经皮子宫动脉栓塞术治疗子宫肌瘤39例临床观察

目的探讨子宫动脉栓塞术(UAE)治疗子宫肌瘤的临床疗效及副反应。方法行常规UAE术。结果UAE治疗6~12个月后临床症状明显缓解。其中UAB治疗后第12个月显效者35例(35/39),有效者4例(4/39);UAB治疗后第18个月显效者23例(23/26),有效者3例(3/26)。结论UAE可有效缩小肌瘤及子宫的体积,并明显改善子宫肌瘤的临床症状。*     

子宫肉瘤128例临床及预后因素分析

目的:探讨子宫肉瘤临床特点和预后因素的分析。方法:回顾性分析128例子宫肉瘤患者的临床资料。结果:子宫肉瘤的临床症状不典型,以阴道异常出血为主,预后较差。128例患者总的2年生存率为58.59%,5年生存率为40.63%。在单因素分析中得出年龄、UICC分期、病理类型、化疗是预后生存因素。在多变量分析中得出年龄、UICC分期是独立的预后因素。年轻、分期较早的子宫平滑肌肉瘤患者预后最好。结论:子宫肉瘤的治疗以手术为主,术后辅以化疗放疗。预后与患者年龄、FIGO分期相关。     

B超监测在子宫畸形合并早孕的人工流产术中的应用

目的:评价B超在子宫畸形合并早孕的人工流产术中的应用价值。方法:收集2003年8月~2004年8月妇产科门诊1 741例人工流产妇女中48例子宫畸形合并早孕患者,在B超监测下行人工流产术。结果:48例手术均为1次成功,无漏吸、吸宫不全、子宫穿孔等并发症发生,手术时间短、出血少。结论:对于子宫畸形合并早孕患者应用B超监测完成人工流产手术安全,病人痛苦小,值得推广。     

超声引导下自凝刀射频治疗子宫肌瘤58例分析

目的:探讨自凝刀射频治疗子宫肌瘤的临床价值。方法:2004年2月~2005年6月选择自愿接受自凝刀射频治疗子宫肌瘤的患者58例,肌瘤68个,瘤体直径1.5~5.5 cm,在B超监视和引导下将自凝刀经阴道宫颈置入肌瘤进行射频治疗。结果:治疗后随访3个月58例、6个月50例(59个肌瘤),治疗有效率、治愈率分别为100%(58/58)、51.72%(30/58)。结论:自凝刀射频治疗子宫肌瘤是1种能保留子宫的微创技术,可重复治疗,疗效确切,操作简单,易推广应用。     

子宫动脉栓塞治疗子宫腺肌病对卵巢功能的影响

目的:探讨子宫动脉栓塞治疗子宫腺肌病对卵巢功能的影响。方法:对27例子宫腺肌病患者采用聚乙烯醇微粒(PVA)进行子宫动脉栓塞治疗,在栓塞前、栓塞后3个月及6个月,评估所有病人的症状改善情况,并且采用经阴道彩色能量多普勒超声对子宫及病灶进行动态监测,监测子宫大小,子宫动脉和卵巢动脉血流动态改变,及基础性激素水平和基础体温情况。结果:子宫动脉栓塞术后3个月,子宫体积显著减小,平均缩小136.48(37.6%),子宫动脉的最大血流速度Vmax(cm/s)显著降低,由(27.27±6.03)cm/s降至(14.19±5.98)cm/s,P<0.05。子宫动脉阻力指数(RI)由0.54±0.03降至0.86±0.04,P<0.05;栓塞术前、后卵巢血流、卵泡刺激素(FSH)、雌二醇(E2)和月经周期无显著性差别。1例患者出现短暂卵巢功能急剧减退。结论:子宫动脉栓塞治疗子宫腺肌病是一种新颖、微创、安全、有效、并发症少且恢复快的治疗方法,可保留子宫的生育功能,对卵巢功能无明显损害,但应注意可能导致卵巢衰竭。     

