不孕症诊断治疗的新手段

目的 探讨宫腹腔镜联合手术在不孕症诊断和治疗中的价值. 方法 对140例不孕症患者行宫腹腔镜联合手术.其中腹腔镜下行盆腔、输卵管卵巢周围粘连松懈术;输卵管伞成形术;输卵管造口术;盆腔子宫内膜异位症手术;多囊卵巢打孔术.宫腔 镜行子宫内膜息肉摘除术;宫腔粘连分离术;子宫纵隔切开术;宫腔异物取出术;双侧输卵管插管术. 结果 对于140例患者均同时完成宫腹腔镜输卵管通液和各种疾病的治疗.不孕症的病因依次为盆腔粘连、输卵管阻塞、子宫内膜异位症、多囊卵巢和子宫内膜息肉.联合手术后妊娠率为46.7%.结论 腹腔镜联合手术可以对不孕的原因进行全面评价和明确诊断,在诊断同时进行治疗,对不孕症的诊断和治疗有重大的意义,值得推广.     

宫腹腔镜联合手术治疗输卵管性不孕症临床效果分析

目的探讨电视宫腹腔镜联合手术治疗输卵管性不孕症诊断和治疗价值。方法回顾分析2007年5月-2011年12月78例输卵管性不孕症患者采用宫腹腔镜联合治疗的临床资料。在腹腔镜下行盆腔粘连分离、输卵管整形、造口术、异位病灶电灼术等,利用宫腔镜直接观察宫腔内膜及输卵管开口,在直视下行输卵管插管。术后随访受孕情况。结果术中诊断输卵管周围炎33例;输卵管卵巢周围炎30例;输卵管积水15例;其中50例是由盆腔炎所致,28例由盆腔子宫内膜异位症所致。术后受孕率:输卵管和卵巢周围炎为42.9%(27/63);输卵管积水为20%(3/15)。结论宫腹腔镜联合手术治疗输卵管不孕症患者既能明确病因同时又能治疗,手术安全,输卵管复通率高,术后妊娠率明显改善。     

宫腔镜联合腹腔镜手术治疗不孕症284例临床分析

目的:通过对宫腔镜联合腹腔镜手术治疗不孕症的临床分析,探讨其在诊断与治疗不孕症方面的价值。方法:在通过宫腔镜联合腹腔镜探查的基础上,对284例不孕症患者进行对症下药,展开相应的治疗。结果:284例患者中子宫因素68例,输卵管因素190例,盆腔粘连122例,卵巢因素60例。术后随访的130例患者妊娠率超过27.69%,伞部及壶腹部阻塞术后再通率为84.71%,在术后随访的130例患者,其妊娠率为28.0%,不存在输卵管阻塞患者的妊娠率为45.0%,同输卵管阻塞患者妊娠率的20.0%相比,差异有统计学意义(P<0.05)。结论:宫腔镜联合腹腔镜手术治疗不孕症,尤其是对于盆腔粘连和输卵管远端阻塞不孕患者而言,是非常好的检查和治疗手段。     

子宫输卵管造影和宫腹腔镜联合诊断女性不孕症118例分析

目的探讨子宫输卵管造影(hysterosalpingography,HSG)和宫腹腔镜联合手术在诊断女性不孕症中的价值。方法对118例女性不孕症患者先后行子宫输卵管碘海醇造影和宫腹腔镜手术和分析。结果 HSG与宫腹腔镜手术诊断输卵管阻塞无统计学意义(P>0.05),HSG诊断输卵管阻塞的敏感度为82.54%,特异度为60.74%;HSG时75例患者盆腔未显影,腹腔镜发现其中42例有盆腔粘连,HSG、腹腔镜对显影的43例患者诊断盆腔粘连无统计学意义(P>0.05),HSG诊断盆腔粘连的敏感度为40.91%,特异性为52.38%;对宫腔病变的检出率HSG和宫腔镜分别为7.63%、50.85%(P<0.05)。结论 HSG对输卵管阻塞有较好的诊断价值,对盆腔粘连的诊断价值有限,对宫腔病变的诊断远不及宫腔镜。     

193例宫、腹腔镜诊治女性不孕症临床分析

目的探讨不孕症的病因及宫腔镜和腹腔镜联合应用诊治不孕症的临床价值。方法对2009年4月至2010年3月收治并排除男性不育因素的193例不孕症患者行宫腔镜和腹腔镜联合诊治,在术中视不同情况来选择具体手术方式并评价手术效果,术后观察妊娠率。结果 193例患者全部明确不孕病因。腹腔镜下发现盆腔病变136例,其中输卵管堵塞及盆腔粘连64例,子宫内膜异位症32例,子宫肌瘤15例,多囊卵巢综合征9例,卵巢囊肿13例,盆腔结核3例;宫腔镜下发现宫腔病变57例,子宫发育畸形10例,子宫纵隔7例,宫腔粘连11例,子宫内膜息肉29例;宫、腹腔镜下均发现病变7例。可见盆腔粘连、输卵管堵塞、子宫内膜异位症、子宫内膜息肉是导致不孕症的主要因素。术后跟踪随访发现193例患者中,妊娠147例,术后妊娠率为76.17%。结论宫、腹腔镜对治疗不孕症具有临床应用价值。     

