安脑丸对急性脑出血大鼠OX42、脑源性神经营养因子及突触素表达的影响

目的:观察安脑丸对大鼠脑出血后OX42、脑源性神经营养因子(BDNF)及突触素(SYN)表达的影响。方法:SD大鼠190只随机分为正常组10只,假手术组、模型组、安脑丸组各60只;后3组又随机分为造模后12h、1d、2d、4d、7d、10d共6个时间点,各10只。模型组制作脑出血模型,安脑丸组加用安脑丸灌胃。于各时间点采用免疫组化法及western blot法检测OX42、BDNF及SYN表达情况。结果:模型组及安脑丸组OX42及BDNF阳性细胞数及SYN、BDNF蛋白表达显著高于正常组及假手术组(P<0.01),安脑丸组OX42阳性细胞数显著少于模型组(P<0.01),BDNF阳性细胞数及SYN、BDNF蛋白表达显著高于模型组(P<0.01)。结论:小胶质细胞的激活、BDNF及SYN的表达与脑出血密切相关,安脑丸可显著减少脑出血后小胶质细胞的活化,增加BDNF及SYN的表达。     

电针联合依达拉奉对糖尿病周围神经病变大鼠坐骨神经的保护作用

目的 研究电针联合依达拉奉对糖尿病周围神经病变(DPN)大鼠坐骨神经的保护作用.方法 SD大鼠100只,10只作为正常组,其余90只采用链脲佐菌素(STZ)1次性腹腔注射诱导建立DPN模型,之后随机分为对照组、电针组和针药联合组,电针组取大鼠足三里、肾俞穴进行电针治疗,针药联合组同时给予依达拉奉(3 mg·kg-1·d-1)腹腔注射共4周.观察坐骨神经运动神经传导速度(MCV)、感觉神经传导速度(SCV)形态和坐骨神经中一氧化氮(NO)、丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性.结果 与正常组比较,时照组大鼠MCV、SCV明显减慢(30.88±3.64)m/s,(28.65±9.44) m/s;(48.39±1.43)m/s,(47.44±8.68)m/s,形态学明显异常,NO、MDA含量明显增多(5.56±0.21)(μ)mol/L,(7.97±0.51)nmol/mg prot;(1.16±0.17)(μ)mol/L,(2.23±0.48)nmol/mg prot,SOD活性显著降低(10.62±1.53) U/mg prot,(20.48±1.55)U/mg prot(P＜0.01),电针组与对照组比较,大鼠MCV、SCV明显加快(36.43±2.28) m/s,(34.43±5.38)m/s(P＜0.01),形态学明显改善,但NO、MDA含量与SOD活性无显著变化(P＞0.05),针药联合组与电针组比较,大鼠MCV、SCV加快更明显(43.67±2.33) m/s,(41.47±5.32) m/s( P＜0.01),形态学有更明显改善,NO、MDA含量较对照组及电针组均明显减少(2.23±0.12)(μ)mol/L,(4.12±0.42)nmol/ mg prot,SOD活性则显著增高(16.69±1.76)U/mg prot(P＜0.01).结论 电针联合依达拉奉应用对DPN大鼠坐骨神经损伤有更明显的保护作用.     

