宫腔镜检查对子宫异常出血的诊断价值

目的探讨宫腔镜检查对异常子宫出血的诊断价值。方法回顾分析2005年6月至2006年6月就诊于我院的非阴道及宫颈因素所致异常子宫出血患者148例,行宫腔镜检查并取活检进行病理诊断。结果宫腔镜检查发现宫颈管息肉25例,子宫内膜息肉47例,粘膜下肌瘤7例,胚物残留4例,子宫内膜炎4例,疑似子宫内膜癌6例,子宫畸形2例,宫腔粘连5例,阳性率67.5%。病理诊断子宫内膜单纯增生70例,单纯伴复杂增生2例,局灶非典型增生3例,子宫内膜癌2例,子宫内膜息肉32例,子宫内膜炎5例,蜕膜样变4例,内膜息肉样增生1例,病理结果异常发生率为80.4%。结论宫腔镜检查异常子宫出血,同时病理诊断对宫内病变的诊断及治疗具有非常重要的价值,值得推广应用。     

宫腔镜诊治继发不孕110例分析

目的探讨宫腔镜对继发不孕患者宫腔内病变的诊断和治疗作用。方法110例继发不孕症患者,行宫腔镜检查及治疗。结果110例中宫腔异常情况为80例（72.7%）,宫腔镜下异常病理情况分别为：宫腔粘连42例,其中轻度粘连24例,中度粘连14例,重度粘连4例;子宫内膜息肉19例;子宫内膜增生17例;粘膜下肌瘤2例。术后1年内妊娠72例（65.5%）,术后2年内妊娠12例。结论宫腔内因素是造成继发不孕的主要原因之一,宫腔镜检查、治疗是诊治继发不孕的一种微创有效的治疗技术。     

宫腔镜诊治92例妇产科不孕不育症的临床研究

目的 探讨宫腔镜在诊治不孕不育症中的临床应用价值.方法 2008年2月～2009年3月收治的92例妇产科不孕不育患者采用宫腔镜进行临床诊断与治疗,取得了良好疗效,现将结果报道如下.结果 本文对收治的92例不孕不育症患者的进行宫腔镜检查发现异常共52例,其中子宫内膜惠肉及息肉样增生占首位,其次为子宫内膜炎和宫腔粘连.宫腔镜检查结果与术后的病理诊断结果进行比较发现二者诊断符合率较高,本文宫腔镜检查异常并行官腔镜手术的24例.结论 随着宫腔镜的飞速发展和长足的进步,不孕不育患者在治疗前,最好能先做宫腔镜检查,更有利于不孕不育症的治疗.     

腹腔镜监视下宫腔镜治疗子宫纵隔53例的临床观察

目的探讨在腹腔镜监视下宫腔镜手术治疗子宫纵隔的临床疗效及应用价值;方法对53例诊为子宫纵隔的患者,在腹腔镜监视下行官腔镜子宫纵隔切除术治疗,观察其临床疗效;结果53例患者均一次手术成功,宫腔镜手术时间平均（22．36±45．71）分钟,术中出血（15．06±37．38）ml,无子宫穿孔、水中毒、感染及大出血等并发症。53例患者中20例已成功足月分娩,1例孕33周胎膜早破,3例发生妊娠中晚期流产;结论腹腔镜监视下行宫腔镜子宫纵隔切除术实现了两种微创手术的优势互补,提高了疾病诊断的准确性、治疗的有效性、手术的安全性。     

宫腔镜诊治子宫内膜息肉30例临床分析

目的探讨宫腔镜下诊治子宫内膜息肉(EP)的临床效果。方法对30例宫腔镜下诊治子宫内膜息肉的资料进行总结。结果术前B超宫腔内异常回声,术后病理证实为EP7例,诊断符合率23.33%,镜下诊断EP30例,病理证实为28例,诊断符合率为93.33%,两者比较差异有显著性(P<0.05)。对30例镜下诊断子宫内膜息肉者,经宫腔镜定位后用刮匙对准息肉部位进行刮取,诊刮不能摘除息肉者,及术后药物治疗欠佳者13例行宫腔镜电切术。术后随访总有效率达100%。结论宫腔镜是诊治子宫内膜息肉的有效方法。     

