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1.
Clinical use of a new forceps for foreign body removal (Intrauterine forceps) is introduced in this paper. The forceps can fit in uterine cavity during operation. A total of 310 foreign bodies in uterus, including IUD breakage, IUD embedment and remained fetal bone were removed satisfactorily by the new forceps. Two case failed.The two failed cases were not diagnosed before operation. One was a broken stainlesss teel ring and embedded into myometrium deeply. It was difficult to remove the IUD and the patient was advised to undergo a hysteroscopy diagnosis. Another one was a stainless steel V-shaped Cu IUD, which was broken into several pieces and removed by the forceps, but a small piece remained and was removed with aid of hysteroscopy.The new type of foeceps was proved to be effective and should be popularized.  相似文献   

2.
正Tuberculosis(TB)is a formidable global health problem and ranks above HIV as the leading cause of death world wide.In2017,a total number of 10.0 million cases of TB were reported, which resulted in1.3 million TB deaths. Resistance to standard anti-TB  相似文献   

3.
Background Obstructive lung disease (OLD, chronic obstructive pulmonary disease or asthma) is an important cause of death in older people. There has been no exhaustive population-based mortality study of this subject in Shanghai. The objective of this study was to use a multiple cause of death methodology in the analysis of OLD mortality trends in the Yangpu district of Shanghai, from 2003 through 2011. Methods We analyzed death data from the Shanghai Yangpu District Center for Disease Control and Prevention for Medical Cause of Death database, selecting all death certificates for individuals 40 years or older on which OLD was listed as a cause of death. Results From 2003 to 2011, there were 8 775 deaths with OLD listed, of which 6 005 (68%) were identified as the underlying cause of death. For the entire period, a significantly decreasing trend of age standardized rates of death from OLD was observed in men (-6.2% per year) and in women (-5.7% per year), similar trends were observed in deaths with OLD. The mean annual rates of deaths from OLD per 100 000 were 161.2 for men and 80.8 for women from 2003 to 2011. While, as the underlying cause of death, the main associated causes of death were as follows: cardiovascular diseases (70.7%), carebrovascular diseases (13.3%), diabetes (8.6%), and cancer (4.3%). The associated causes and the principal overall underlying causes of death were cardiovascular diseases (37.0%), cancer (30.3%), and cerebrovascular disease (15.3%). A significant seasonal variation, with the highest frequency in winter, occurred in deaths identified with underlying causes of chronic bronchitis, other obstructive pulmonary diseases, and asthma. Conclusions Multiple cause mortality analysis provides a more accurate picture than underlying cause of total mortality attributed on death certificates to OLD. The major comorbidities associated with OLD were cardiovascular disease, cancer, and cerebrovascular disease. From 2003 to 2011, the mortality rate from OLD decreased substantially in the Yangpu district of Shanghai.  相似文献   

4.
Objective To improve the therapeutic and preventive measure for elderly patients (75 years and over) with idiopathic Parkinson’s disease (OEIPD). Methods Fifteen OEIPD patients were observed prospectively over a long period of time. Their diagnosis was confirmed by autopsy. Based on clinical and pathological data, the causes of death were analyzed.Results The mean clinical course in OEIPD patients was 6.2±3.6 years. The majority of the 15 patients were the akinetic type and the akinetic type with tremor (80.0%). In the late stages of disease (4.8±3.5 year), choking occurred in 12 OEIPD patients who received nasal feeding for an average of 4 months after the occurrence of choking. The most common complication in 12 patients was repeated pulmonary infections with an average rate of 2.9±1.9. The causes of death were bronchial pneumonia and shock induced by pulmonary infection (11 cases, accounted for 73.3%), acute myocardial infarction (2 cases), one case with cardiac rupture and one case with rupture of aortic aneurysm. Conclusions The clinical course was shorter in OEIPD patients. Levodopa therapy should be started early in OEIPD patients. Bronchial pneumonia and infectious shock constitute the major cause of death and choking was one of the main causes of aspiration pneumonia. Nasal feeding should be started as early as possible after the appearance of choking. Silent aspiration can be reduced by teaching the patient to protect the airway by ’supraglottic swallowing’.  相似文献   

5.
The purpose of this investigation was to offer evidence that immumohistochemical staining is applicable to the determination of morphin distribution in human tissues from cases of opiate associated death. We studied 4 cases of opiate associated death and 2 cases of sudden cardiac death without a history of drug abuse as control. The samples were taken from cerebral cortex and  相似文献   