高压氧治疗对大鼠脑穿刺损伤后胶质疤痕形成和炎性反应的抑制作用

目的 观察高压氧(HBO)治疗对大鼠大脑皮质损伤后胶质疤痕形成的影响,并初步探讨其对炎性反应产生抑制作用的内在作用机制.方法 选取健康成年雄性SD大鼠96只,建立大脑穿刺损伤模型,采用随机数字表法将其分为对照组和治疗组,每组48只,对照组不做特殊干预处理,治疗组则给予HBO治疗.分别于脑穿刺损伤后1、3、7、14和28 d取大鼠右侧大脑组织,利用免疫组化染色比较2组大鼠损伤灶周围星形胶质细胞和小胶质细胞的数目变化,并通过ELISA法测定脑组织内肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)的含量.结果 制模后7、14和28 d,对照组大鼠的伤口面积分别为(2.73±0.05) μm2、(3.42±0.18)μm 2、(2.41±0.09) μm2,与制模后7d及14 d比较,制模后28 d时的伤口面积明显缩小(P＜0.05);治疗组大鼠制模后7、14和28 d的伤口面积分别为(2.78 ±0.12)μm2、(2.59±0.08) μm2、(1.20±0.06) μm2,与制模后7d比较,制模后14 d时的伤口面积缩小(P＜0.05),且制模后28 d时的伤口面积进一步缩小(P＜0.05),制模后14 d及28 d时的伤口面积均小于对照组(P＜0.05).与制模后7d比较,对照组及治疗组制模后14 d和28 d的星形胶质细胞数目均增多(P＞0.05);与组内制模后14 d比较,对照组及治疗组制模后28 d的星形胶质细胞数目下降(P＜0.05);与对照组同时间点比较,治疗组星形胶质细胞的数目少于对照组(P＜0.05).与制模后1d比较,对照组及治疗组制模后3d、7d的小胶质细胞均增多(P＞0.05);与组内制模后7d比较,对照组及治疗组制模后14 d的小胶质细胞数目下降(P＜0.05);与对照组同时间点比较,治疗组小胶质细胞的数目少于对照组(P＜0.05).与制模后1d比较,对照组制模后3d及7d的TNF-α浓度均较高(P＞0.05),但制模后7d的TNF-α浓度较制模后3d低(P＜0.05);制模后3d及7d,对照组IL-1β浓度和治疗组TNF-α浓度均呈先升高后降低趋势;治疗组IL-1β浓度则呈逐渐降低趋势(P＜0.05).与对照组同时间点比较,治疗组TNF-α浓度及IL-1β浓度均较低(P＜0.05).结论 HBO治疗可促进脑穿刺损伤伤口愈合,减少胶质疤痕形成,其机制可能与星形胶质细胞及小胶质细胞活化水平下调、参与炎性反应的细胞因子含量减少有关.     

健脑益智胶囊对脑出血大鼠血清及脑组织中SOD和MDA的影响

目的 探讨健脑益智胶囊对脑出血大鼠脑保护作用的机制.方法 采用自体血注入法建立大鼠脑出血模型.将50只SD大鼠按照随机原则分为假手术组、模型组及健脑益智胶囊小、中、大剂量治疗组(分别为0.5、1.0、2.0 g/kg,每日1次),均给药14 d.用Longa评分法和Bederson评分法观察各组大鼠行为学评分变化.术后14 d处死大鼠,分别检测血清和脑组织中超氧化物歧化酶(SOD)和丙二醛(MDA)水平.结果 药物治疗14 d,大鼠运动能力的改善与治疗药物的剂量呈正相关,大剂量组Bederson评分显著低于假手术组和模型组(P均<0.05).药物治疗大剂量组血清和脑组织中SOD活性均高于其他各组,MDA含量均低于其他各组,与假手术组和模型组比较差异均有统计学意义(P均<0.05),与小、中剂量治疗组比较差异无统计学意义(P均>0.05).结论 健脑益智胶囊能升高脑出血模型大鼠血清和脑组织中SOD活性,降低MDA含量,对脑出血后氧自由基的清除有明显作用.     

线粒体分裂蛋白抑制剂对小胶质细胞氧化损伤的保护作用

目的：研究线粒体分裂蛋白抑制剂(mdivi-1)能否减轻β淀粉样蛋白（Aβ）诱导的体外原代培养小鼠小胶质细胞的氧化应激损伤。方法：随机将体外原代培养BALB/C小鼠小胶质细胞分为con组、Aβ组、mdi组和 Aβ+mdi 组,con 组不予处理,Aβ组中加入 Aβ,mdi 组中加入 mdivi-1,Aβ+mdi 组分别加入2、5、10、20μmol/L mdivi-1后1 h加入Aβ。分别检测小胶质细胞存活率及凋亡、线粒体膜电位、丙二醛（MDA）含量、超氧化物歧化酶（SOD）活性、8-羟基脱氧鸟苷（8-OHdG）含量。结果：与con组相比,Aβ组小胶质细胞存活率下降,凋亡增加,线粒体膜电位下降,MDA和8-OHdG含量升高,SOD活性下降,差异有统计学意义（＜0.05）;与Aβ组相比,Aβ+mdi组小胶质细胞存活率上升,凋亡减少,线粒体膜电位增加,细胞内MDA和8-OHdG水平下降,SOD活性上升,差异有统计学意义（＜0.05）。结论：mdivi-1对Aβ诱导的体外原代培养小胶质细胞氧化应激损伤具有保护作用。     

