绝经后宫内节育器取出术的临床观察及护理

目的:探索戊酸雌二醇联合米索前列醇应用于绝经后女性宫内节育器取出的效果.方法:2009年3月～2010年12月,将已放置宫内节育器绝经后女性共302例,随机分成两组:研究组152例,口服戊酸雌二醇片1mg,每日1次,共7d;对照组150例,不给予药物.两组均术前30min将米索前列醇片400μg(捣碎)放入阴道后穹窿,术中采用BELSON700型全程超导可视下行取环术,术中观察宫颈软化情况、术中取出宫内节育器效果情况比较.结果:两组宫颈软化情况比较,研究组宫颈软化程度优于对照组,具有显著性差异性(P＜0.05);两组术中取器效果比较.研究组术中顺利取器141例,困难取器11例;对照组术中顺利取器55例,困难取器94例,取器失败1例,具有显著性差异(P＜0.05).结论:给口服戊酸雌二醇片1mg,阴道后穹窿放入米索前列醇片400μg(捣碎),术中在全程超导可视下行取环术的操作,安全、可靠、成功率高,值得临床应用.     

Management of androgenetic alopecia in postmenopausal women

Female androgenetic alopecia or female-pattern alopecia is one of the most common causes of hair loss, affecting 50 % of women over their lifetime. The appearance of this condition is the cause of significant stress and psychological problems, making appropriate management important. Cases exist in which it is associated with hyperandrogenism. Here, we review the different clinical forms (diffuse, male-pattern, and Christmas-tree pattern), discuss the most appropriate laboratory tests (complete blood count, thyroid stimulating hormone, ferritin, prolactin, free and/or total testosterone, and dehydroepiandrosterone sulfate), and the different treatments, including finasteride.     

脉冲染料激光治疗面部毛细血管扩张162例临床分析

脉冲染料激光 (585nm)是一种直接作用于皮肤血管损害的激光,治疗鲜红斑痣 [1,2],国内已见文献报告 [1,2],本文总结其治疗面部毛细血管扩张的临床疗效,现报告如下。 1一般资料： 162例面部毛细血管扩张患者,男性 5例,女性 147例;年龄 5～ 40岁;其中 89例为面颊片状皮损,最大面积为 60cm2, 33例为鼻翼周边弧形分布皮损, 40例为蜘蛛痣。 2治疗方法：仪器是美国 Candela公司生产的脉冲染料 SPTI- 1b,波长为 585nm,脉宽为 450μ s,光斑直径为 7mm,密度为 7.5～ 8.5 J/cm2。能量密度大小取决于患者年龄、皮肤颜色深浅及部位。治…     

Finasteride treatment of patterned hair loss in normoandrogenic postmenopausal women

BACKGROUND: Finasteride, an inhibitor of type 2 5alpha-reductase, inhibits conversion of testosterone to dihydrotestosterone, resulting in a decrease in serum and scalp dihydrotestosterone levels believed to be pathogenic in androgenetic alopecia. Oral finasteride has been shown to be effective in the treatment of hair loss in men, while its efficacy in women has remained controversial. METHODS: 5 postmenopausal women without clinical or laboratory signs of hyperandrogenism were given 2.5 or 5 mg/day oral finasteride for the treatment of pattern hair loss. Efficacy was evaluated by patient and investigator assessments, and review of photographs taken at baseline and at months 6, 12 and 18 by an expert panel. RESULTS: Finasteride treatment improved scalp hair by all evaluation techniques. The patients' self-assessment demonstrated that finasteride treatment decreased hair loss, increased hair growth and improved appearance of hair. These improvements were confirmed by investigator assessment and assessments of photographs. No adverse effects were noted. CONCLUSIONS: Oral finasteride in a dosage of 2.5 mg/day or more may be effective for the treatment of pattern hair loss in postmenopausal women in the absence of clinical or laboratory signs of hyperandrogenism.     