6.
Analysis of Nine Cases of Acute Thallium Poisoning   总被引:1,自引:0,他引:1  
In this study nine cases of thallium poisoning in a series of homicidal poisoning were analyzed in order to provide more information concerning thallium poisoning. It was found that the most common clinical feature of thallium poisoning was peripheral neuropathy and paraesthesia was more common than amyasthenia. Understanding of these clinical characteristics of thallium poisoning was helpful to early identification and differential diagnosis. Since the early administration of Prus- sian Blue, as a specific antidote for thallium poisoning, can substantially improve the prognosis, it is of great importance to establish a correct and early diagnosis.  相似文献   

7.
Changes of spinal evoked potentials (SEP) were observed in rats by stimulatingthe sciatic nerves on both sides under various pressure conditions (normal,hyperbaric,rapid decompression,safe decompression,and recompression treatment) and in acuteanoxia.It was observed that occurence of acute decompression sickhess (DCS) was relatedwith changes of SEP.The changes of SEP late components (N_3,P_3,N_2) occurred earlierthan SEP early components (P_2,N_1,P_4).It was shown that in using SEP method tomonitor DCS,late components were more sensitive as compared with early components andspecial attention should be given to the amplitudes of SEP.As soon as changes of latecomponents appeared,acute DCS would follow.If recompression would be given at thispoint,DCS could be reduced or eliminated.When early components showed changes,DCSwas in such a stage as to cause immediate death of the animals.Recompression had noeffects at this point.The late components and early components,therefore,were ofsignificantly different value in reflecting the level of DCS.N_2 wave was an important key.The results suggest that using the SEP method to monitor acute DCS is a sensitive andaccurate way.  相似文献   

8.
Objective To investigate the perioperative treatment,the cause of death,and complications of the lung resection for therapy of central type carcinoma of lung.Methods we retrospectively analyzed the treatment and prognosis of 136 patients with central type carcinoma of lung using the bronchus-first lung resection through pericardium during May 1993 to December 2006.Results Total amount of complications in this group was 40 cases,among them,5 cases with pulmonary arterial bleeding,4 cases with respiratory dysfunction,3 cases with contralateral lung pneumonia,6 cases with heart dysfunction,15 cases with arrhythmia,2 cases with injury of recurrent laryngeal nerve,3 cases with chylopleura,and 2 cases with leaking of the bronchus nub.The total complication rate was 27.9%.3 cases died during perioperation,and the mortality was 2.2%.The older the patients were,the higher rate of complications occurred.Conclusion In this group of 136 cases of lung carcinoma,the frequent postoperative complications were the complications of respiratory system and cardiovascular system.The leading causes of death were respiratory dysfunction and heart dysfunction.According to our data,we concluded that the prevention and treatment should be performed during perioperation as follows:Airway should be intensively cared and prepared before operation.The ventilation should be kept unblocked after operation.Assistant ventilation should be performed if necessitated.For those with coronary heart disease or pulmonary heart disease active treatment should be given carefully.Efficient acesodyne and sedation and strictly monitoring of cardiograph should be given postoperatively,finding out the cause of arrhythmia for the correct therapy to protect the heart function.In addition,the indication of operation should be strictly predominated and the principle of operation should be kept on.  相似文献   

9.
A 27-year-old patient was diagnosed by hysteroscopy with uterine diverticulum in pregnancy and admitted to the hospital Under the guidance of hysteroscopy combined with methotrexate, the scraping of the uterus was done and operation successfully completed. The management of this case showed that hysteroscopy was a kind of valuable approach to the diagnosis and treatment of uterine diverticulum and curettage of the uterus under hysteroscope combined with drug was a safe, effective and conservative treatment .  相似文献   

10.
Background There are many different materials used for ligament reconstruction. Currently, autograft, allograft, and artificial ligaments are used in the reconstruction. The objective of this study was to explore the clinical result of cruciate ligament reconstruction under arthroscopy. Methods Eighty-one cases were reconstructed with the LARS ligament under arthroscopy, including 43 cases of anterior cruciate ligament (ACL) injury, 20 cases of posterior cruciate ligament (PCL) injury, and 18 cases of ACL combined with PCL injuries of the knee. The follow up period was 10 to 49 months. The International Knee Documentation Committee (IKDC) and Lysholm knee score scales were used for functional evaluation. We examined the anterior and posterior stability of the knee with KT-1000. Results According to the Lysholm knee function score scale, the average preoperative score of (44.6±1.4) increased to a postoperative score of (82.8±2.5) in the ACL group and from (46.6±2.3) to (80.8±2.0) in the PCL group. In the ACL combined with PCL injury group, the preoperative score increased from (45.2±1.2) to (85.5±2.3). According to IKDC score standards, in ACL group we evaluated 19 cases as C and 24 cases as D, preoperatively, and postoperatively 27 cases as A, 14 cases as B and two cases as C. In the preoperative PCL group, we had 11 cases defined as C and nine cases as D that resolved to 12 cases as A, seven as B and one case of C in postoperative evaluation. In the ACL combined with PCL injury group we defined four cases as C and 14 as D during preoperative scoring. These patients had postoperative grades of six cases as A, 10 as B, and two cases as C. All of the results have statistical significance. Conclusions ACL, PCL, or combined ACL and PCL reconstruction using the LARS ligament under arthroscopy is a minimally invasive, safe and effective method to treat cruciate ligament injuries of the knee. Clinical results are satisfactory in the short term.  相似文献   