Ⅰ型磷酸酶抑制亚基1对大鼠心肌细胞缺氧/复氧损伤的保护作用

目的 探讨Ⅰ型磷酸酶抑制亚基1(PPI1)对大鼠乳鼠心肌细胞缺氧/复氧(H/R)损伤的保护作用及其机制.方法 用PPI1野生型和活化型突变体表达质粒分别转染乳鼠心肌细胞,并建立乳鼠心肌细胞缺氧/复氧H/R模型,测定各组心肌细胞的存活率、丙二醛(MDA)、乳酸脱氢酶(LDH)的含量、caspase-3活性及超氧化物歧化酶(SOD)活力,此外用流式细胞术测定各组心肌细胞凋亡率,Western blot分析PPI1对凋亡相关蛋白表达及PI3K/Akt信号通路的影响.结果 与正常组比较,模型组LDH、MDA含量、caspase-3活性及细胞凋亡率增高(P<0.05),细胞存活率和SOD活性降低(P<0.05);PPI1活化型突变体转染组细胞的LDH、MDA含量、caspase-3活性和细胞凋亡率则降低,细胞存活率和SOD活性升高,与缺氧/复氧组比较各实验指标差异均具有统计学意义(P<0.05).Western blot表明该组细胞P53、Bax 表达下调,pAkt表达上调.结论 PPI1活化型突变体对H/R造成的心肌细胞损伤具有保护作用,其机制与稳定心肌细胞膜、减轻氧自由基损伤及减少细胞凋亡有关.     

褪黑素对癫痫大鼠海马氧化应激及神经元凋亡的影响

目的探讨褪黑素对癫痫大鼠海马氧化应激及神经元凋亡的影响及其机制。方法成年雄性Sprague-Dawley大鼠72只等分为对照组、模型组、褪黑素低剂量组和褪黑素高剂量组。模型组侧脑室注射马桑内酯50μg/kg,褪黑素低、高剂量组分别于腹腔注射褪黑素20 mg/kg和60 mg/kg后30 min,侧脑室注射马桑内酯50μg/kg。癫痫持续60 min后,采用紫外分光光度计检测丙二醛(MDA)、超氧化物歧化酶(SOD)的含量;原位末端标记法(TUNEL法)检测大鼠海马CA3区神经元凋亡;电镜观察海马CA3区神经元及其线粒体改变。结果与对照组相比,模型组海马神经元、线粒体出现明显超微结构损伤,凋亡细胞数显著增多(P0.001),海马SOD显著降低(P0.001),MDA显著升高(P0.001)。与模型组相比,褪黑素低剂量组大鼠海马神经元、线粒体超微结构损伤有所改善,凋亡细胞数明显减少(P0.01),SOD升高(P0.05),MDA降低(P0.05);褪黑素高剂量组大鼠海马神经元、线粒体超微结构损伤明显改善,凋亡细胞数显著减少(P0.001),且与对照组相比无显著性差异(P0.05),SOD显著升高(P0.001),MDA显著降低(P0.001)。结论给予外源性褪黑素可明显减少癫痫大鼠海马神经元凋亡,高剂量效果更佳,其作用机制可能涉及褪黑素对抗氧化应激反应,减轻神经元、线粒体损伤。     

米诺环素对癫痫海马小胶质细胞P2X7表达的影响

目的:观察米诺环素(minocycline,MC)对癫痫海马小胶质细胞P2X7表达的作用.方法:原代培养大鼠海马小胶质细胞并建立海人酸(kainic acid,KA)损伤模型,并分组:空白对照组、KA对照组、米诺环素处理组,观察各组细胞形态学的变化,检测各组P2X7受体mRNA的表达变化.结果:经KA处理后,海马小胶质细胞从静息状态变为激活状态,而米诺环素处理可以抑制小胶质细胞形态学的改变;经KA处理后,P2X7受体mRNA表达增多,与空白对照组比,升高值为1.825±0.24倍,有统计学意义(P＜0.05);而米诺环素处理组,P2X7受体mRNA表达量为1.114±0.09倍,与KA组比较,有明显的统计学意义,P＜0.01.结论:米诺环素能有效抑制癫痫海马小胶质细胞的活化,减少P2X7受体的表达.     

