宫腔镜在宫内节育器取出困难中的应用与护理73例

宫内节育器(intrauterine contraceptive device,IUD)作为一种有效的避孕措施已被广泛推广使用多年,它方法简便,安全性高,易于接受[1].然而,放置IUD后取出困难时有发生,如果处理不当,可造成严重的并发症,由此给患者带来的身心伤害须引起广大医护人员的重视.宫腔镜的检查及手术为各种困难取器提供了一种新的途径.现将我院2004-01至2009-06在宫腔镜下取出的困难取器的73例临床资料及护理体会总结报道如下.     

宫内节育器取器困难问题探讨

目的：解决常规方法取宫内节育器（IUD）困难的问题。方法：对23例取IUD失败患者采用宫腔镜系统取IUD。结果：均一次取IUD成功。手术时间（6.12±0.53）min,出血量≤6 mL,均未发生并发症。结论：宫腔镜系统取IUD效果好、安全。     

宫腔镜联合超声诊治IUD取出困难52例分析

宫内节育器是一种安全、有效、简便的避孕方法，如IUD尾丝迷失、断裂、残留、嵌顿以及穿出子宫外，导致IUD取出困难，采用宫腔镜联合超声检查，对IUD准确定位，进行诊断和处理，疗效满意。     

宫腔镜联合B超在节育器嵌顿中的临床价值

目的:探讨在超声监测下应用宫腔镜取出嵌顿节育器的临床应用价值。方法:局麻或腰硬联合麻醉下,在B超指导下应用宫腔镜取出嵌顿于子宫肌层的宫内节育器。结果:48例嵌顿于子宫肌层的宫内节育器经宫腔镜一次性取出,操作简单、安全、无并发症。结论:超声监测下应用宫腔镜取出嵌顿的节育器,定位准确,成功率高,并发症少。     

B超观察子宫腔内节育器及其临床应用

B超显像法观察子宫腔内节育器(IUD)是目前临床上常用的方法之一。1986年10月～1991年10月,我们采用B超显像法追踪观察放置宫内IUD的健康育龄已婚妇女456例,发现避孕失败、带器妊娠与宫内IUD的位置有关,现将结果报告如下。     

米索前列醇用于绝经后妇女取宫内节育器80例临床观察

宫内节育器(IUD)是我国育龄妇女采用最多的一种安全有效的避孕工具。为了探索绝经取IUD的方法，提高手术的成功率，减轻绝经后妇女取器的痛苦，我们采用米索前列醇术前阴道给药，后取器的方法，取得了良好的效果，现报告如下。     

经阴道三维超声诊断宫内节育器位置异常的价值

宫内节育器（intrauterine device,IUD）是目前我国育龄妇女首选的避孕工具,据统计我国使用IUD的女性约占育龄妇女的50%以上[1]。本研究对经阴道二维超声检查怀疑IUD异常患者行三维超声成像检查,将其结果与宫腔镜、     

宫内节育器脱落1638例原因分析

宫内节育器(IUD)是我国育龄妇女采取的主要避孕措施,是一种安全、有效、简便、经济、可逆,长效的避孕方法。但宫内节育器脱落,带器妊娠等失败也给育龄妇女身心健康造成一定影响,严重影响了工作、生活[1]。2008-05～2011-08,我院体检中心检查已婚带器女性11 760例,其中有节育器脱落史者1 638例,占13.9%,对其原因进行回顾性分析,     

B超对不同类型宫内节育器的探查及临床观察

宫内节育器是一种常用的节育方法,据报道,全世界约有5亿以上的育龄妇女使用了这种方法.为了解不同类型宫内节育器(IUD)的避孕效果及其利弊,特对375例IUD放置者进行B超追踪探查及多项临床指标观察.     

补佳乐配伍复方萘普生栓用于绝经后妇女取环的临床观察

宫内节育器（intrauterinedevice．IUD）是一种放置在子宫腔内的避孕装置，由于初期使用的装置多是环状的，通常叫节育环。节育环对全身干扰较少，作用于局部，取出后不影响生育，具有安全、有效、可逆、简便、经济等优点，是最常用的节育用具之一^[1]。采用宫内节育环避孕者在我国占40％以上。有效率约为90％。女性在绝经之后。其卵巢功能会出现衰退，其雌激素水平也会随之降低。女性生殖器官将出现萎缩，宫颈缩小、组织变硬、弹性变差，从而大大增加了取宫内节育器的难度。故绝经后女性取节育器可引发疼痛、损伤、出血，乃至宫内节育器断裂等并发症阁。为了提升绝经后取环的成功率，降低疼痛，防止各类并发症的出现，作者选取了2009年9月～2012年9月期间，在绝经期宫内取节育器的320例患者，并对其临床情况进行了回顾性分析。现报道如下。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

我国医用辐射防护研究概况

医学放射学技术的迅速发展及介入放射学在临床广泛应用，使更多的人受到电离辐射的照射，同时也促进了医疗照射防护工作的发展。文中重点综述了我国医用辐射防护工作者近年来在Ｘ射线ＣＴ的医疗照射防护、对介入放射学工作者的剂量监测以及应用医疗照射防护体系，降低医疗照射剂量等方面所作出的成绩和研究进展     

新时期军医学院人才培养的思考

在新的历史条件下 ,军医学院迎接未来高技术局部战争的挑战 ,适应部队武器装备的不断更新以及医学科技、社会发展对人才素质提出的新要求 ,必须在更为广阔的时空背景下找准人才培养的着眼点 ,科学确立人才培养方向 ,提高人才培养质量。现就人才培养思考如下 :1　改变教育观念 ,     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。