502例不孕症患者宫腔镜检查结果分析

目的探讨宫腔镜检查在女性不孕症患者中的应用。方法回顾性分析原发性不孕180例,继发不孕322例患者进行宫腔镜检查的结果,比较不同不孕症的差异。结果1.不孕症中输卵管阻塞为167例（33.27%）,另外子宫内膜炎（24.90%）、子宫内膜息肉（10.76%）、子宫腔粘连（5.18%）、宫颈管肿物（3.98%）和先天性子宫发育异常（3.19%）也是常见原因。2.原发性不孕症中子宫内膜息肉、宫颈管肿物比例明显高于继发性不孕组,子宫内膜炎和输卵管阻塞方面继发性不孕组高于原发性不孕组。3.普通不孕组在子宫腔粘连方面明显低于试管婴儿组,在鞍状子宫等子宫先天性发育异常方面明显高于试管婴儿组。4.进行试管婴儿失败患者中原发性不孕与继发性不孕在宫腔异常分别为43.94%和36.84%,两者在子宫内膜息肉、子宫粘膜下肌瘤、宫腔粘连、宫颈管肿物、子宫内膜炎、先天性子宫发育异常等方面无显著性差异。结论宫腔镜具有创伤小,恢复快,病人无需住院的优点,在女性不孕症临床中有重要作用。     

宫腔镜联合B超诊治合并子宫假道的宫腔病变23例临床分析

目的探讨宫腔镜联合B超在诊治合并子宫假道的宫腔内病变的临床价值。方法选择2010年12月~2013年12月应用宫腔镜联合B超诊治合并子宫假道宫腔病变的患者23例,年龄22~65岁。其中异常阴道出血5例,闭经1例,不孕症2例,胚物残留8例,宫内节育器取出失败5例,宫腔粘连2例。行宫腔镜联合B超检查明确诊断,必要时随即行宫腔镜电切术或取环术。结果 23例患者均在宫腔镜联合B超下明确子宫假道的诊断,随即行宫腔镜下胚物残留电切术8例,宫腔镜下取环术5例,宫腔镜下宫腔粘连电切术2例,腹腔镜下子宫假道缝合1例。手术时间为5~40 min;术中出血量5.0~30.0 m L。无子宫穿孔、空气栓塞及经尿道前列腺电切术(TURP)综合征等并发症发生。结论宫腔镜联合B超检查是确诊子宫假道的方法,对合并子宫假道患者的宫腔镜手术在严密监护下谨慎快速完成操作是可行的、安全的。     

阴道超声联合宫腔镜对子宫内膜息肉的诊断分析

目的:分析阴道超声联合宫腔镜对子宫内膜息肉的诊断价值.方法:回顾性分析2018年1月至2020年7月德兴市中医院超声科接收的146例子宫内膜病变患者的临床资料,以子宫内膜活检为"金标准",比较阴道超声、宫腔镜以及联合检查诊断子宫内膜息肉的准确度差异,并统计检查过程中患者出现的不良反应.结果:经子宫内膜活检80例患者确诊为子宫内膜息肉.阴道超声诊断子宫内膜息肉的敏感度为78.75％,特异度为87.88％,准确度为82.87％.宫腔镜检查诊断子宫内膜息肉的敏感度为90.00％,特异度为93.94％,准确度为91.78％.联合检查诊断子宫内膜息肉的敏感度为97.50％,特异度为98.48％,准确度为97.94％.阴道超声不良反应发生率明显低于宫腔镜检查和联合检查(P<0.05).结论:阴道超声联合宫腔镜能应用于子宫内膜息肉的早期诊断,具有较高临床诊断价值.     

188例异常子宫出血宫腔镜检查的临床分析

目的 分析异常子宫出血(abnormal uterine bleeding,AUB)原因,探讨宫腔镜在异常子宫出血中的应用价值.方法 回顾分析188 例AUB患者宫腔镜检查和诊断结果.结果 AUB患者良性病变占95.74%(169/188),包括子宫内膜息肉、粘膜下肌瘤、子宫内膜炎等;恶性病变子宫内膜癌占4.26%(188).结论 宫腔镜对诊断异常子宫出血的准确率高,对有些良性病变可同时治疗,是一种安全可靠的方法.     

