中国中原地区33555名妇女妇科疾病发生情况与五种因素关系的调查报告

自１９９２年３月至１９９４年５月，对中原地区４个省２０多个县（市）近２００个单位３３５５５名２０～７５岁的已婚妇女，进行妇科疾病发生情况与年龄、职业、文化、月经、孕产等五种因素关系的调查分析。在３３５５５名妇女中，患病者２２３７０人，总患病率为６６．６７％，查出妇科疾病４２种，计７６９７４例次。结果证明：以２５～３５岁年龄组发病率最高，其中以内生殖器炎症为主；职业以经商者发病率高，特别是性病患者高于其他职业者二倍以上；文化程度以小学、初中者发病率高，尤其宫颈炎更明显；月经情况：随着经前期紧张综合征的加重，更年期综合征发病率增高；孕产次数越多，患病率越高。本次调查未发现宫颈癌，进一步证明我国对妇女保健工作的关心和重视。     

男医学生在妇产科实习的素质能力培养

21世纪需要高素质人才，素质教育是关键。从一定意义上说素质教育就是因材施教，妇产科作为一门比较特殊的学科，在实践教学工作中女患者不愿意示教的情况越来越严重，尤其对于男医学生。本文对男医学生在妇产科实习的素质能力培养进行实践与研究，提出以素质教育为中心，培养出具备高尚的医德、扎实的专业本领和丰富的人文知识的新型人才。     

喉罩全麻通气用于妇产科临床麻醉的麻醉效果及安全性评价

目的:探究妇产科麻醉中采用喉罩全麻通气的麻醉效果与安全性。方法:选取本院收治的妇产科手术患者90例,按照通气方式的不同分为2组,对照组实施气管内插管通气,观察组实施喉罩全麻通气,比较两组患者置管成功率、收缩压、舒张压、平均动脉压、心率的变化。结果:对照组通气后收缩压与舒张压水平高于通气前(P<0.05);观察组通气后收缩压与舒张压水平均低于对照组(P<0.05);对照组通气后平均动脉压与心率水平均比通气前高(P<0.05);观察组通气后平均动脉压与心率水平均比对照组低(P<0.05)。结论:产科麻醉中采用喉罩全麻通气麻醉,麻醉效果与安全性都较高。     

0．75％罗哌卡因硬膜外麻醉用于妇产科手术的临床观察

目的 观察０．７５％罗哌卡因硬膜外用于妇产科手术的临床效果、方法 选择７２例ＡＳＡＩ－Ⅱ级妇产科手术随机分为两组．Ｉ组为０．７５％罗哌卡因组（３６例）Ⅱ组为０．５％布比卡因组（３６例）,两组均取腰１－２行硬膜外穿刺,观察两组的感觉阻滞、运动阻滞、镇痛效果及对循环呼吸的影响和不良反应,结果 两组感觉阻滞达Ｔ８的时间。切皮时ＶＡＳ评分、运动恢复时间有显著性差异（Ｐ＜０．０５）,不良反应中寒颤的发生率Ⅰ组明显比Ⅱ组少（Ｐ＜０．０５）,结论０．７５％罗哌卡因具有起效时间快,镇痛效果好,运动阻滞恢复早,对循环呼吸的影响小,神经毒性低的临床特点。     

Increased risk of neonatal complications and infections in children of kidney-transplanted women: A nationwide controlled cohort study

