妊娠晚期羊水过少56例临床分析

目的：探讨妊娠晚期羊水过少的分娩方式,寻找正确的处理方法,降低围生儿死亡率。方法：对妊娠晚期羊水过少56例作回顾性分析。结果：56例中,30例以羊水过少作为指标行剖宫产,新生儿窒息率为0,19例在临产过程中12例并发胎儿窘迫,7例并发其它高危因素行剖宫产,新生儿窒息率为5．3％,7例经阴道分娩,新生儿均有不同程度窒息。结论：羊水过少一经确诊,应积极引产,估计短时间内不能分娩,及时剖宫产是处理羊水过少较为安全的重要措施。     

Arthrodesis of the first metatarsophalangeal joint: The “when and how”

Arthrodesis of the first metatarsophalangeal (MTP) joint has been established as the “gold standard” for the treatment of several first ray disorders, due to its perceived efficacy and the consistently reported good results in the literature. Arthrodesis is a commonly performed procedure for the treatment of end stage arthritis, rheumatoid arthritis with severe deformity, selected cases of severe hallux valgus (with or without signs of degenerative joint disease), as well as a salvage procedure after failed previous operation of the first ray. The goals of a successful 1^st MTP arthrodesis are pain alleviation and deformity correction in order to restore a comfortable gait pattern and to improve shoe wear. Several techniques have been reported with several proposals regarding the preparation of the articular surfaces and the method of definitive fixation. As with any given surgical procedure, various complications may occur after arthrodesis of the 1^st MTP joint, namely delayed union, nonunion, malunion, irritating hardware, etc.      

Mechanical dilation to remove incarcerated laminaria during a second trimester abortion

Cervical preparation with laminaria reduces complications with 2nd trimester dilation and evacuation. During a surgical abortion at 22 weeks, we could not remove laminaria manually or with ring forceps due to laminaria “dumbbelling” [1]. Without pushing laminaria into the uterus, we mechanically dilated the cervix and removed the incarcerated laminaria.     

妊娠晚期胎膜早破对产妇分娩方式及妊娠结局的影响

目的探讨妊娠晚期胎膜早破对产妇分娩方式及妊娠结局的影响。方法回顾性分析2018年9月至2019年3月医院收治的87例妊娠晚期产妇的临床资料,将体感不适但无胎膜早破的43例产妇设为对照组,将胎膜早破的44例产妇设为试验组,统计并比较两组胎方位、分娩方式和不良妊娠结局。结果试验组枕前位发生率低于对照组,枕横位、枕后位发生率高于对照组,差异有统计学意义(P<0.05);试验组自然顺产率低于对照组,剖宫产率、阴道助产率均高于对照组,差异有统计学意义(P<0.05);试验组产妇及胎儿不良妊娠结局发生率均高于对照组,差异有统计学意义(P<0.05)。结论胎膜早破与难产密切相关,不仅增加了胎位异常、剖宫产、阴道助产的发生率,还易引起母婴不良妊娠结局,临床应加强对胎膜早破的产妇监护,及时发现异常并采取有效措施,以降低不良妊娠结局的发生率。     

Adductor pollicis. The missing interosseous

Summary This paper highlights the many similarities between the adductor pollicis and the palmar interossei. In particular it compares their anatomy, innervation and function. It suggests that adductor pollicis should be considered as the first palmar interosseous and that this view simplifies the teaching of hand anatomy and the tests of ulnar nerve function. Further support for the view that adductor pollicis is the thenar counterpart of the second, third and fourth palmar interossei is gained from studies of the literature on hand evolution, in particular published details of fossil records and dissection of primate hands.

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L'adducteur du pouce : l'interrosseux perdu

Résumé Cet article souligne les nombreuses similitudes qui existent entre le m. adducteur du pouce et le m. premier inter-osseux palmaire. Il compare en particulier l'anatomie l'innervation et la fonction de ces muscles. Le m. adducteur du pouce semble bien devoir être considéré comme le m. premier inter-osseux palmaire et ce point de vue simplifie l'enseignement de l'anatomie de la main ainsi que l'évaluation de la fonction du nerf ulnaire. Des arguments supplémentaires en faveur de l'hypothèse d'un m. adducteur du pouce qui serait la contre-partie thénarienne des second, troisème et quatrième mm. inter-osseux palmaires proviennent de l'étude de la littérature concernant la phylogénèse de la main et en particulier des résultats d'études portant sur les fossiles et les dissections de mains de primates.

     

91例首次住院精神疾病患者死亡原因分析

目的研究首次住院精神痰病患者的死亡原因。方法回顾性分析首次住院死亡精神痰病患者的病历资料，进行统计学分析。结果首次住院死亡91例，死亡原因有躯体疾病、猝死、治疗综合征、自杀、意外事故，分别占50．5％、22．0％、11．0％、8．8％、7．7％；住院10天内死亡45例（49．5％）。结论躯体疾病、猝死是导致首次住院精神病人死亡的主要原因，医护人员应高度重视住院10天内的精神病患者。     

孕妇血清标记物在中孕筛查中的应用

目的 :通过对孕妇血清标记物甲胎蛋白 (AFP)和人绒毛膜促性腺激素 ( β -HCG )测定来筛选缺陷儿。 方法 :用放射免疫法对 6 2例孕 14～ 2 3周妊娠妇女上述标记物连测 3次 ,每次隔 12～ 14d ,以两次异常为高危个体。每例筛查者跟踪至胎儿出生后。结果 :在筛查中发现了 1例先天愚型和 1例无脑儿。结论 :上述两种血清标记物可以作为神经管缺陷和先天愚型筛查的一项常规方法     

阴道内放置PGE_2用于足月妊娠引产351例疗效观察

目的　比较 PGE2 阴道栓剂及催产素静滴引产的效果。方法　将 5 85例同样条件孕妇 ,随机分两组 ,分别给PGE2 阴道栓剂和催产素静脉滴注引产。结果　前列腺素组及催产素组引产成功率分别为 96 .3%和 79.92 % ;临产发动时间及总产程分别为 (2 .70± 0 .6 3) h,(3.0 1± 3.41) h和 (3.91± 0 .71) h,(6 .0 3± 3.5 0 ) h;剖宫产率分别为6 .8%和 18.18% (P<0 .0 1) ,有显著差异。结论　 PGE2 栓剂用于足月妊娠引产效果显著、安全、方便 ,对促宫颈成熟意义重要 ,可缩短住院天数 ,减少住院费用。