822例不孕症宫腔镜诊治的临床意义

目的探讨宫腔镜手术在不孕症患者诊治中的应用价值。方法回顾性分析应用宫腔镜诊治不孕症822例的临床资料。结果 822例不孕症患者行宫腔镜检查,宫腔及输卵管近端异常检出率为83.5%(686/822)。其中:宫腔大致正常者136例(16.6%);子宫内膜病变45l例(54.9%);宫腔粘连125例(15.2%);输卵管近端阻塞69例(8.4%);子宫畸形34例(4.1%);子宫粘膜下肌瘤5例(0.6%);宫内异物2例(0.2%)。822例不孕患者经宫腔镜治疗后随访,有204例正常宫内妊娠,术后妊娠率为24.8%(204/822)。其中:宫腔大致正常者25/136(18.4%,);子宫内膜病变103/451(22.8%,);宫腔粘连39/125(31.2%,);输卵管近端阻塞20/69(29%,);子宫畸形15/34(44.1%,);子宫粘膜下肌瘤2/5(40.0%,);宫内异物0/2(0%,)。结论宫腔镜诊治不孕症准确、有效、简单、微创、并发症少,是目前诊治女性不孕症最有效的手段之一,值得临床应用、推广。     

激光泪道成形术治疗泪道阻塞的临床观察

目的 观察激光泪道成形术治疗泪道阻塞的效果及复发病例再次激光联合插管治疗的效果。方法 采用Nd：YAG激光泪道成形术治疗泪道阻塞102例。132眼。对复发病例。再次行激光联合插管治疗。结果 113眼一次治愈，有效9眼。术后10眼复发，再次行激光联合插管治疗，7眼治愈，3眼未愈。本组总治愈率90．9％，有效率97．7％。结论 Nd：YAG激光泪道成形术治疗泪道阻塞操作简单，安全有效，复发病例联合插管治疗可以提高治愈率。     

强脉冲光联合Nd:YAG激光治疗黄褐斑疗效观察

目的:探讨强脉冲光联合Nd:YAG激光治疗黄褐斑的疗效。方法:60例患者按治疗方法不同分成3组:强脉冲光组、Nd:YAG激光组、联合组（强脉冲光联合Nd:YAG激光组）,每组20例患者,观察3组患者疗效和副作用。结果:3组之间疗效两两比较采用Mann-Whitney秩和检验,强脉冲光组和激光组疗效无显著差异,而联合组疗效显著好于强脉冲光组（Z=7.123, P=0.024）和激光组（Z=6.024, P=0.030）。3组患者治疗后均无出现色素沉着加重、色素脱失病等不良反应。强脉冲光组和激光组的满意度无显著差异,而联合组的满意度显著好于强脉冲光组（Z=7.361, P=0.029）和激光组（Z=6.831, P=0.027）。结论:强脉冲光联合Nd:YAG激光治疗黄褐斑是一种安全有效的治疗方法,值得临床推广。     

Endoscopic laser surgery for subglottic stenosis in Wegener's granulomatosis

PURPOSE: Wegener's granulomatosis (WG) is a rare multisystem inflammatory disease, which infrequently involves the subglottic area and trachea. Treatment usually involves the use of immunosuppressive agents with corticosteroids. Some patients, however, continue to have symptoms of airway obstruction after clinical remission following the standard therapeutic regimen. OBJECTIVE: To investigate laser treatment for subglottic stenosis in five patients suffering from WG. MATERIALS AND METHODS: We endoscopically treated 5 patients with subglottic stenosis due to WG and airway obstruction by Nd:YAG and CO2 lasers. One of the patients had preoperative tracheostomy and after treatment was decannulated and could not breathe without dyspnea. Another patient required stenting of the subglottic area. RESULTS: All five patients were able to breathe without dyspnea after the treatment. Three patients were treated with an Nd:YAG laser but needed repeated laser treatment every four to six months, whenever they complained of dyspnea. The other two patients were treated with a CO2 laser; one of these patients had preoperative tracheostomy and was treated twice by CO2 laser and decannulated, with no further difficulty in breathing. The follow-up period was 1-5 years. CONCLUSIONS: Nd:YAG and CO2 lasers are recommended in the treatment of subglottic stenosis (SS) due to WG, particularly when the stenosis is in continuity or close proximity to the vocal cords.     

Nd：YAG激光泪道成形术和鼻泪管支架术治疗慢性泪囊炎的疗效对比

目的比较Nd：YAG激光泪道成形术和鼻泪管支架术治疗慢性泪囊炎的临床效果。方法 93例（102眼）慢性泪囊炎患者随机分成两组,一组应用Nd：YAG激光泪道成形术治疗,另一组应用鼻泪管支架术治疗,比较两组的治疗效果。结果应用Nd：YAG激光泪道成形术治疗57眼,有效39眼（68.42%）;鼻泪管支架术治疗45眼,有效40眼（88.89%）,两组疗效差异有统计学意义（χ2=6.03,P〈0.01）。结论鼻泪管支架术相对于同样微创的Nd：YAG激光泪道成形术治疗慢性泪囊炎疗效更加稳定,手术成功率更高,不失为微创治疗慢性泪囊炎的首选术式。     