宫腹腔镜联合手术诊治不孕症125例分析

目的 探讨宫腹腔镜联合手术治疗不孕症的应用价值.方法 对125例行宫腹腔镜联合手术治疗的不孕症患者进行回顾性分析.结果 125例患者中原发不孕者56例,继发不孕者69例.不孕症的主要原因为盆腔粘连(49例,39.2%),子宫内膜异位症(19例,15.2%),卵巢囊肿(17例,13.6%)及子宫内膜息肉(10例,8%).输卵管复通率为91.21%,术后妊娠率达31.2%.结论 宫腹腔镜联合手术能诊断和治疗子宫和输卵管性不孕以及一些卵巢异常,在诊断和治疗女性不孕症中起主要作用.     

腹腔镜对女性不孕症90例的诊断和治疗

目的 应用腹腔镜诊断技术探讨不孕症的病因,对不孕症的诊断治疗价值.方法 对我院2008年03月至2010年03月90例女性不孕患者的腹腔镜检查资料进行分析. 结果不孕患者中93%存在影响妊娠的盆腔疾病,其中慢性盆腔炎、子宫内膜异位症、多囊卵巢、子宫肌瘤、卵巢肿瘤、子宫输卵管卵巢盆腔未发现特殊,分别占52%、14%、10%、8%、7%、9%.慢性盆腔炎是引起不孕的主要疾病.针对不同的病因,腹腔镜可进行盆腔粘连分解术,输卵管造口术,子宫内膜异位灶破坏及切除术,卵巢多点穿刺电灼术等多种手术治疗.结论 腹腔镜手术具有早期、迅速明确病因,融诊断、治疗于一体,缩短诊断时间,为术后进一步治疗提供正确的方向等优点.建议对不明原因的不孕症尽早行腹腔镜手术,以明确诊断及治疗.     

宫、腹腔镜联合手术在输卵管性不孕症的应用体会

目的　为了探讨宫、腹腔镜联合手术诊治输卵管性不孕症的临床价值。方法　对 93例经子宫输卵管碘油造影检查提示输卵管性不孕症患者 ,同时行宫、腹腔镜联合手术治疗。腹腔镜下行输卵管造口术或伞扩张术、盆腔粘连松解术、子宫内膜异位症病灶电凝术。宫腔镜下行输卵管口插管疏通术、子宫黏膜下肌瘤切除术、子宫内膜息肉摘除术、宫腔粘连松解术。结果　 93例输卵管性不孕症的患者中 ,输卵管近端梗阻的再通率为 6 1 5 4 % ,输卵管远端梗阻的再通率为 96 2 4 %。结论　宫、腹腔镜联合手术治疗输卵管性不孕症 ,避免单独应用这两种手术的缺点 ,是值得推广的手术。     

应用腹腔镜诊治子宫内膜异位症及不孕症的临床疗效观察

目的:探讨分析应用腹腔镜诊治子宫内膜异位症及不孕症的临床疗效.方法:选取我院2008年8月至2011年9月收治的220例子宫内膜异位症及不孕症患者的临床资料,进行回顾性分析.220例患者均在腹腔镜下进行诊断和治疗,进行了盆腔腹膜内异病灶电灼术或者子宫内膜异位囊肿剥除术,对有粘连的患者进行输卵管整形术、盆腔粘连分解术,同时用腹腔镜美蓝通液术观察输卵管通畅情况.手术后用GnRh-a治疗3个月,三个月后进行随访,了解术后妊娠情况.结果:采用腹腔镜诊断和治疗后,患者的妊娠率是52.73％.且1年内的妊娠率比1-2年内的妊娠率高.结论:腹腔镜诊断和治疗子宫内膜异位症及不孕症,疗效良好,而且安全,值得推广.     

宫腹腔镜联合手术诊治不孕症148例临床分析

目的总结宫腔镜、腹腔镜联合手术诊治不孕症的临床效果。方法对采用宫、腹腔镜联合治疗的148例不孕症患者的临床资料进行回顾性分析。结果 148例患者中139例有盆腔病变,32例有宫腔病变,129例输卵管阻塞。盆腔粘连、宫腔粘连致输卵管阻塞为不孕症的第1位病因。宫腔镜、腹腔镜联合手术的输卵管再通率为77.4%,术后妊娠率49.5%。结论宫、腹腔镜联合能同时进行宫腔、盆腔疾病的诊断和治疗,能明显提高手术成功率及术后妊娠率,为目前治疗不孕症的首选方法。     

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…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.     

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.     

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.