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991.
992.
993.
妊娠高血压综合征血浆叶酸同型半胱氨酸和内皮素浓度变化 总被引:9,自引:1,他引:9
目的 了解妊娠高血压综合征 (妊高征 )患者血浆叶酸 (FA)、同型半胱氨酸 (Hcy)和内皮素 (ET 1)浓度的变化。方法 采用放免法检测 4 3例妊高征患者 (妊高征组 )分娩前后及 67例正常晚孕妇女 (正常晚孕组 )和15例正常非孕妇女 (正常非孕组 )血浆FA、维生素B12 (VB12 )及ET - 1含量。用荧光标记免疫检测法测定血浆Hcy的含量。 结果 ①正常晚孕组血浆叶酸浓度 [( 11 3 6± 5 3 8)nmol/L]明显低于正常非孕组 [( 2 7 77± 7 75 )nmol/L ,P <0 0 5 ];妊高征组分娩前血浆叶酸浓度 [( 6 4 3± 2 4 0 )nmol/L]明显低于正常非孕组及正常晚孕组(P <0 0 1,P <0 0 5 ) ;妊高征组分娩后血浆叶酸 [( 2 0 85± 8 80 )nmol/L]明显高于分娩前 (P <0 0 5 ) ;②正常晚孕组血浆同型半胱氨酸浓度 [( 7 89± 3 2 7) μmol/L]明显高于正常非孕组 [( 6 63± 1 0 7) μmol/L ,P <0 0 5 ];妊高征组分娩前血浆同型半胱氨酸浓度 [( 12 0 0± 4 5 9) μmol/L]明显高于正常非孕组及正常晚孕组 ( P <0 0 1,P <0 0 1) ;妊高征组分娩后血浆同型半胱氨酸浓度 [( 7 63± 3 2 9) μmol/L]明显低于分娩前 ( P <0 0 0 1) ;③妊高征组分娩前血浆内皮素 - 1质量浓度 [( 13 8 4 7± 3 0 0 3 )ng/L]明显高于正常晚孕组 [( 10 3 7 相似文献
994.
双胎妊娠合并贫血与妊娠结局的分析 总被引:8,自引:0,他引:8
目的:探讨双胎妊娠合并贫血对妊娠结局的影响,方法:将496例双胎妊娠分为两组,妊娠合并贫血者(贫血组)共321例,其余175例为对照组,对两组病的妊高征,产前出血,产后出血,早产,胎膜早破发生率与平均孕周,平均出生体重分别进行对照分析。结果:贫血组妊高征,产后出血,早产,胎膜早破发生率显著高于对照组(P<0.05),且贫血严重程度与妊高征,产后出血发生率呈正相关(P<0.05),与平均孕周呈负相关(P<0.05)。两组新生儿平均出生体重无显著差异(P>0.05),但重度贫血病例的新生儿平均出生体重与对照组比较,有显著性差异(P<0.05)。结论:双胎妊娠合并贫血时各种并发症发生率成倍增加,特别是重度贫血对孕产妇和围生儿有严重的威胁。 相似文献
995.