Long-Pulsed Nd:YAG Laser Treatment of Warts: Report on a Series of 369 Cases

Various treatment methods have been adopted in the management of warts; however, there is still no consensus on first-line treatment. This study was designed to evaluate the efficacy of long-pulsed Nd:YAG laser in the treatment of warts. Over the course of 1 yr, 369 patients with recalcitrant or untreated warts were exposed to a long-pulsed Nd:YAG laser. The following parameters were used: spot size, 5 mm; pulse duration, 20 msec; and fluence, 200 J/cm². No concomitant topical treatment was used. In all, 21 patients were lost during follow up; hence, the data for 348 patients were evaluated. The clearance rate was 96% (336 of the 348 treated warts were eradicated). The clearance rate of verruca vulgaris after the first treatment was very high (72.6%), whereas the clearance rate of deep palmopantar warts after the first treatment was low (44.1%). During a median follow-up period of 2.24 months (range, 2-10 months), 11 relapses were seen (recurrence rate, 3.27%). In conclusion, long-pulsed Nd:YAG laser is safe and effective for the removal or reduction of warts and is less dependent on patient compliance than are other treatment options.     

Q开关Nd：YAG激光联合左旋维生素C离子导入治疗黄褐斑的临床观察

目的：探讨Q开关Nd：YAG激光联合左旋维生素C离子导入治疗黄褐斑的临床疗效和安全性,为黄褐斑的治疗提供疗效确切并安全的治疗方法。方法：将90例黄褐斑的患者随机分为3组,每组30例。治疗组给予Q开关Nd：YAG激光联合左旋维生素C离子导入治疗;对照1组单纯给予Q开关Nd：YAG激光治疗;对照2组单纯给予左旋维生素C离子导入治疗。激光治疗每两周1次,左旋维生素C离子导入每周1次,共治疗16周。分别在治疗8周后和16周后通过MSAI评分进行疗效分析,并在治疗结束后以水疱、座疮以及色素沉着和色素减退来进行不良反应分析。结果：在治疗8周后,联合治疗组与对照1组疗效差异无统计学意义（尸〉0．05）,与对照2组疗效差异有统计学意义（P＜O．05）;16周时治疗组有效率为73．33％,对照1组为73．33％,对照2组为36．67％,差异有统计学意义（P均〈O．05）;治疗组不良反应发生率为20．00％,对照l组为33．33％,对照2组为3．33％,差异无统计学意义（P〉0．05）结论：治疗8周后,Q开关Nd：YAG激光联合左旋维生素C离子导人治疗的方法疗效并不优于单纯激光治疗,但优于单纯左旋维生素C离子导人的方法;治疗16周后,Q开关Nd：YAG激光联合左旋维生素C离子导入治疗黄褐斑比两者单独应用效果好;安全性有保障,值得临床推广。     

Nd：YAG泪道激光成形术治疗泪道阻塞的体会

目的 探讨应用泪道激光治疗泪道阻塞的方法及疗效。方法 应用Nd：YAG泪道激光仪按泪道探通方法连续击射阻塞部位。用抗生素和丝裂霉素C混合液冲洗畅通后植入义管，每周冲洗一次，1月后拔管。结果共治疗53例60眼，随访1～3月。治愈57眼占95％，好转2眼占3．33％，无效1眼仍有溢脓，1月后行泪囊鼻腔吻合术治愈。结论 激光泪道成形术治疗泪总管、鼻泪管阻塞及泪囊炎，方法简单、疗效满意。     

Pulsed laser deposition of pseudowollastonite coatings

Pseudowollastonite (alpha-CaSiO3) is a bioactive ceramic material that induces direct bone growth. A process to obtain pseudowollastonite coatings that may be applied to implants is described and evaluated in this work. The coatings were first deposited on titanium alloy by laser ablation with a pulsed Nd:YAG laser tripled in frequency. After deposition, they were submitted to a soft laser treatment with a continuous wave Nd:YAG infrared laser. Coatings were characterised by X-ray diffractometry, Raman spectroscopy, scanning electron microscopy and energy dispersive spectroscopy before and after the laser treatment. As-deposited coatings are composed of pseudowollastonite and amorphous material. They have a porous structure of gathered grains and poor cohesion. After the laser treatment the coatings crystallinity and cohesion are improved. The laser treatment also makes the coatings dense and well adhered to the substrate. Therefore, this two-step process has been demonstrated as a valuable method to coat titanium implants with pseudowollastonite.     

Long term following up of G lens of phaco model

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