孕晚期羊水过少分娩结局临床分析

目的 探讨羊水过少对胎儿宫内窘迫、新生儿窒息率、胎位、新生儿体重及分娩方式的影响。方法 对孕37w-41w孕妇行常规产前检查,B型超声测量羊水深度≤3cm诊断为羊水过少,对100例羊水过少病例分析其对胎儿宫内窘迫、胎位、新生儿窒息率及分娩方式的影响。结果 羊水过少组病例的胎儿宫内窘迫率及新生儿窒息率明显高于对照组,臀位比例及剖宫产率也明显高于对照组,新生儿体重则明显低于对照组。结论 羊水过少对围产儿预后及分娩方式,有明显的不良影响,应极早发现并积极处理。     

B超诊断羊水过少的临床价值

目的研究B超诊断羊水过少的临床价值.方法采用羊水池的最大深度(AFD)＜3cm为羊水过少;羊水指数(AFI)＞8cm为羊水过少.并对胎儿生长进行B超评估和胎儿体表及内脏结构发育的B超检查.结果对174例羊水过少的胎儿进行追踪、统计.结果表明中期妊娠羊水过少发生率较晚期妊娠低,但妊娠结局较晚期妊娠差.结论 B超是诊断羊水过少的首先方法.可以通过B超对胎儿及羊水的监测指导临床及时作出正确的产科处理.     

潍坊地区羊水过少100例临床分析

目的 :探讨羊水过少的相关因素 ,寻找正确的处理方法 ,降低围产儿的病死率。方法 :对羊水过少 10 0例临床资料进行回顾性分析。结果 :羊水过少高发于孕 40周后 ,羊水Ⅱ度以上粪染 ,胎盘成熟度Ⅲ级及胎盘钙化、胎儿窘迫、妊高征、胎儿宫内发育迟缓、新生儿窒息率、剖宫产率均明显高于羊水正常组。结论 :羊水过少确诊后适时以剖宫产结束分娩为宜 ,以达到优生优育。     

羊水过少86例临床分析

目的 探讨晚期妊娠羊水过少对围生期结局的影响.方法 应用超声测定羊水指数(AFI)对估测羊水量及分娩时羊水总量<300ml的86例妊娠妇女临床情况及围生期结局进行分析.结果 羊水过少高发于40-42+6周,占5.40%(35/648);有妊娠合并症,并发症的高危妊娠,羊水过少多发生于孕37-39+6周,占71.4%(25/35).围生儿死亡率为1.16/万.用超声测定羊水指数作为监测羊水量的指标,符合率为93.33%(70/75).剖宫产率为73.26%(63/86).结论 晚期妊娠羊水过少胎儿窘迫及新生儿窒息发生率高,及时剖宫产是较为安全而重要的措施.     

乌鲁木齐地区151例羊水过少病例临床分析

乌鲁木齐地区１５１例羊水过少病例临床分析兰州军区乌鲁木齐总医院妇产科（８３００００）邢玲玲，张莉，贾勃民，倪晓霞羊水过少是指孕足月羊水量少于３００ｍｌ［１］。本文回顾性分析我院１９９３年１月－１９９６年６月间１５１例羊水过少病例，以探讨其对围产儿的影...     

泉州地区羊水过少158例临床分析

探讨羊水过少在各孕周的发生率,有无其它高危因素,分娩方式及围产儿预后。方法：对于１９９３年１月至１９９７年１２月羊水过少１５８例发生率２．６９％,羊水过少发生于４０周至４１＋６周５３．１６％（８４／１５８）,５９例高危妊娠合并羊过少多发生于４０周前占６９．４９％（４１／５１）,用Ｂ超作为监测羊水的指标,符合率达９５．４７％,结果：剖宫产尽快结束分娩能显著改善围产儿预后,１５８例中出现胎儿窘迫５７例     

泉州地区羊水过少125例临床分析

目的 探讨羊水过少病因及其相关因素,旨在降低围产儿死亡率。方法 分析我院近5年来,羊水过少12例,发生率3.08％。初产妇109例,经产妇16例。孕周<40w63例(2.21％),≥40w62例(5.12％)。随机抽取同期羊水量正常的100例产妇为对照组。诊断标准B超测量最大羊水暗区垂直径<3cm或产时及手术中直接测量羊水量<300ml为羊水过少。结果 羊水过少组胎儿窘迫、羊水粪染、新生儿窒息的发生率分别为28.2 ％、25.6％、12％,而对照组3者的发生率分别为13％、11％、5％,两组对照有显著性差异。结论 羊水过少时胎儿窘迫、羊水粪染、新生儿窒息的发生率明显高于羊水正常的产妇,因此,羊水过少一经确诊,应严密监测羊水量及胎盘情况,胎心监护,并及时给予处理,以剖宫产终止妊娠为宜。     