Objective To investigate clinical value of Tei index used for monitoring right ventricular (RV) function in pregnant women complicating cardiac disease accompanying pulmonary hypertension(PH) and the influence on left ventricular(LV) function due to overload pressure of RV. Methods Fifty-eight pregnant women complicating cardiac disease (including 32 cases with congenital heart disease,14 cases with rheumatic heart disease and 8 cases with arrhythmia)were enrolled in this study, among 26 cases coexisted with pulmonary hypertension. According to the pressure of PH, those patients were divided into three groups:11 cases in mild group[30-49 mm Hg (1 mm Hg=0.133 kPa)],9 cases in moderate group (50-79 mm Hg)and 6 cases in severe group (≥80 mm Hg). In the mean time, 15 healthy pregnant women were matched as control. Tei index were measured for LV and RV respectively. Results (1) The isovolumetric relaxation time [IRT,(93±52) ms] and isovolumetric contraction time [ICT,(66±41) ms] of RV in PH group were significantly higher than normal controls [(39±19) ms in IRT and (38±20) ms in ICT] and the other patients without PH group[(59±12) ms in IRT and (43±19)ms in ICT, P<0.01, P<0.05;P<0.05,P<0.05]; however, ejection time (ET) was(239±46) ms significantly shortened in PH group (P<0.05,P<0.01) when compared with (250±41) ms in patients without PH and (299±38) ms in normal controls. Tei index in PH group were 0.72±0.49, which were significantly higher than 0.38±0.12 in normal controls and 0.43±0.16 in patients without PH (P<0.01,P<0.05). (2) The IRT[(99±27)ms] and ICT[(71±40) ms] of LV in PH group were significantly higher than in normal controls [(88±20) ms,(50±24)ms] (P<0.01,P<0.01). ET of LV in PH group [(202±26)ms] were significantly shortened that (290±21)ms in normal controls and (220±36)ms in patients without PH (P<0.01,P<0.05). Tei index of LV in PH group were significantly higher than 0.43±0.15 in normal controls and 0.58±0.21 in patients without PH (P<0.01,P<0.05). (3) Positive correlation between Tei index of RV and pressure of pumonaroy artery were observed (r=0.84, P<0.01). (4) Tei index of RV in severe PH were significantly higher than mild PH (0.75±0.43 vs. 0.68±0.35, P<0.01) and moderate PH (0.75±0.43 vs. 0.71±0.14, P<0.05). Conclusions (1)The Tei index is a novel efficient Doppler index in assessing RV function of pregnant women complicating cardiac disease accompanying PH. And the fluctuation of Tei index might reflect seriousness of the disease. (2) The overload pressure of RV pressure due to PH has significant influence on LV function. 相似文献
996.
A primiparous, full-term, 28-year-old woman underwent an emergency lower segment Caesarean section under epidural anaesthesia for failure to progress in the first stage. Despite an uneventful pregnancy and delivery, she developed a hypertensive crisis in the postoperative period complicated by acute pulmonary oedema requiring ventilation for 48 h in the intensive care unit. Intravenous magnesium sulphate infusions and hydralazine boluses were used to control the blood pressure, which was associated with clonus, hyperreflexia, tachycardia and profuse sweating. The patient made a good recovery. Later measurement of urinary catecholamines in the recovery phase showed greatly elevated levels of norepinephrine, dopamine and vanillyl mandelic acid. Further investigations included a normal abdominal computed tomography scan and a I-123 meta-iodo-benzyl-guanidine scintigraphy scan which revealed a 3- to 4-cm irregular tumour located at the level of the lower pole of the right kidney and further liver hot spots. Intravenous magnesium sulphate infusion proved successful in controlling hypertension caused by a phaeochromocytoma in the postpartum period. 相似文献
997.
998.
Corrarino JE Williams C Campbell WS Amrhein E LoPiano L Kalachik D 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2000,29(4):369-376
Obiective : To conduct a pilot study to assist pregnant substance abusers to enter drug treatment.
Design : A nonexperimental design provided eligible women with outreach/home visits from a team led by a public health nurse.
Setting : All services for the women were provided in homes in the northeastern United States.
Participants : Ten pregnant substance-abusing women who were not in drug treatment upon entry into prenatal care enrolled in the project.
Interventions : Home visits by a public health nurse were provided to the women to jointly develop a plan of care targeted to each woman's needs. A substance abuse counselor was available as a consultant and for home visits. An interdisciplinary team met monthly to coordinate services, discuss therapeutic approaches and treatment strategies, and address needed changes in the health services system.
Main Outcome Measures : Rates of entry into substance abuse treatment, retention of custody of the index child, and scores on the Addiction Severity Index (ASI).
Results : Although the expected rate of entry into treatment was 10%, 90% of the women ( n = 9) entered treatment. All had full-term newborns. Eighty percent ( n - 8) retained custody of the index child. Upon the participants' enrollment, AS1 scores indicated a moderate to extreme problem with alcohol and drug use for all women, and moderate to extreme psychiatric problems for 89% of the women. Subsequent ASI scores demonstrated marked improvement in all three subscales.
Conclusion : This project provides strategies that nurses can use to assist substance-abusing pregnant women to enter drug treatment. 相似文献
Design : A nonexperimental design provided eligible women with outreach/home visits from a team led by a public health nurse.