不同避孕节育技术对已婚育龄妇女性生活质量影响的观察研究

目的：探讨不同避孕节育技术对已婚育龄女性性生活质量的影响,指导女性选择合适的避孕节育措施。方法：选取已婚育龄女性2384例作为调查对象,对其基本资料进行登记,要求所有被调查者对性生活质量满意程度进行评价,并通过《女性性生活质量量表》对其性生活质量进行评价。结果：被调查者有无生育史所采取的避孕措施存在着明显差异,无生育史者以避孕套、计算排卵期最为常见,分别占54．11％和31．32％,其次是采用避孕药避孕,占14．11％,没有人采用宫内节育器或者是结扎避孕。而有生育者多采用宫内节育器避孕,占59．34％,其次是避孕套和避孕药,分别占21．85％和15．01％,仅有少数患者采取结扎以及计算排卵期避孕。被调查是否有生育史所采取的避孕方式具有明显的差异,且这种差异具有统计学意义（P〈0．05）。未生育女性以及各种分娩方式的已经分娩女性采取不同避孕节育措施对性生活满意程度无明显差异,且《女性性生活质量量表》评分也无明显差异（P〉0．05）。结论：不同的避孕方式不会对女性的性生活质量造成明显的影响,已婚育龄女性可以根据自身的生育需求选择适宜的避孕措施。     

Endocrine factors in pre- and postmenopausal women with hidradenitis suppurativa

The relationship between hidradenitis suppurativa (HS) and hyperandrogenism is largely based on the finding of an increased free androgen index due to a low sex hormone binding globulin (SHBG). As SHBG is now believed to be regulated by factors that influence body weight, and previous studies were not controlled for body weight, we have re-evaluated the androgen status of female patients with HS. We have studied the endocrine status of 66 women with HS. Twenty-three had acne, and 23 were significantly obese (body mass index: BMI >30). There was no relationship between obesity and disease duration. Nineteen of 56 women were hirsute. A premenstrual flare in disease activity was reported by 32 women, but this was not related to menstrual disturbances. No consistent relationship was reported with pregnancy. Eight women with HS were menopausal at presentation, and one developed her disease 6 years after the menopause. Plasma androgens in women with HS were compared with controls matched for BMI and hirsuties. There was no difference between HS and controls. Testosterone and dehydroepiandrosterone sulphate were normal in all subjects with HS. In obese subjects, SHBG was reduced, consistent with BMI-matched controls. We have found no supporting evidence for biochemical hyperandrogenism in women with HS when compared with age-, weight- and hirsuties-matched controls. We report the continuation and primary development of HS in postmenopausal women.     

围绝经期抑郁症与性激素水平关系的研究

目的:探讨围绝经期抑郁症同性激素水平之间的相关性。方法:选择我院就诊的围绝经期女性采取抑郁自评量表对患者抑郁状态进行评定,分为有抑郁症组和无抑郁症组,每组患者50例,选择同期正常育龄女性50例作为对照组,检测性激素水平情况。结果:围绝经期抑郁症组E2(44.29±15.47)pmol/L,FSH(18.91±10.86)IU/L,LH(14.59±5.68)IU/L,上述指标同围绝经期无抑郁症组比较差异有统计学意义(t=21.1929、5.6134、6.3077;P0.05);同正常育龄期女性比较差异有统计学意义(t=26.0704、5.7674、6.5832;P0.05)。围绝经期抑郁症组PRL(290.31±34.63)pg/m L,P(3.61±2.07)m IU/m L,T(0.35±0.31)ng/m L,上述指标同围绝经期无抑郁症组比较差异无统计学意义(t=0.2583、0.0955、0.1639;P0.05);同正常育龄期女性比较差异无统计学意义(t=0.5326、0.1923、0.3174;P0.05)。结论:围绝经期抑郁症状发生同患者血清中雌激素减少以及卵泡刺激素和黄体生成激素升高相关,通过早期检测性激素水平有助于及时了解并调整患者内分泌缺失状态,能够早期诊断围绝经期抑郁症并评估抑郁程度,对提高围绝经期女性生活质量具有重要意义。