重组人粒细胞集落刺激因子对实验性脑出血大鼠星形胶质细胞表达的影响

背景:星形胶质细胞是中枢神经系统的主要成分之一,具有对各种损伤产生强烈反应的特性,脑出血后星形胶质细胞大量表达、活性增强,这种由常态转变为反应性状态的星形胶质细胞的病理生理学意义是目前研究热点.目的:探讨重组人粒细胞集落刺激因子对脑出血后星形胶质细胞表达的影响.设计、时间及地点:随机对照动物实验,于2006-03/11在泸州医学院中心实验室完成.材料:清洁级健康榷性SD大鼠50只,随机分为3组:假手术组10只、模型组20只、实验组20只.重组人粒细胞集落刺激因子为深圳新鹏生物工程有限公司产品.方法:模型组、实验组利用鼠脑立体定向仪、采用断尾取自体血法制备脑出血动物模型,假手术组用等量生理盐水代替自体血,余干预措施与模型组一致.造模1 h后,实验组大鼠腹腔注射重组人粒细胞集落刺激因子60 μg/kg,余2组未注射任何物质.主要观察指标:分别于干预后6 h,24 h,48 h,72 h,7 d采用免疫组织化学ABC法检测胶质纤维酸性蛋白阳性细胞的表达.结果:假手术组未见胶质纤维酸性蛋白阳性细胞的表达.模型组干预6 h即有少量胶质纤维酸性蛋白阳性细胞表达,48 h后开始增多,至72 h胶质纤维酸性蛋白阳性细胞数量达高峰(P＜0.05),7 d后仍有大量胶质纤维酸性蛋白阳性细胞表达,但较72 h时有所减少.实验组干预6 h时胶质纤维酸性蛋白阳性细胞的表达与模型组相似,干预24 h,48 h,72 h,7 d时胶质纤维酸性蛋白阳性细胞较模型组明显减少(P＜0.05),细胞变形程度减轻.结论:重组人粒细胞集落刺激因子能够抑制脑出血后星形胶质细胞的过度活化,可能对损伤脑组织重建和功能恢复起重要作用.     

干扰表皮生长因子受体表达对脑出血后星形胶质细胞活化的影响及其机制

目的观察干扰表皮生长因子受体(EGFR)表达对脑出血后星形胶质细胞活化的影响。方法注射Ⅶ型胶原酶制备脑出血模型大鼠,同时设置假手术组作为对照。术后7 d,行神经功能评分判断造模成功与否。取脑出血模型大鼠和假手术大鼠,行SP免疫组化法检测脑组织EGFR和神经胶质纤维酸性蛋白(GFAP)表达。分离新生大鼠皮层星形胶质细胞,体外培养。观察干扰EGFR表达对细胞的影响,实验分4组:(1)对照组:不处理;(2)重组大鼠睫状神经营养因子(CNTF)组:加入20μg/L CNTF;(3)阴性组:加入20μg/L CNTF,并转染EGFR siRNA阴性对照;(4)EGFR组:加入20μg/L CNTF,并转染EGFR siRNA。采用实时荧光定量PCR和蛋白印迹法检测各组细胞EGFR、GFAP、磷酸化酪胺酸激酶JAK1(p-JAK1)、磷酸化信号传导与转录激活因子3(p-STAT3)的表达。结果脑出血模型大鼠造模成功率89.5%(17/19)。脑出血模型大鼠脑组织EGFR和GFAP表达显著高于假手术组(P0.05)。EGFR组EGFR mRNA和蛋白相对表达量显著低于对照组、CNTF组和阴性组(P0.05)。CNTF组和阴性组GFAP mRNA和蛋白相对表达量显著高于对照组和EGFR组(P0.05),而对照组和EGFR组比较无显著差异(P0.05)。CNTF组和阴性组p-JAK1和p-STAT3蛋白相对表达量显著高于对照组和EGFR组(P0.05),而对照组和EGFR组比较无显著差异(P0.05)。结论脑出血大鼠EGFR和GFAP表达升高,星形胶质细胞活化。干扰EGFR表达可抑制大鼠星形胶质细胞活化,其机制可能与阻滞JAK1和STAT3磷酸化有关。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.