Information related to short- and long-term risks of children born to kidney-transplanted women remains limited. With the aim of investigating the risk of neonatal complications, and the short- and long-term risk of infections in offspring of kidney-transplanted women, all children born to kidney-transplanted women in Denmark from 1964 to 2016 were identified in a nationwide retrospective matched cohort study. A total of 124 children of kidney-transplanted women were identified and matched on gender, birth year, and number of siblings at birth 1:10 with children born to nontransplanted women identified in the Danish general population. Prevalence of low birth weight (37.9%, risk ratio [RR] = 12.61; 95% confidence interval [CI], 8.5-18.5), premature birth (46.0%, RR = 11.32; 95% CI, 8.1-15.7) and malformations (11.3%, RR = 1.98; 95% CI, 1.2-3.4) was increased in children of kidney-transplanted women compared with controls. Similarly, prevalence of hospitalization due to infection was increased during the first year of life (21.0%, RR = 1.94; 95% CI, 1.3-2.8), from age 1 to 5 (34.2%, RR = 1.89; 95% CI, 1.4-2.5), and overall (41.9%, RR = 1.67; 95% CI, 1.3-2.1). The risk of infection was also higher in children of kidney-transplanted mothers born preterm or with low birth weight compared with similar controls. In conclusion, risk of neonatal complications, malformations, and both early and late infection were increased in children born to kidney-transplanted women.     

腹腔镜下妇科手术硬膜外阻滞和全麻的比较

目的:比较硬膜外阻滞和气管内全麻腹腔镜下妇科手术CO2 气腹对患者呼吸循环的影响。方法 :60例妇科腹腔镜 (GL)病人随机分成硬外和全麻两组 ,监测两组各时点的血压、心率、SPO2(血氧饱和度 )、VT(潮气量 )、f(呼吸频率) ,PETCO2(呼气末CO2 分压 )、血气分析等。结果 :全麻组各项指标平稳 ,PETCO2、PaCO2 值均在正常范围 ;硬外组气腹后15min变化最大 ,表现在SBP(收缩压 )、DBP(缩张压 )、HR、f、PaCO2、PETCO2 升高 ,P<0.01 ,气腹后30min各值基本恢复到气腹前水平。结论 :GL下妇科手术 ,气管内全麻优于硬膜外麻 ,但可选择性地采用硬膜外阻滞 ,而对有心肺疾病 ,年老体弱或肥胖病人以及手术难度大 ,估计气腹时间长者宜选择全麻     

Primary and preventive care in a university obstetrics and gynecology group practice

Objective: Our purpose was to determine whether primary and preventive care is practiced by a university obstetrician-gynecologist group practice.Study design: A retrospective chart review spanning 2 years of four academic physicians' private practices was performed. A total of 335 patients were reviewed with 739 patient encounters and 1032 patient problems identified. The definition of a primary care physician according to The American College of Obstetricians and Gynecologists was used to standardize data collection and evaluation.Results: Obstetric complaints accounted for 27.7% of all visits, whereas 65.4% were for gynecologic problems. Almost 7% of all complaints were neither obstetric nor gynecologic, and of those 74.6% were primary care problems completely managed by the obstetrician-gynecologist. Only 19.7% of these were referred for management. More than 89% of all encounters () involved some element of primary care.Conclusion: This study provides evidence that the majority of health care provided by the obstetrician-gynecologists is primary care.     

计算机辅助细胞检测系统对子宫颈病变筛查的意义

目的:对应用计算机辅助细胞(CCT)检测系统进行子宫颈病变的细胞学诊断作出初步评价。方法:对妇科病普查中936例宫颈涂片标本采用PAPNET全自动电脑扫描和诊断系统行细胞学筛选,按TBS诊断分类标准诊断,并按不同年龄及宫颈光滑与糜烂程度进行对照。结果:正常821例,异常115例,其中不典型鳞状细胞性质未定(ASCUS)87例,低度鳞状上皮内病变(LSIL)26例,高度鳞状上皮内病变(HSIL)2例,异常涂片多见30~49岁年龄组,且宫颈光滑组与宫颈糜烂组阳性检出率无显著差异。结论:CCT是细胞学诊断的重要革新,有很高的敏感性和特异性,且效率高,适用于宫颈癌患者的大规模普查。     

多媒体课件在妇产科学示教课中的应用探索

使用多媒体课件进行妇产科学示教课程教学，与传统教学手段相比有着不可替代的优势，有助于培养全面发展的医学人才，能够显著提高妇产科学示教课程教学效果。