妊娠晚期羊水过少128例临床分析

目的探讨妊娠晚期羊水过少母儿围生结局的影响。方法从2006年1月至2008年12月由B超提示AFI≤5cm或AFV≤2cm超声诊断羊水过少,产时或剖宫产时收集全部羊水测量〈300ml即确诊为羊水过少,共发现羊水过少128例为羊水过少组,选择同孕周超声检查羊水正常的单胎孕妇120例作为对照组。结论羊水过少组妊娠并发症、剖宫产率、新生儿低出生体重率、新生儿窒息率均明显高于对照组。     

深圳地区羊水过少226例临床分析

目的探讨羊水过少与妊娠并发症的关系及其分娩方式的选择与围生儿预后关系。方法收集我院2005年6月至2006年5月住院分娩的羊水过少孕妇226例,随机抽取我院同期分娩的羊水量正常孕妇220例为对照组,两组病例就妊娠并发症、分娩方式及围生儿情况进行比较。结果羊水过少组中过期妊娠、妊娠期高血压疾病、胎儿生长受限（FGR）及胎儿畸形的发生率均高于对照组（P〈0.01）。羊水过少组羊水粪染、胎儿窘迫、胎粪吸入综合征（MAS）的发生率明显高于对照组（P〈0.05,P〈0.01）。羊水过少伴妊娠并发症组羊水粪染、胎儿窘迫、新生儿窒息的发生率明显高于无并发症组,（P〈0.01,P〈0.05）,剖宫产率明显增加（P〈0.01）,而胎粪吸入综合征（MAS）与围生儿死亡率无显著差异（P〉0.05）。单纯羊水过少者围生儿结局与对照组无显著差异（P〉0.05）。结论羊水过少与妊娠并发症密切相关,羊水过少伴有妊娠并发症者围生儿结局不良,应放宽手术指征,单纯羊水过少者可以阴道试产。     

羊水过少对围产儿影响因素的分析

目的 探讨羊水过少对母婴的影响。方法 采用回顾分析方法，对羊水过少组80例及同期羊水正常组3173例进行对比分析。结果 羊水越少，羊水粪染率及胎儿窘迫发生率越高；羊水过少组新生儿窒息率明显高于对照组。结论 羊水过少确诊后适时以剖宫产结束分娩为宜。     

Intrapartum Rupture of the Uterus Diagnosed by Ultrasound

Background

Spontaneous uterine rupture is a life threatening obstetrical emergency encountered infrequently in the emergency department. Its diagnosis is often missed or delayed, leading to maternal and fetal mortality.

Method

We present a case of ruptured uterus diagnosed by ultrasound in a 33-year-old gravid female with two previous cesarean sections.

Objective

To show the role of ultrasound in uterine rupture

Result

Ultrasound demonstrates uterine laceration and intra-abdominal dislocation of placenta and foetus

Conclusion

Because of the severity of the complication and the great variation of symptoms in connection with it, the authors encourage the use of ultrasound screening in the detection of this rare, but often catastrophic complication.     

26例异常染色体核型与临床分析

本文对26例异常染色体检查结果及其临床表现进行了分析,其中两例较为少见,对于由染色体畸变引起的儿童智力低下,生长发育迟缓,多发性畸形等原因进行了探讨。     

Clinical Manifestations and Genetic Analysis of 5 Korean Choroideremia Patients Initially Diagnosed With Retinitis Pigmentosa

BackgroundTo investigate the clinical findings of choroideremia patients and perform genetic analysis by whole-exome sequencing (WES).MethodsA total of 94 patients initially diagnosed with retinitis pigmentosa (RP) at another hospital, and who visited our hospital for genetic analysis by WES, were included in the study, along with 64 family members. All subjects underwent comprehensive ophthalmic evaluation, including best-corrected visual acuity, slit lamp examination, fundus photography, fundus autofluorescence (FAF), fluorescein angiography (FAG), visual field (VF), electroretinogram (ERG), and optical coherence tomography (OCT).ResultsIn six male patients with suspected choroideremia, extensive retinal pigment epithelium (RPE) and severe loss of choroid were observed in the fundus, but not in the macula. CHM gene mutation was confirmed in five patients. A novel single nucleotide variant at a splice site was observed in one patient. OCT showed marked thinning of the outernuclear layer and choroid, except in the macula. FAF showed a small area of hyperfluorescence in the posterior pole. In addition, characteristic interlaminar bridges were observed in four patients. On FAG, hypofluorescence was seen up to the far-peripheral retina in five patients.ConclusionOf the 94 patients initially diagnosed with RP, CHM mutation was identified in five (5.3%) by WES. Choroideremia should be considered as a differential diagnosis of RP. WES would be useful for identifying the causes of hereditary retinal disease.     