11.
对我院 1991年至 1998年住院 13例宫内节育器 (Intrauterine Contraceptive Device ,IUD)异位的分析发现 ,怀疑 IU D异位的主要原因为带器妊娠取环失败 (8/ 13)。 IUD异位的诊断及定位需综合应用腹部 B超、盆腔 X线、宫腔镜及腹腔镜等检查手段。异位分类中 5例为子宫肌壁嵌顿 ,其中单纯经宫腔镜手术 3例取出完整 IU D,1例取出部分断裂的 IUD而遗留少许于子宫壁内 ,1例经开腹取出因断裂而完全嵌顿于肌壁间的 IUD;8例为腹腔异位 ,经腹腔镜取出 5例 ,2例开腹取出 ,1例放弃。宫腔镜及腹腔镜手术取出异位环 ,诊断及治疗可同时进行 ,且对患者损伤小 ,术后恢复快 ,因此在绝大多数异位 IUD的诊治中将取代开腹取环术。但对异位于腹腔伴有严重粘连的 IU D,或者合并脏器损伤时 ,开腹取环并修补脏器损伤仍为必要。  相似文献   

12.
目的探讨迷路宫内节育器(IUD)应用超声引导下监视宫腔镜取环的临床应用价值。方法对28例常规取环困难、常规及宫腔镜取环失败者采用超声引导全程监视宫腔镜取环。结果 28例患者均顺利取出节育环,未发生子宫损伤或子宫穿孔。结论 B超引导下监视宫腔镜取环,具有直观、准确、及时、全面等优点,可减少并发症,提高手术成功率及安全性。  相似文献   

13.
宫腔镜联合B超在宫内节育器取出困难时应用分析   总被引:7,自引:0,他引:7  
目的:探讨宫腔镜联合B超在宫内节育器(IUD)取出困难时的应用价值。方法:对125例常规取IUD困难患者,采用宫腔镜联合B超检查,准确定位后经阴道或经腹取IUD。结果:宫腔镜联合B超检查发现位置正常49例,部分嵌顿41例,断裂残留28例,扭曲变形6例,腹腔内1例。除腹腔内1例经腹取出外,其余124例全部经阴道一次成功取出。结论:宫腔镜联合B超能够正确指导取器方法,提高成功率和安全性。  相似文献   

14.
宫腔镜处理难取宫内节育器55例分析   总被引:1,自引:0,他引:1       下载免费PDF全文
为探讨宫腔镜处理难以取出的宫内节育器的安全性和有效性 ,以及术中B超和 (或 )腹腔镜监护的必要性 ,回顾性分析 1 998年 1月至 2 0 0 3年 6月在外院取器失败而转入我中心诊治的 5 5例患者的临床资料。全部患者手术均行B超监护 ,有 4例术中同时腹腔镜监护。结果 :宫腔镜下取出 5 3例 ,1例异位至腹腔者在腹腔镜下取出 ,另 1例术前B超发现双侧卵巢囊实性肿物改行全子宫和双附件切除术 ,有 2例合并宫腔粘连者术中发生子宫穿孔。提示 :宫腔镜处理难以取出的宫内节育器是安全和有效的 ,术中B超和 (或 )腹腔镜监护是必须的。  相似文献   

15.
目的分析宫内节育器异位的成因、临床诊断、治疗和预防措施。方法对2008年1月-2012年5月进行的21例宫内节育器异位病例进行分析。结果 11例(52.38%)部分异位于子宫颈或者子宫肌层,4例(19.05%)完全异位于子宫颈或者子宫肌层,1例(4.76%)异位于直肠子宫凹陷,2例(9.52%)异位于膀胱子宫凹陷,1例(4.76%)异位于阔韧带和2例(9.52%)异位于腹腔。所有病例借助X-射线、CT、腹腔镜或者宫腔镜成功取出。结论节育器异位的准确定位、诊断和治疗需要结合多种方法,如CT、宫腔镜等。选择适宜的时机和节育器类型,遵守严格的节育器操作规程以及加强置器后的随访有助于节育器异位的预防。  相似文献   

