早期宫内妊娠误诊无胚胎妊娠的临床分析

目的：探讨早期宫内妊娠的临床诊断,减少漏诊率。方法：对门诊可疑无胚胎妊娠患者采用B超检查结合测定血绒毛膜促性腺激素和孕激素的变化并延长观察时间,结合临床症状综合判断确诊48例;与参照标准确诊的无胚胎妊娠（难免流产）50例对比,分析其临床症状及B超、血绒毛膜促性腺激素（HCG）的倍增、血孕激素（P）水平。结果：正常宫内早孕腹痛、阴道流血及早孕反应均显著少于对照组,孕囊、HCG倍增同期小于对照组,P显著高于对照组。结论：早期宫内妊娠诊断应依临床症状、B超及血激素、细胞因子动态观察而确定。     

绝经后子宫肌瘤临床病理分析

子宫肌瘤是女性生殖系统最常见的良性肿瘤,育龄妇女发病率可达20%～30%.绝经后,由于卵巢功能的衰退,子宫肌瘤多停止生长并逐渐萎缩,但临床上经常遇到绝经后肌瘤非但不萎缩,反而增大,或合并子宫出血、腹痛及直肠、膀胱压迫等症状,如何正确处理这些异常情况临床有不同意见.笔者就我院2003年1月～2007年6月收治的绝经后子宫肌瘤患者58例进行临床病理资料分析,探讨其临床病理特征和处理方法.     

宫颈环形电切术与阴道镜下活检在诊断宫颈上皮内瘤样变价值比较

Objective To compare the diagnostic clinical significance between loop electrosurgical excision procedure (LEEP) and colposcopical biopsy for cervical intracpithelial neoplasia(CIN). Methods 130 cases of pa-tients diagnosed as CIN under colposcopical biopsy were treated by LEEP in court of gynecology clinic. The conven-tional pathologic diagnosis was recorded in all conization specimens. Results The coincidence rate between colpo-scopical biopsy and LEEP biopsy in CIN Ⅰ, CIN Ⅱ, CIN Ⅲ (not comprised carcinoma in situ) was 55.26%,66.10% ,78.79% respectively;The total coincidence rate was 66.15%. The accuracy of colposcopic biopsy for diag-nosing CINⅢ was higher than that for CIN Ⅰ and CIN Ⅱ,but there was no statistical difference. Conclusion Colpo-scopical biopsy for cervical lesions can be achieved for the frist time the results of pathology, have limitations. LEEP biopsy can compensate partially the deficiency of colposcopic biopsy. In a dear diagnosis of CIN, LEEP biopsy and colposcopical biopsy may complement each other, and achieve thcrpeutic effects.     

宫颈环形电切术与阴道镜下活检在诊断宫颈上皮内瘤样变价值比较

Objective To compare the diagnostic clinical significance between loop electrosurgical excision procedure (LEEP) and colposcopical biopsy for cervical intracpithelial neoplasia(CIN). Methods 130 cases of pa-tients diagnosed as CIN under colposcopical biopsy were treated by LEEP in court of gynecology clinic. The conven-tional pathologic diagnosis was recorded in all conization specimens. Results The coincidence rate between colpo-scopical biopsy and LEEP biopsy in CIN Ⅰ, CIN Ⅱ, CIN Ⅲ (not comprised carcinoma in situ) was 55.26%,66.10% ,78.79% respectively;The total coincidence rate was 66.15%. The accuracy of colposcopic biopsy for diag-nosing CINⅢ was higher than that for CIN Ⅰ and CIN Ⅱ,but there was no statistical difference. Conclusion Colpo-scopical biopsy for cervical lesions can be achieved for the frist time the results of pathology, have limitations. LEEP biopsy can compensate partially the deficiency of colposcopic biopsy. In a dear diagnosis of CIN, LEEP biopsy and colposcopical biopsy may complement each other, and achieve thcrpeutic effects.     

