坐骨棘筋膜固定术的临床解剖学研究

Objective The study was to explore the safety, firmness and convenience of the fascia around the ischial spine as a new fixation site for the vaginal fornix. Methods Between June 2007 and January 2008, detailed dissections and related measurements of the regions around the ischial spine were performed on 10 Chinese female cadavers (3 unembalmed and 7 embalmed cadavers). At the same time, the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were exposed and the pull-out strength sequentially tested using a digital push-pull force gauge. Results The fascia on the ischial spine was firm and strong, with a thickness of 3 about mm. No major vessels or nerves were observed on the ischial spine. The greatest pullout strengths of the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were (102±26),(64±15),(33±8)and(32±6)N, respectively. Conclusion The fascia at 1 cm from anterior lateral ischial spine, free of major vessels and nerves, is safe and strong and could be used as a new site for suspension in vaginal prolapse.     

静脉注射阿莫西林致幻视抑郁一例

患者:女性,17岁,学生.2004年2月31日因感冒、上呼吸道感染来诊.该患者平素健康,既往无药物过敏史,青霉素皮试(-),给予注射阿莫西林钠(amoxicillin sodium,哈尔滨制药集团制药总厂生产,商品名:益萨林)2.0 g加入生理盐水250ml静脉滴注,每日1次.连续用药3 d后患者突感头晕、视力模糊、产生幻视、精神抑郁而拒绝去医院输液、就医.自行停药2 d后上述症状均恢复正常.2004年2月26日患者再诊又给予上次同一厂家同一批号阿莫西林静脉滴注,当晚患者又出现视力模糊、幻视及精神抑郁现象.     

坐骨棘筋膜固定术的临床解剖学研究

Objective The study was to explore the safety, firmness and convenience of the fascia around the ischial spine as a new fixation site for the vaginal fornix. Methods Between June 2007 and January 2008, detailed dissections and related measurements of the regions around the ischial spine were performed on 10 Chinese female cadavers (3 unembalmed and 7 embalmed cadavers). At the same time, the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were exposed and the pull-out strength sequentially tested using a digital push-pull force gauge. Results The fascia on the ischial spine was firm and strong, with a thickness of 3 about mm. No major vessels or nerves were observed on the ischial spine. The greatest pullout strengths of the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were (102±26),(64±15),(33±8)and(32±6)N, respectively. Conclusion The fascia at 1 cm from anterior lateral ischial spine, free of major vessels and nerves, is safe and strong and could be used as a new site for suspension in vaginal prolapse.     

HPLC-荧光法测定盐酸文拉法辛胶囊的生物等效性

目的 采用HPLC-荧光检测法测定盐酸文拉法辛胶囊的生物等效性.方法 采用液-液萃取法处理血清样品,用Hypersil C18 色谱柱,流动相为乙腈-pH6.8磷酸盐缓冲液-三乙胺(30:70:1,用磷酸调pH2.8);荧光检测器检测,激发和发射波长分别为276、598 nm,流速1.0 ml · min-1. 结果 18名健康志愿者分别空腹po 150 mg盐酸文拉法辛胶囊后,两种制剂在受试者体内的药动学参数Cmax分别为348.38±98.99、344.20±96.22 μg · L-1;t1/2分别为5.079±1.322、5.046±1.503 h;AUC0-∞分别为2425.2±874.5、2431.1±819.1 μg · h · L-1,受试制剂与参比制剂的相对生物利用度为99.94%±14.22%.结论 所建方法灵敏、简便、快速、准确.两种制剂具有生物等效性.     

坐骨棘筋膜固定术的临床解剖学研究

Objective The study was to explore the safety, firmness and convenience of the fascia around the ischial spine as a new fixation site for the vaginal fornix. Methods Between June 2007 and January 2008, detailed dissections and related measurements of the regions around the ischial spine were performed on 10 Chinese female cadavers (3 unembalmed and 7 embalmed cadavers). At the same time, the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were exposed and the pull-out strength sequentially tested using a digital push-pull force gauge. Results The fascia on the ischial spine was firm and strong, with a thickness of 3 about mm. No major vessels or nerves were observed on the ischial spine. The greatest pullout strengths of the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were (102±26),(64±15),(33±8)and(32±6)N, respectively. Conclusion The fascia at 1 cm from anterior lateral ischial spine, free of major vessels and nerves, is safe and strong and could be used as a new site for suspension in vaginal prolapse.     

青春期子宫内膜异位症

子宫内膜异位症（endometriosis，EM）是困扰育龄妇女的常见妇科疾患，研究表明青春期EM发病率并不低于成年妇女EM发病率，但由于其年龄等特殊性，尚未引起患者、家长以及医务工作者的足够重视，容易延误诊治。本文就青春期EM的发病率、发病机制、临床特点、诊断分期及治疗做一综述。     

成年女性骶棘韧带区的临床应用解剖研究

目的研究骶棘韧带（sacrospinous ligament,SSL）区的血管神经解剖特点,为骶棘韧带固定术（sacrospinous ligament fixation,SSLF）提供解剖学基础。方法对10具（20侧）成人女性尸体的SSL区进行解剖、观查并测量其与周围血管神经的解剖关系。结果SSL的长度是（52．3±4．2）mm,距离坐骨棘2．5cm处的宽度为（12．0±2．1）mm。大部分臀下血管（15／20）出骨盆前经过SSL外侧一半的后方或紧邻上缘,且大部分（18／20）在近SSL上缘处发出尾动脉,它在SSL上缘处距离坐骨棘（15．7±5．6）mm。阴部神经在坐骨棘内侧从内上向外下斜行跨越SSL背侧进入坐骨小孔,位于阴部内血管的内侧或内上方,在SSL上、下缘其最内界与坐骨棘的距离分别是（23．4±3．6）mm和（15．7±1．3）mm。15个半骨盆中（15／20）找到肛提肌神经,其跨越SSL上缘处与坐骨棘的距离是（39．6±8．3）mm。结论SSLF中,选择缝合SSL距离坐骨棘至少2．5am处、宽度为韧带靠近下缘的1／2、深度为韧带全层厚度的浅层之1／2,即宽度约5mm,深度约1mm,可避免损伤其后方及上缘的血管神经。     

阴道上皮内瘤变的研究进展

阴道上内瘤变（VAIN）是癌前病变，它在1952年由Graham和Meigs首次报道，大约占女性下生殖道上皮内瘤变的1．0％.近年来女性生殖道人乳头状瘤病毒（HPV）感染增加，该病发病率也有升高的趋势。随着阴道细胞涂片和阴道镜的广泛应用，我国也不断检查出VAIN病例，其诊治开始受到重视。现就VAIN的高危因素、转归、临床表现、诊断、治疗和随诊等方面综述如下。     

二种治疗社区获得性肺炎方案的经济学分析

经济学分析是优化治疗方案、指导临床的合理用药,使患者以最少的经济负担得到最佳的治疗效果,本文采用甲磺酸加替沙星氯化钠注射液和进口头孢哌酮钠二组,共102例患者,对比二种方案的临床疗效,运用经济学原理,进行成本一效果分析,为临床合理用药提供参考.     

中盆腔缺陷的手术治疗

女性一生中因盆腔器官脱垂行手术治疗的风险是10%.子宫或阴道穹隆脱垂等中盆腔缺陷的手术治疗方法有很多种,现在常用的有骶骨阴道固定术、骶棘韧带固定术、经阴道后路悬吊带术、后穹隆成形术、全盆底重建术等.本文就这些手术方式的适应证、手术要点、效果、并发症及防治复发等做一综述.