产妇妊娠期并发高血压疾病的危险因素,提出相关干预措施。方法:选择进行产前检查并住院待产孕妇480例,其中妊娠高血压孕妇50例,发病率为10.4%,对临床资料进行了调查与观察预后。结果:双胎、年龄、基础舒张压、体重指数、高血压家族史及补充叶酸为导致妊娠高血压孕妇的主要独立发病因素(P<0.05)。经过积极的干预后,都顺利分娩,产妇无严重并发症发生,新生儿都健康。结论:妊娠高血压孕妇的发病因素包括双胎、年龄、基础舒张压、体重指数、高血压家族史及补充叶酸,为此需要加强积极地治疗与护理。     

妊娠高血压综合征130例临床分析

目的探讨妊娠期高血压综合征临床特点。方法回顾性分析我院2004年1月～2008年12月1750例住院分娩孕产妇的病史资料。结果在1750例孕妇中,妊高征130例,发病率为7.42%,≥35岁的发病率明显增高,初产妇中有合并有妊娠高血压综合征高于经产妇,双胎或多胎妊娠高于单胎妊娠,提早终止妊娠妊高征高于正常妊娠,妊高征低体重儿明显高于正常孕妇,妊高经阴道分娩征明显低于正常孕妇。结论对年龄≥35岁的孕妇、双胎或多胎妊娠的孕妇、初产妇应加强常规的孕期保健及产前检查。妊高征患者的早期监测和积极治疗可以降低妊高征对母体的影响。     

异常妊娠

980973.一1997妊娠高血压/熊庆//中华妇产科杂志,32(9)一569一572 妊娠高血压是导致孕产妇和围产儿死亡的主要原因,研究表明,社会经济状况低下、孕妇年龄小、PIH家族史、慢性高血压、慢性肾脏疾病等是其危险因素。PIH的临床表现:血压持续升高使收缩压达18.7KPa或舒张压12.OKPa。血管痉挛是妊高征患者器官受累的主要原因。妊高征患者肾小球损伤的结果是肾小球滤过率下降,蛋白尿及钠贮留。妊高征患者常有反射亢进,还可能出现肺水肿。PIH的临床处理:小剂量阿司匹林能预防妊高征的发生;补钙可能降低PIH发生的危险。终止妊娠是治疗妊高征…     

早期发生型妊娠高血压综合征的妊娠结局

妊娠高血压综合征(简称妊高征)是严重危害母婴健康的常见疾患,其发病原因及机制尚不十分清楚,迄今国际上尚无统一命名与分类。近年来国外有人提出早期发生型妊高征(early onset preeclampsia)这一概念,认为这类妊高征经常伴有胎盘梗阻、胎儿生长迟缓(IUGR),预后不良。我们通过回顾性分析重症妊高征患者45例,探讨早期发生型妊高征的特点及患者的母婴预后。     

重度妊高征剖宫产39例临床分析

妊娠高血压综合征(妊高征)是妊娠期特发疾病,重度妊高征由于病情严重,对母婴危害极大.大量资料证明,重度妊高征除药物治疗外,适时剖宫产是抢救重度妊高征的一种有效手段.如何加强重度妊高征围手术期采取切实有效的具体措施,将直接影响母婴预后.为此,本文收集我院5年来对39例重度妊高征患者手术期资料进行回顾性分析,探讨重度妊高征的处理原则,现报告如下.     

长沙市北区妊娠高血压综合征二年流行病学调查分析

长沙市北区12万人群2年前瞻性妊娠高血压综合征(妊高征)流行病学调查结果发病率为14.9％(439/2945),重度占2.8％、子痫占0.27％,无孕产妇死亡,围产死亡率为10.8‰。妊高征组特别是重度者对母儿危害远高于对照组。年龄大、劳动强度大、初孕妇、双胎、有高血压家族史或合并贫血、肝炎、慢性高血压(慢高)者发病率明显高于对照组。     

妊娠高血压综合征危险因素的Logistic回归分析

目的：探讨妊娠高血压综合征(妊高征)发生的影响因素。方法：采用1：1配比的病例对照研究方法,对妊高征危险因素进行条件Logistic回归分析。结果：孕产妇年龄、丈夫吸烟、体重指数(BMI)、母亲妊高征史、性格类型、基础舒张压等是妊高征的危险因素;孕产妇的文化程度、尿钙／肌酐(Ca／Cr)比值是妊高征的保护因素。结论：在妊高征的防治工作中既要重视生物遗传因素对妊高征的影响,也要对社会心理因素在妊高征发病中的重要意义给予足够重视。     

妊娠高血压综合征与MTHFR基因及血浆同型半胱氨酸水平的关系

目的探讨妊娠高血压综合征与N5,N10-亚甲基四氢叶酸还原酶(MTHFR)基因及血浆同型半胱氨酸(Hcy)水平的关系。方法运用多聚酶链反应-限制性内切酶片段长度多态性技术(PCR-RFLP)检测42例妊高征患者,36例正常妊娠妇女及30例非妊娠妇女,MTHFR基因多态性,用高效液相色谱仪和电化学检测法测定42例妊高征患者,36例正常妊娠妇女及30例非妊娠妇女血浆总Hcy水平。结果MTHFR基因型有3种,即纯合子(T／T)型,杂合子(T／C)型,纯合子(C／C)型。非妊娠组,正常妊娠组及妊高征组之间的基因型和等位基因频率差异均无显著性(P＞0.05)。妊高征组总Hcy水平(14.06±6.06)μmol／L明显高于正常妊娠组(P＜0.001);并随妊高征病情的加重,总Hcy水平呈逐渐上升趋势,重度妊高征明显高于轻度妊高征(P＜0.05)。结论MTHFR基因突变与妊高征发生无关;高同型半胱氨酸血症是妊高征发病的一个新的危险因素。     

妊娠高血压综合征的诊治进展

妊娠高血压综合征是产科严重威胁母婴健康的疾病，发病原因至今尚未明了，一般认为发病与家族史、情绪、肥胖、妊娠时的年龄和钙代谢失衡等因素有关。预测性诊断有助于妊高征的早期发现、早期诊断和早期治疗，其治疗原则是解痉及镇静、降压、适时终止妊娠。     

重度妊娠高血压综合征的观察及护理

妊娠高血压综合征 (以下简称妊高征 )是孕妇特有的全身性疾病 ,其主要特征为妊娠晚期孕妇出现水肿、高血压、蛋白尿 ;重症患者可出现头痛、胸闷、视力障碍、甚至抽搐或昏迷等。严重地威胁着母婴的生命安全。本病一般发生于妊娠 32周以后 ,多见于初孕妇及畸胎、羊水过多、多胎妊娠等。1997年 1月至 1998年 11月我院共收治妊高征 5 5例 ,现谈谈妊高征患者的护理体会。1　临床资料　　 5 5例中 ,年龄 2 0～ 30岁 35例 ,30～ 45岁 2 0例 ,其中子病人 15例 ,占妊高征 2 7.30 % ,均采用镇静、解痉、降压、降低颅内压、利尿等综合处理 ,颈静脉穿…     

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…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.