老年盆底功能障碍性疾病影响因素及盆底肌肉训练的干预效果

目的分析老年盆底功能障碍性疾病(PFD)发病因素,探讨盆底肌肉训练(PFMT)的干预效果。方法选择160例行盆底检查的老年女性,其中60例经临床诊断为PFD(PFD组)和100例盆底功能正常(对照组),采集受试者一般资料、分娩史、盆底肌力、日常活动能力等信息,分析老年PFD发病的危险因素。随机将PFD患者分为PFMT组(30例)和常规组(30例),PFMT组采用PFMT治疗,常规组采用常规治疗和指导。观察两组治疗前后盆底肌力,PFD严重程度、生活质量的差异。结果年龄≥75岁、体重指数(BMI)≥25 kg/m²、阴道分娩次数、盆底肌力不足、PFD家族史、合并慢性阻塞性肺疾病、日常活动能力下降是老年女性罹患PFD的高危因素(P<0.05)。PFMT组治疗后Oxford盆底肌力分级3~4级、盆底肌力最大收缩力、持续收缩力、压力性尿失禁(SUI)好转情况明显优于对照组(P<0.05),尿失禁影响问卷(UIQ-7)评分、盆腔脏器脱垂影响问卷(POPIQ-7)评分明显低于对照组(P<0.05)。结论高龄、肥胖、分娩方式、分娩次数、PFD家族遗传史、慢性阻塞性肺疾病、日常生活能力低下是老年PFD患病高危因素,PFMT可改善患者临床症状和PFD严重程度,提高生活质量。     

皮下美容缝合技术在剖宫产术后切口处理中的应用效果

目的:探究皮下美容缝合技术在剖宫产术后切口处理中的应用。方法:笔者医院2017年1月-2019年4月收治的152例产妇,按照随机数表法分为观察组与对照组,各76例。对照组采用常规缝合技术,观察组采用皮下美容缝合技术。比较两组治疗效果、手术相关指标、术后疼痛视觉模拟评分(Visual analogue scale,VAS)、不良反应发生率及切口愈合等级。结果:观察组总有效率为96.05%,对照组为80.26%,差异有统计学意义(P<0.05)。观察组切口缝合时间、手术时间显著短于对照组,差异有统计学意义(P<0.05);两组切口长度比较,差异无统计学意义(P>0.05)。两组术后7d、30d两组VAS评分呈下降趋势,观察组相同时间点均低于对照组(P<0.05)。观察组切口瘢痕增生率、瘢痕宽度、瘢痕最薄厚度均低于对照组,差异有统计学意义(P<0.05)。观察组与对照组不良反应发生率分别为3.95%、15.79%,差异有统计学意义(P<0.05)。观察组切口愈合甲级为97.37%,而对照组为93.42%,但组间比较差异无统计学意义(P>0.05)。结论:皮下美容缝合技术用于剖宫产可有效提高切口愈合质量,显著改善瘢痕形成和术后疼痛,减少并发症发生,值得推广应用。     

子痫前期患者血清VEGF、PAPP-A水平与妊娠结局的相关性研究

目的 探讨子痫前期(PE)患者血清血管内皮生长因子(VEGF)、妊娠相关蛋白A(PAPP-A)水平与妊娠结局的相关性。方法 选取2020年3月—2023年3月海南现代妇女儿童医院收治的100例PE患者,根据病情程度分为PE组(68例)和重度PE组(32例),另取该院同期体检无妊娠期高血压疾病的孕妇40例作为对照组。收集资料和检测血清VEGF、PAPP-A、CC趋化因子配体17(CCL17)水平和叉头盒蛋白A1(FOXA1)、HIPK3相对表达量;采用多因素逐步Logistic回归模型分析影响PE患者妊娠结局的危险因素。结果 根据不同妊娠结局将100例PE患者分为结局不良组(38例)和结局良好组(62例)。对照组血清VEGF、CCL17、FOXA1 mRNA、HIPK3均高于PE组和重度PE组(P <0.05),PAPP-A水平低于PE组和重度PE组(P <0.05);PE组血清VEGF、CCL17、FOXA1 mRNA、HIPK3高于重度PE组(P <0.05),PAPP-A水平低于重度PE组(P <0.05)。结局良好组血清VEGF、CCL17、FOXA1 m...     

CCL18在上皮性卵巢癌患者血清中的表达及意义

Objective?To investigate the expression and clinical significance of chemokine 18 (CCL18) in serum of patients with epithelial ovarian cancer (EOC). Methods?104 patients with EOC, 42 patients with benign ovarian diseases and 20 healthy women were enrolled and divided into malignant group, benign group and control group respectively. The serum CCL18 levels of the three groups were measured, and their relationship with clinicopathological features of EOC patients were explored. Results?The level of CCL18 in malignant group was significantly higher than that benign group and control group. (P<0.01) The level of CCL18 in patients with EOC was correlated with FIGO stage, the level of CA125 and response to chemotherapy (P<0.05). It was not correlated with age, degree of differentiation, pathological type, lymph node metastasis and ascites (P>0.05). The area under the ROC curve was 0.814, and the best cutoff value was 1.80, with a sensitivity of 0.712 and a specificity of 0.887. Conclusions?The expression level of CCL18 in serum of patients with epithelial ovarian cancer is increased, and related to FIGO stage, serum CA125 level and chemotherapy response. It could be used as a potential tumor marker of ovarian cancer.