Setting : All services for the women were provided in homes in the northeastern United States.
Participants : Ten pregnant substance-abusing women who were not in drug treatment upon entry into prenatal care enrolled in the project.
Interventions : Home visits by a public health nurse were provided to the women to jointly develop a plan of care targeted to each woman's needs. A substance abuse counselor was available as a consultant and for home visits. An interdisciplinary team met monthly to coordinate services, discuss therapeutic approaches and treatment strategies, and address needed changes in the health services system.
Main Outcome Measures : Rates of entry into substance abuse treatment, retention of custody of the index child, and scores on the Addiction Severity Index (ASI).
Results : Although the expected rate of entry into treatment was 10%, 90% of the women ( n = 9) entered treatment. All had full-term newborns. Eighty percent ( n - 8) retained custody of the index child. Upon the participants' enrollment, AS1 scores indicated a moderate to extreme problem with alcohol and drug use for all women, and moderate to extreme psychiatric problems for 89% of the women. Subsequent ASI scores demonstrated marked improvement in all three subscales.
Conclusion : This project provides strategies that nurses can use to assist substance-abusing pregnant women to enter drug treatment. 相似文献
999.
Ectopic pregnancy 总被引:13,自引:0,他引:13
Lehner R Kucera E Jirecek S Egarter C Husslein P 《Archives of gynecology and obstetrics》2000,263(3):87-92
Ectopic pregnancy is a implantation occurring elsewhere than in the cavity of the uterus, whereas nintynine percent of extrauterine
pregnancies occur in the fallopian tube. The incidence of extrauterine pregnancy has increased from 0.5% thirty years ago,
to a present day 1–2%. The most frequent cause of tubal pregnancy is previous salpingitis. Mortality rates for tubal pregnancies
used to be approximately 1.7% in the 1970 s but dropped to 0.3% in 1980 s. Diagnosis: Using transvaginal ultrasound it is possible to obtain positive evidence of an ectopic pregnancy at a very early stage. In
cases of hCG titers>2000 IU/l, intrauterine pregnancy can be diagnosed with certainty. The most important differential diagnosis
of ectopic pregnancy is early intrauterine pregnancy. Clinical management and therapy: Regardless of the therapeutic strategy selected by the physician, informing the patient is a major aspect of the management
of ectopic pregnancy. If surgery is considered appropriate, the patient must be informed about the nature, side effects and
complications of the procedure. However, it should be remembered that in some cases, the actual chances of cure first become
apparent at surgery. In asymptomatic patients with a serum hCG titer <1000 IU/l that is falling, it is appropriate to wait
and watch. In clinically stable patients with an unruptured tubal pregnancy and steady hCG levels, systemic treatment with
methotrexate might also be considered. In unruptured tubal pregnancy with a hCG titer between 1000 and 2500, a further therapeutic
alternative is intratubal injection of prostaglandins, hyperosmolar glucose of NaCl. Generally speaking, the currently widespread
laparoscopic surgical treatment of the fallopian tube hardly influences the risk of recurrence. If the gestational mass is
larger, the serum hCG titer higher than the approximate limit of 2500 mU/ml and/or the tube already ruptured, surgery is usually
required. Prevention: The most effective prevention is to avoid tubal inflammation or, in cases of preexisting inflammation, to administer effective
therapy.
Received: December 1998 / Accepted: 25 May 1999 相似文献
1000.
In the amniotic fluid, urinary trypsin inhibitor (UTI) seems to inhibit polymorphonuclear elastase (PMNE) activity. The PMNE
and UTI concentrations in normal amniotic fluid at 16–20 and 38–40 gestational weeks were measured. The PMNE concentration
increased significantly at 38–40 weeks, whereas UTI concentration decreased significantly. According to concentrative relationships
between both substances, PMNE may be activated more at the full term pregnancy. Since PMNE-induced tissue injury potentially
causes degradation of amniotic collagen, the present result suggests that the quotient of PMNE and UTI concentrations is a
reliable index to estimate the occurrence of rupture of the membranes.
Received: May 1999 / Accepted: 11 January 2000 相似文献