16.
宫腔镜检在不育及习惯性流产诊治中的价值   总被引:1,自引:0,他引:1  
本文分析1983年4月至1990年7月在我院行宫腔镜检的不育及习惯性流产患者90例。镜检发现宫内异常占74.4%。在镜检中或镜检后手术治疗60例,追随45例,其中妊娠19例。宫腔粘连13例妊娠5例,子宫内膜息肉22例妊娠6例。另外6例虽经手术处理但因黄体功能不足尚在继续治疗中,经分析看出宫腔镜检、B超声及子宫碘油造影在不育检查中各有优点,但宫腔镜检与后两种技术比较,能更真实、准确反映宫腔内状况,并且可以同时手术而解决因宫内异常造成的不育。故宫腔镜检在不育诊治中有重要意义。  相似文献   

17.
目的探讨宫腔镜处理宫内节育器取出困难的优势和必要性。方法回顾性分析2005年6月~2011年7月我院收治的53例节育器取出困难患者,经宫腔镜检查发现,在宫腔镜直视下(必要时B超引导),采取直接夹取、针状电极电切粘连带,游离节育器后,以取环钩取出、环形电切环切除黏膜下肌瘤后,宫腔镜下取环钩取出,2例因宫内节育器异位入盆腔,经宫腹腔镜联合手术取出。结果 53例患者中,51例经宫腔镜处理后取出,2例经宫腹腔镜联合手术取出。结论宫内节育器取出困难的原因与节育器嵌顿子宫黏膜下层、嵌入肌层、套入黏膜下肌瘤蒂部及宫腔形态异常、宫腔粘连包裹节育器及异位有关,宫腔镜有操作方便、直观、图像放大、止血迅速、创伤小、无伤口等优点,是处理宫内节育器取出困难时的首选措施。  相似文献   

18.
Ninety cases of infertility and habitual abortion were analyzed by hysteroscopy between April 1983 and July 1990 in PUMC hospital. Abnormal changes of the uterine cavity were seen in 74.4%. The result of hysterosalpingography corresponded with that of hysteroscopy in 62.5%, and the result of B-ultrasound corresponded to that of hysteroscopy in 52.5%. The diagnosis of adhesion and polyps of the uterine cavity was made accurately by hysteroscopy, and both could be operated under hysteroscopy. After operative removal of the adhesion, an IUD should be put into the uterine cavity for 3 months. In 60 cases operations were performed during or after hysteroscopy. Of the 45 patients followed, 19 achieved pregnancy. Five patients achieved pregnancy after operative removal of the adhesion. It is concluded that hysteroscopy is more important than B-ultrasound and hysterosalpingography in the examination and treatment of infertility.  相似文献   

19.
宫腔镜联合B超监测下取出嵌顿宫内节育器60例临床分析   总被引:1,自引:0,他引:1  
邓贞霞  江莉 《医学综述》2011,17(18):2864-2866
目的探讨宫腔镜联合B超监测下取出嵌顿宫内节育器(IUD)的临床价值。方法选取哈密市中心医院2007年6月至2009年6月嵌顿IUD患者60例,随机分为三组,单用B超监测下取出嵌顿IUD(A组)20例,单用宫腔镜监测下取出嵌顿IUD(B组)20例,宫腔镜联合B超监测下取出嵌顿IUD(C组)20例。对60例患者的临床资料进行分析,并比较种不同方法取出IUD的时间和一次性成功取出率,并观察不良反应和并发症。结果 A组一次性成功取出率为80%(16/20),B组成功取出率为70%(15/20),C组成功取出率为100%(20/20),三组一次性成功取出率比较差异有统计学意义(P<0.05)。A、B、C三组的手术操作时间分别为(7.0±2.5)min(、5.0±2.0)min和(3.5±1.0)min。三组手术时间比较差异有统计学意义(P<0.05)。三种方法取出IUD均未发现明显不良反应和并发症。结论 B超监视下宫腔镜取环可提高各种嵌顿IUD的一次性成功取出率,提高手术的准确性,缩短手术时间,减轻患者的痛苦,值得临床推广应用。  相似文献   

20.
目的探讨宫腔镜在常规方法取宫内节育器(IUD)失败后病例中的应用价值。方法回顾性分析39例应用常规方法取IUD失败后病例应用宫腔镜处理的结果。结果应用宫腔镜及宫腔电切镜成功取出37例,2例通过腹腔镜取出。结论宫腔镜可作为常规取IUD失败后的首选诊断和治疗方法。  相似文献   

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