联合应用子宫输卵管造影和B超监测卵泡治疗不孕症的疗效观察

目的 观察联合应用子宫输卵管造影和B超监测卵泡治疗不孕症的疗效.方法 将584例不孕症患者按照随机数字表法分为对照组(接受综合优化治疗)和研究组(接受综合优化治疗及优势输卵管侧助孕治疗),每组292例.所有患者均接受子宫输卵管造影,研究组接受B超监测卵泡以确定优势卵泡.结果 研究组宫内妊娠率高于对照组[40.07%(117/292)比19.86%(58/292)](P＜0.01),异位妊娠率低于对照组[29.79%(87/292)比51.37%(150/292)](P＜0.01).输卵管通而不畅者异位妊娠率[74.36%(58/78)]高于输卵管积水[38.96%(30/77)]、输卵管阻塞[38.24%(104/272)]、输卵管尚通[28.66%(45/157)](P＜0.01).结论 子宫输卵管造影可以了解不孕症患者输卵管情况,B超监测卵泡发育可以确定优势卵泡.两者结合指导性生活,可以提高妊娠率,值得临床推广.

Abstract：

Objective To observe the therapeutic effect on the infertilitas feminis combining hysterosalpingography (HSG) and B ultraphonic monitor for the follicle. Methods Five hundred and eighty-four patients with infertility were divided into two groups by random digits table: control group with 292 patients received the combined optimized treatment, and study group with 292 patients received the combined optimized treatment and optimizing fallopian tube to be pregnant. All patients received the HSG while the patients of the study group received the B ultraphonic monitor for the dominant follicle besides. Results The intrauterine gestation rate in the study group was higher than that in the control group [ 40.07% (117/292) vs. 19.86% (58/292)] (P ＜0.01),and the eccyesis rate was lower than that in the control group [29.79% (87/292) vs. 51.37%(l50/292)](P＜0.01). The eccyesis rate in fallopian tube incompletely unobstructed [74.36% (58/78)] was higher than that in hydrosalpinx [ 38.96% (30/77)] , salpingemphraxis [38.24% (104/272)] and fallopian tube unobstructed[28.66%(45/157)](P＜0.01). Conclusions HSG can detect and imply the situation of the fallopian tube of the infertilitas feminis women, and B ultraphonic can monitor the follicular development to catch the dominant follicle. Combining these two detection and guiding sexual life can raise the intrauterine gestation rate. It should be widely use in clinic.     

新式剖宫产术的术式探讨

我院１９９９年９月～２００１年３月开展新式剖宫产术１５４例 ,此手术顺应解剖生理特点 ,简化手术步骤 ,取得了良好的效果 ,现报道如下。１资料与方法１ １一般资料 :新式剖宫产术 (观察组)１５４例 ,年龄２２～３９岁 ,平均年龄２８岁 ;其中初产妇１４７例 ,经产妇７例。传统式子宫下段剖宫产术 (对照组)１５４例 ,两组年龄、孕周、孕产次及手术指征无显著性差异。两组产妇均采用连续硬膜外麻醉。１ ２手术方法 :１ ２ １新式剖宫产 :(１)切口选择 :取耻骨联合上３ｃｍ横向切开皮肤１０～１３ｃｍ(长度因胎头大小而异)。(２)在切口正中切…     

剖宫产术后产褥感染相关因素分析

目的:探讨剖宫产手术后发生产褥感染的相关因素及防范措施。方法:对本院1995年5月~2008年9月剖宫产手术后发生产褥感染病例进行回顾性分析。结果:3 486例剖宫产病人中排除手术原因后12例(0.35%)发生产褥感染,其高危相关因素如下:前置胎盘反复阴道出血、第二产程剖宫产、胎膜早破(>12 h)、盆腔炎性疾病反复发作、孕期阴道炎反复发作、妊娠合并症和并发症。结论:盆腔炎性疾病反复发作、孕期阴道炎反复发作、前置胎盘反复阴道出血、第二产程剖宫产、胎膜早破(>12 h)是剖宫产手术后产褥感染的主要相关因素,对有高危因素的产妇,术前积极治疗原发病,纠正感染因素,抗生素围手术期预防性应用及术中采取防范措施,可减少术后产褥感染发生。     