脐血流速度波形监测对高压氧治疗胎儿宫内发育迟缓疗效观察

本文通过对２８ 例胎儿宫内发育迟缓（ＩＵＧＲ）伴有脐动脉血流异常的孕妇，采用高压氧治疗，进行多普勒血流检测。治疗后有１７ 例脐动脉多普勒Ａ／Ｂ比值恢复正常，１１ 例持续异常，２８ 例分娩前一周胎儿监护均为阴性。正常组与异常组的小于孕龄儿发生率、ＩＵＧＲ及其手术产率、１ｍｉｎ Ａｐｇａｒ　评分的发生率有明显不同，正常组的新生儿预后良好，而且脐动脉多普勒血流指标比胎儿监护更早及更有效地预测胎儿宫内窘迫。同时，高压氧治疗ＩＵＧＲ 有一定疗效，值得推广。     

宫颈环形电切术与阴道镜下活检在诊断宫颈上皮内瘤样变价值比较

Objective To compare the diagnostic clinical significance between loop electrosurgical excision procedure (LEEP) and colposcopical biopsy for cervical intracpithelial neoplasia(CIN). Methods 130 cases of pa-tients diagnosed as CIN under colposcopical biopsy were treated by LEEP in court of gynecology clinic. The conven-tional pathologic diagnosis was recorded in all conization specimens. Results The coincidence rate between colpo-scopical biopsy and LEEP biopsy in CIN Ⅰ, CIN Ⅱ, CIN Ⅲ (not comprised carcinoma in situ) was 55.26%,66.10% ,78.79% respectively;The total coincidence rate was 66.15%. The accuracy of colposcopic biopsy for diag-nosing CINⅢ was higher than that for CIN Ⅰ and CIN Ⅱ,but there was no statistical difference. Conclusion Colpo-scopical biopsy for cervical lesions can be achieved for the frist time the results of pathology, have limitations. LEEP biopsy can compensate partially the deficiency of colposcopic biopsy. In a dear diagnosis of CIN, LEEP biopsy and colposcopical biopsy may complement each other, and achieve thcrpeutic effects.     

新辅助化疗对中晚期宫颈癌作用的临床分析

目的:探讨新辅助化疗(NACT)治疗中晚期宫颈癌的疗效。方法:收集我院45例宫颈癌局部病灶特别大的Ⅰb期、Ⅱ期和Ⅱb期以上晚期患者,术前予静脉化疗或子宫动脉灌注化疗1~3个疗程,其中28例行静脉化疗,17例行子宫动脉灌注化疗。结果:NACT总有效率达82.2%(37/45),完全恢复占11.1%(5/45)。子宫动脉灌注化疗对中晚期宫颈癌近期疗效与静脉用药相比,差异无统计学意义,但可减少患者骨髓抑制反应发生率,减少术中出血。结论:新辅助化疗对宫颈癌临床分期的改善和手术疗效有着重要的意义;与静脉化疗相比,子宫动脉灌注化疗有利于患者手术恢复。     

卵巢移位术在早期宫颈癌根治术中的应用

目的 探讨卵巢移位术在早期宫颈癌根治术中应用的临床意义。方法 对我院收治的32例年轻宫颈癌患施行根治术同时行卵巢移位术，术后均接受盆腔放疗，该点距离盆腔放射照野边缘有5cm的安全距离。结果随访观察无性激素水平下降而导致的各种症状出现。结论 为了提高宫颈癌患术后的生活质量，卵巢移位术对保留年轻宫颈癌患放疗后的卵巢功能有一定的临床应用价值。     

妊娠合并心脏病患者的护理

妊娠合并心脏病是产科常见合并症 ,是导致孕产妇和围产儿死亡的重要原因之一。孕妇严重心功能不良使胎儿处于不良生长环境 ,而且往往为抢求孕妇而提前终止妊娠 ,导致医源性早产。笔者通过对 4 1例妊娠合并心脏病患者的临床资料回顾 ,探讨产前护理、产程护理、产褥期的护理要点 ,以降低产妇的死亡率。1　临床资料我院自 1999年至 2 0 0 2年共有 2 85 8人次分娩 ,其中妊娠合并心脏病人 4 1人 ,发病率为 1.4 3%。患者年龄大都在 2 2～ 35岁 ,其中初产妇 35人 ,经产妇 6人 ,孕周 30～ 38周。有 36人自妊娠后坚持门诊定期检查 ,入院时 ,心功能Ⅱ…     

米非司酮联合甲氨蝶呤治疗异位妊娠的临床效果观察

目的观察米非司酮联合甲氨蝶呤治疗异位妊娠的临床效果。方法选择2010年1月‐2017年1月该院收治的异位妊娠患者78例,随机分为对照组和观察组,各39例。对照组采用甲氨蝶呤进行治疗,观察组采用米非司酮+甲氨蝶呤联合治疗,观察两组治疗效果。结果对照组临床症状改善时间明显高于观察组,治疗有效率低于观察组,差异有统计学意义(P0.05)。结论米非司酮联合甲氨蝶呤治疗异位妊娠临床效果显著,可快速缓解患者临床症状。