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1.
我院近10年间因产科急诊行子宫切除39例,发生率为0.43%。其中剖宫产并子宫切除23例,占同期剖宫产的2.28%;阴道分娩后行子宫切除4例,占同期阴道分娩的0.05%。39例子宫切除中,胎盘因素因素居第一位占48.72%,子宫破裂居第二位,占17.95%,围产儿死亡率为410‰,孕产妇病死率为76.9‰。  相似文献   

2.
本院自1993年12月~2003年12月共分娩28930例,剖宫产6654例,因产科并发症行子宫切除19例,发生率0.066%,其中剖宫产时子宫切除比例占47.37%,剖宫产后子宫切除比例占10.53%,阴道分娩后比例占47.37%。19例子宫切除术中子宫次全切除16例。  相似文献   

3.
产后出血致子宫切除18例临床分析   总被引:40,自引:2,他引:38  
探讨产后出血致子宫切除的原因及处理方法。方法对1984年1月~1997年12月在北京医科大学第一医院分娩的21,816例孕妇中因产后出血致子宫切除的18例患者的情况进行了回顾性分析,总结了其孕期特点、分娩方式、剖宫产适应症、产后出血的原因及子宫切除的并发症。结果产后出血致子宫切除者占分娩人数的0.83‰。其中阴道分娩5例,剖宫产13例。行子宫全切术者6例,子宫次全切术者12例。出血原因为;宫内感染(33.3%),胎盘植入(22.2%),前置胎盘(16.7%),胎盘粘连(11.1%),胎盘早剥(11.1%),宫缩乏力(16.7%),子宫复旧不良(5.56%)、子宫切除术后无并发症发生。结论子宫切除术是抢救产后大量出血的重要手段,但其对产妇的身心健康有一定影响。产后出血致子宫全切的发生率在剖宫产组中高于阴道分娩组,故应掌握剖宫产指征,降低剖它产率,并加强围产保健,尽量减少产后出血所致的子宫切除术。  相似文献   

4.
目的分析近10年来产科急症子宫切除的手术指征及术后并发症。方法对产科急症子宫切除28例进行回顾性分析。结果28例实施急症子宫切除术的手术指征依次为:胎盘因素(39.3%),宫缩乏力(25%),子宫破裂(21.4%),剖宫产术后晚期出血(14.3%),产科急症子宫切除围产儿病死率为22.6%。结论胎盘因素是近年来产科急症子宫切除的主要手术指征。产科急症子宫切除术是抢救急症重出血孕产妇生命的重要措施。同时严格掌握剖宫产指征,加强手术基本操作,减少剖宫产子宫切口裂开以减少产科出血所致的子宫切除术。  相似文献   

5.
目的:探讨剖宫产子宫切除术与介入治疗的指征、时机及风险预测.方法回顾性分析2012年1月至2013年1月行子宫下段剖宫产术发生产后出血经介入治疗后仍行子宫全切术病例9例患者的临床资料,记录患者手术指征、疾病特点、各阶段手术用时及出血量相关参数.结果引起产后出血剖宫产手术最常见指征为凶险性前置胎盘,占56%,依次为Ⅲ度胎盘早剥、重度子痫前期.剖宫产手术中出血占总出血量的62%~70%.抢救总耗时(7.4±1.4) h,总出血量(7100±2250) mL.发生凝血功能障碍与手术时间、术中出血量呈显著相关性.结论对于具有疤痕子宫、前置胎盘、胎盘早剥、多孕多产等高危因素的剖宫产引起的产后出血,必须放宽指征及时切除子宫;产后出血早期进行介入治疗对于降低子宫切除率,减少术中、术后失血有重要意义.  相似文献   

6.
目的:对产科子宫切除原因进行探讨,总结经验教训。方法:通过对本院2002年1月-2004年8月产科急症子宫次全切除术18例进行回顾性分析。结果:在18例子宫切除中,剖宫产时子宫切除10例,占55.56%;阴道分娩时子宫收缩乏力行子宫切除4例,占22.22%;子宫破裂导致子宫切除3例,占16.66%;剖宫产后感染引起晚期产后出血切除子宫1例,占5.56%。结论:剖宫产行子宫切除的主要原因是前置胎盘、胎盘植入、胎盘早剥致子宫卒中及疤痕子宫造成的肌壁缺损而无法修补;阴道分娩时子宫收缩乏力多数是经产妇、多胎、妊娠合并贫血;子宫破裂多数是疤痕子宫以及多胎。急症产科子宫切除是治疗产时并发症、挽救产妇生命而采取的紧急措施之一,是一种破坏性手术,具有一定的特殊性,因此有必要对其发生原因及预防措施进行临床分析。  相似文献   

7.
为了减少围产期孕妇并发症及死亡发生,降低产科子宫切除发生率。我院自1976年1月至1997年12月共分娩21680例.其中剖宫产2710例,占12.5%,产科子宫切除17例,占0.078%,剖宫产子宫切除10例,产后子宫切除7例,(1例死亡),本文对产科子宫切除的指征、并发症、经验教育及预防措施进行临床分析。1临床资料1.1一般状况:产科子宫切除术.产妇平均年龄29.63岁(23岁至38岁);平均孕周38.5周.孕周最少为36周,>42周2例,人工流产、中期引产、产后清宫史7例,最多产次为9次。本组子宫次全切15例(占88.2%).全子宫切除术2例(占11…  相似文献   

8.
陈筱波 《现代实用医学》2005,17(8):505-505,470
目的探讨绝经后妇女卵巢肿瘤手术的经验。方法回顾性分析2000年1月~2004年12月收治的绝经后妇女卵巢肿瘤106例的临床资料。结果106例中良性肿瘤60例(占56.6%),恶性肿瘤37例(占34.9%);上皮性肿瘤86例(占81.1%)。95例行附件(单侧或双侧)切除,同时行子宫全切73例,子宫次全切除4例,盆腔淋巴结清扫12例;11例行细胞减灭术。术后早期患者恢复良好。结论绝经后妇女卵巢恶性肿瘤发生率高,应根据肿瘤性质行不同范围的手术切除。  相似文献   

9.
目的总结我院产科6年剖宫产手术近期并发症的发生情况,探讨剖宫产手术并发症的预防措施。方法对2003~2008年我院产科行剖宫产手术患者1436例近期并发症临床资料进行回顾性分析。结果1436例剖宫产手术患者中,发生产后出血73例(5.08%),子宫切口裂伤28例(1.49%);产褥感染21例(1.46%);腹胀10例(0.69%);副损伤1例(0.07%),这些病例均治疗成功。结论严格掌握剖宫产指征,手术前、手术中积极采取相应预防措施,以及手术后精心护理,是提高产科质量,减少剖宫产手术并发症发生的重要环节。  相似文献   

10.
子宫切除治疗重度产后出血14例分析   总被引:2,自引:0,他引:2  
韦献琼 《广西医学》2009,31(6):893-894
目的分析产科子宫切除的发生率、手术指征及母儿预后。方法回顾性分析我院6年间14例产科子宫切除患者的临床资料。结果产科子宫切除发生率0.11%,其中剖宫产子宫切除占85.7%。子宫切除术主要指征是胎盘因素占42.9%,子宫收缩乏力占21.4%。结论产科子宫切除是抢救产妇生命的重要措施,胎盘因素是产科子宫切除的主要原因。  相似文献   

11.
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.  相似文献   

12.
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.  相似文献   

13.
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.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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