电疗裤配合中药外敷治疗痛经的临床研究

目的 :研究治疗原发性痛经的有效方法。方法 :采用自制电疗裤配合中药温经止痛液外敷。结果 :治疗 5 2例 ,显效 39例 ,有效 12例 ,总有效率98 1%。结论 :电疗裤配合中药外敷治疗原发性痛经方法简便 ,无痛苦 ,疗效可靠 ,尤其适合患者在家庭中应用。     

Levonorgestrel releasing-intrauterine system for the treatment of menorrhagia and/or frequent irregular uterine bleeding associated with uterine leiomyoma

ABSTRACT

Objective To evaluate the effectiveness of the levonorgestrel releasing-intrauterine system (LNG-IUS) in the treatment of menorrhagia and/or frequent irregular uterine bleeding in women with uterine myomas.

Study design Prospective study whereby 102 women with intramural myomas (in a few cases associated with submucous or subserous myomas), suffering from menorrhagia and/or frequent irregular uterine bleeding, were evaluated by means of the Pictorial Blood Assessment Chart (PBAC; Higham score) and ultrasound, three, six and 12 months after insertion of a LNG-IUS.

Results The PBAC score dropped (from a mean value of 231.7 to 17.6 at 12 months). The duration of menstrual bleeding diminished significantly (p < 0.001). Uterine volume decreased from a mean of 145 cm³ to 129 cm³ at 12 months (p = 0.01). Changes in the volume of the myomas were not statistically significant (p = 0.23). Satisfaction rate was good in 91 cases (89%), fair in four cases (4%), and poor in seven cases (7%). During the one-year period of follow-up, 11 cases of expulsion or removal of the LNG-IUS were recorded.

Conclusion The LNG-IUS is effective in controlling heavy menorrhagia and/or frequent irregular uterine bleeding related to the presence of myomas, but has no significant effect on the size of the tumours.     

宫腔镜下双极汽化治疗月经过多临床观察

目的观察宫腔镜下双极汽化治疗月经过多的临床效果。方法月经过多患者40例,≥45岁为第一组,行双极汽化子宫内膜去除术;35～45岁为第二组,根据患者月经量过多程度行双极汽化去除1/3～4/5子宫内膜。结果第一组10例中8例闭经治愈,2例好转;第二组30例中28例治愈,2例好转。两组有效(治愈+好转)率均为100%。结论宫腔镜下双极汽化治疗月经过多是一种简单、快速、安全、经济、有效的微创手术方法。对围绝经期月经过多患者采用第一组治疗方案可达到闭经、可保留子宫且经济,避免开刀之苦;对年龄较轻月经过多患者采用第二组治疗方案可达到减少过多经量且保留子宫及恢复正常月经的效果。     

阻抗控制子宫内膜去除术(NovaSure)与微波子宫内膜去除术(MEA)治疗月经过多的临床观察

目的:通过对阻抗控制子宫内膜去除术(NovaSure)与微波子宫内膜去除术(MEA)治疗月经过多进行临床观察,探讨NovaSure的有效性和安全性。方法:对月经过多行MEA治疗的50例患者(M组)和进行NovaSure治疗的52例患者(N组)进行术中观察和随访,记录治疗时间、并发症发生情况、术后疼痛评分及术后1个月、3个月、6个月月经量的变化和满意度情况,并对其进行比较。结果:两组治疗时间及术后疼痛评分比较差异有统计学意义(P<0.05),两组疗效和满意度比较差异无统计学意义(P>0.05),两组均无并发症发生。结论:NovaSure能使月经过多患者得到安全、有效的治疗,并且操作简便,手术时间短,患者术后更为舒适。     

热球子宫内膜去除术治疗月经过多临床分析

目的 观察热球子宫内膜去除术(TBEA)治疗月经过多的效果。方法 采用美国Gyrmecare公司研制的TBEA系统。术前官腔镜检查排除宫内占位性病变。对48例月经过多的患者实行子宫内膜去除术。结果 48例中有效率98％。出现闭经18例(37．5％)。点滴状量月经14例(29％)．少量月经13例(27％)。正常月经2例(4％)．无明显效果1例(2％)。结论 热球子宫内膜去除术治疗月经过多疗效高，简便，安全。无并发症。     

From bodies to lives, complainers to consumers: Measuring menstrual excess

Feminist research has shown repeatedly the extent to which medical accounts pathologize menstruation, yet there has been very little examination of how clinicians and medical researchers actually study and assess menstruation. This paper analyzes 30 US medical journal articles to examine how researchers work to distinguish the specific menstrual disorder of menorrhagia, or excessive bleeding, from normal menstruation. I focus specifically on measurement as a key process in diagnosing menstrual pathology, arguing that measurement practices construct women's bodies as appropriate objects of medical attention in ways that also shape women's positions as participants in knowledge production. I begin with the alkaline hematin method's narrow focus on physical proof of bleeding that proves or disproves women's complaints and trace the emergence of new methods that incorporate women's own assessments of bleeding. Changing ways of measuring menstruation point to shifts in understandings of the body as the object of medical treatment and of patients as medical subjects.     

米非司酮治疗排卵型月经过多及子宫内膜脱卸不全的临床效果

目的探讨米非司酮对排卵型月经过多和子宫内膜脱卸不全的临床治疗效果.方法诊断性刮宫明确病理诊断后或撒血性月经周期的第20天起,每日口服米非司酮10mg,连用5天,治疗3个月后随访3个月,观察患者的月经周期、经期和经量变化.结果96例排卵型月经过多患者治疗期间,88例经量明显减少(91.67%),83例治疗后疗效得以维持(86.46%/94.32%).131例子宫内膜脱卸不全者治疗后经期由10.6±2.3天减少至5.8±2.2天,随访期间的月经期为6.1±2.3天.结论米非司酮是治疗排卵型月经过多和子宫内膜脱卸不全的有效药物.