盐酸利托君在早产保胎治疗中的护理措施探讨

目的：探讨应用盐酸利托君提高早产保胎治疗的临床效果。方法2011年1月—2013年12月期间我院收治的60例早产保胎患者按照双盲对照随机原则分为对照组和观察组各30例，其中对照组患者给予硫酸镁治疗，观察组给予盐酸利托君治疗，治疗1个月后观察2组患者治疗效果。结果对照组患者的临床治疗效果（心率、显效时间、延长孕期、新生儿平均体重）明显低于观察组患者，2组比较差异有统计学意义（P<0.05）。结论盐酸利托君用于早产保胎过程中，不仅效果显著，而且可以明显降低母婴不良事件的发生率，值得临床推广应用。     

八珍益母胶囊联合激素疗法治疗气血两虚兼血瘀型月经不调疗效观察

目的:观察八珍益母胶囊联合激素疗法治疗气血两虚兼血瘀型月经不调的临床疗效。方法:将84例患者随机分为2组各42例,对照组给予雌、孕激素周期疗法和克罗米芬促排卵法,观察组在对照组基础上给予八珍益母胶囊。均治疗4周,比较2组临床疗效和不良反发生率。结果:对照组总有效率为71.4%,观察组总有效率为90.5%,2组总有效率比较,差异有显著性意义(P0.05)。不良反应发生率观察组为7.1%,对照组为4.8%,2组比较,差异无显著性意义(P0.05)。结论:八珍益母胶囊联合激素疗法治疗气血两虚兼血瘀型月经不调疗效好,不良反应少。     

B超监护妇产科手术仪在瘢痕子宫妊娠早期无痛人工流产术中的应用

目的观察B超监护妇产科手术仪在瘢痕子宫早孕无痛人工流产术中的临床应用价值。方法按自愿的原则,将瘢痕子宫妊娠早期（孕周6～10周）患者400例分成2组,观察组（200例）术前含服米索前列醇后,B超监护妇产科手术仪无痛人工流产术;对照组（200例）术前含服米索前列醇后,行传统的无痛人工流产术。观察两组手术时间、术后出血及术后并发症的发生率。结果观察组的手术时间短于对照组,观察组的出血量少于对照组,差异均有统计学意义（均P〈0.05）。两组并发症发生率差异有统计学意义（P〈0.05）。结论应用B超监护妇产科手术仪性无痛人工流产术具有直观性,能引导手术器械操作,缩短手术时间,从而减少手术出血、子宫穿孔、宫内残留及宫腔粘连等并发症的发生率。     

联合应用子宫输卵管造影和B超监测卵泡治疗不孕症的疗效观察

Objective To observe the therapeutic effect on the infertilitas feminis combining hysterosalpingography (HSG) and B ultraphonic monitor for the follicle. Methods Five hundred and eighty-four patients with infertility were divided into two groups by random digits table: control group with 292 patients received the combined optimized treatment, and study group with 292 patients received the combined optimized treatment and optimizing fallopian tube to be pregnant. All patients received the HSG while the patients of the study group received the B ultraphonic monitor for the dominant follicle besides. Results The intrauterine gestation rate in the study group was higher than that in the control group [ 40.07% (117/292) vs. 19.86% (58/292)] (P ＜0.01),and the eccyesis rate was lower than that in the control group [29.79% (87/292) vs. 51.37%(l50/292)](P＜0.01). The eccyesis rate in fallopian tube incompletely unobstructed [74.36% (58/78)] was higher than that in hydrosalpinx [ 38.96% (30/77)] , salpingemphraxis [38.24% (104/272)] and fallopian tube unobstructed[28.66%(45/157)](P＜0.01). Conclusions HSG can detect and imply the situation of the fallopian tube of the infertilitas feminis women, and B ultraphonic can monitor the follicular development to catch the dominant follicle. Combining these two detection and guiding sexual life can raise the intrauterine gestation rate. It should be widely use in clinic.     

妊娠肝内胆汁淤积症44例临床分析

目的分析肝内胆汁淤积症（ICP）患者血中总胆汁酸、肝酶与羊水粪染的变化关系.方法对44例ICP患者临床特点及血生化指标进行回顾分析.结果所有ICP患者血液总胆汁酸升高并与羊水粪染呈正相关,肝酶大部分轻中度升高.结论提高对ICP的认识,加强产前检查,做到早诊断,对降低母亲及胎儿的危害具有临床意义.