青春期子宫出血54例临床分析

目的 探讨青春期子宫出血的病因、诊断和治疗方法。方法 对1990-01-2004-05中山大学附属第二医院54例青春期子宫出血病例进行回顾性分析。结果 54例青春期子宫出血患者，功能失调性子宫出血（功血）共34例占63．0％，血液系统疾病14例占25．9％，生殖道器质性病变3例占5．6％，其他疾病3例占5．6％。54例均经超声检查，9例有异常发现者再接受宫腔镜检查，3例发现器质性病变。功血患者经性激素治疗均达止血效果。结论 青春期子宫出血的病因以功血为多，但需排除其他疾病。超声结合诊断性刮宫和宫腔镜检查，是有力的诊断手段。     

激素治疗对绝经妇女子宫肌瘤的影响

目的:观察个体化周期序贯激素治疗对绝经妇女子宫肌瘤发生及生长的影响。方法:选择因绝经相关症状且合并单发性子宫肌瘤(肌瘤最大径线<5 cm)的绝经妇女60例,给予雌孕激素周期序贯方案,起始剂量为口服戊酸雌二醇1.0 mg,每日1次,连用21~25天,后10~14天加用甲羟孕酮每日4 mg。随后,根据每人对药物的不同反应,调整口服戊酸雌二醇的每日用量为0.5~2.0 mg,甲羟孕酮的每日用量相应为4~6 mg。不能连续应用激素治疗或失访者被排除。分别于治疗前及治疗3、6、122、43、6个月时采用阴道超声测定肌瘤大小及子宫内膜厚度。结果:53例患者完成了3年的观察,平均年龄51.4(44~57)岁,绝经年限平均2.3(1~7)年。激素周期序贯治疗3、6、12、24、36个月,肌瘤大小均无明显改变(P>0.05),没发现新生肌瘤(P>0.05),子宫内膜厚度均无明显增厚(P>0.05)。结论:根据个体对药物反应不同制定不同剂量的激素周期序贯方案,不促进绝经妇女子宫肌瘤的发生和生长。     

The Manchester operation for uterine prolapse.

OBJECTIVE: To evaluate the clinical characteristics, complications, and satisfaction scores of patients who underwent the Manchester operation. METHODS: This retrospective observational study evaluated data from 204 women who underwent the Manchester operation at the Department of Obstetrics and Gynecology of Hacettepe University School of Medicine, Ankara, Turkey, from January 1985 to April 2004. RESULTS: Mean age was 34.68+/-4.24 years and parity 2.47+/-0.96; 85.8% of the patients were premenopausal; 176 patients (86.28%) had grade 3 and 28 (13.72%) had grade 2 uterine prolapse; 95.1% of the patients had associated cystoceles and 51.3% had associated rectoceles; and 81.4% had urinary incontinence. Regarding early postoperative complications, 27 patients (13.23%) had febrile morbidity; retroperitoneal hematoma occurred in 1 patient (0.49%); urinary retention occurred in 45 patients (22.05%), and cervical stenosis occurred in 23 patients (11.27%). At 1 year, 1 patient had undergone abdominal hysterectomy because of unsuccessful cervical dilatation; and a mean of 3.6 years following the operation, 8 patients (3.9%) had undergone the tension-free vaginal tape procedure plus a vaginal hysterectomy for recurrent stress urinary incontinence and uterine prolapse. The mean satisfaction/acceptance score for the operation was 8.52+/-2.13 (range, 2-10). CONCLUSION: A high degree of acceptance/satisfaction and a low morbidity rate show the Manchester operation to be a good option for the treatment of uterine prolapse in women who wish to keep their uterus.     

Complex hyperplastic endometrium in a peritoneal leiomyoma following a CISH hysterectomy

We describe a case of a patient presenting with an abdominal tumor 4 years after a classical intrafascial serrated-edged macro-morcellated hysterectomy. The tumor was removed surgically and proved microscopically to be a peritoneal leiomyoma containing complex hyperplastic endometria. To our knowledge, this has never been described before. In addition, the pathogenesis of this rare disease is discussed.     

Multiplex Reverse Transcription-Polymerase Chain Reaction for Simultaneous Screening of 29 Chromosomal Translocation in Hematologic Malignancies

Cytogenetic evaluation has been proved to be one of the most important factors to predict prognosis and de-lineate patients with some specific subtypes to be treated accordingly. Classical cytogenetic analysis is very time-consuming and often limited by the insufficient metaphases yielded from bone marrow samples. For this reason, much efforts had been taken to design RT-PCR to detect chromosomal translocation in hematologic ma-lignancies, of which multiplex reverse transcrip-tion-polymerase…