拉莫三嗪单药治疗新诊断的成人癫痫的临床疗效

目的：观察拉莫三嗪对新诊断成人癫痫的疗效。方法：对56例新诊断癫痫患者给予拉莫三嗪单药治疗。结果：56例患者中完全控制13例,显效22例,有效9例,无效8例,失访4例,完全控制率为23％,总有效率为79％。结论：拉莫三嗪是治疗新诊断成人癫痫的一种安全、有效药物。     

初诊哮喘患者的呼出气一氧化氮与大小气道功能的 相关性及临床价值分析

目的 探讨初诊支气管哮喘患者的呼出气一氧化氮水平与大小气道功能的相关性,以及在哮喘规范化治疗中的变化趋势及临床意义。方法 选择2016年3月~2016年5月就诊于新乡医学院第一附属医院呼吸科的初诊成人支气管哮喘患者80例,为哮喘组;选择同期健康体检志愿者40名,为对照组。哮喘组在治疗前及治疗后3、6、9、12月分别行FeNO和肺功能检查包括FEV1%、FEF75%、FEF50%、MMEF%以及哮喘控制测试（ACT）;健康志愿者仅行一次肺功能及FeNO检查。结果 初诊哮喘的FeNO与FEV1%无相关性（P＞0.05）,与FEF75%、FEF50%、MMEF%存在负相关（P＜0.05）。经治疗大气道功能的恢复时间6个月早于小气道功能的恢复时间12个月,FeNO的恢复时间约3月。小气道功能异常的哮喘患者比小气道功能正常者具有更高的FeNO,且在1年的治疗过程中具有更高的急性发作次数和吸入糖皮质激素（ICS）用量,差异有统计学意义（P＜0.05）。结论 相比于大气道,小气道功能异常与气道炎症FeNO的关系更密切。大气道功能不能完全反映哮喘的临床控制情况,需联合检测FeNO与小气道功能。     

Genetical Analysis of All Danish Patients Diagnosed with Chronic Granulomatous Disease

Chronic granulomatous disease (CGD) is a rare inherited disorder of the innate immune system caused by a defect in NADPH oxidase, leaving the granulocytes unable to kill invading microorganisms. CGD is caused by mutation in one of the five components gp91phox, p22phox, p47phox, p67phox and p40phox, encoded by the X‐linked CYBB gene and the autosomal CYBA, NCF1, NCF2 and NCF4 genes respectively. We have collected samples from all Danish patients with known CGD followed in the clinic or newly diagnosed during a 5‐year period, a cohort of 27 patients, and characterized them genetically. The cohort includes 10 male patients with X‐linked CGD and one female with extremely lyonized expression of a defective CYBB allele. Six patients had mutation in CYBA. Seven of 10 patients with a defect in NCF1 were homozygous for the common GT deletion, one was compound heterozygous for the GT deletion and a splice‐site mutation, and two patients were homozygous for a nonsense mutation in exon 7. Three novel mutations were detected, a deletion of exon 6 in CYBA, a duplication of exon 8–13 in CYBB and a splice site mutation in intron 7 of NCF1.     

Bacterial Vaginosis Diagnosed by Analysis of First-Void-Urine Specimens

Bacterial vaginosis (BV) is traditionally diagnosed using vaginal samples. The aim of this study was to investigate whether BV can be diagnosed from first-void urine (FVU). Self-collected vaginal smears, vaginal swabs, and FVU were obtained from 176 women. BV was diagnosed by Nugent''s criteria. The FVU and vaginal swabs were analyzed by quantitative PCRs (qPCRs) for selected vaginal bacteria (Atopobium vaginae, Prevotella spp., Gardnerella vaginalis, bacterial vaginosis-associated bacterium 2, Eggerthella-like bacterium, “Leptotrichia amnionii,” Megasphaera type 1), and all had an area under the receiver operating characteristic (ROC) curve of >85%, suggesting good prediction of BV according to the Nugent score. All seven bacteria in FVU were significantly associated with BV in univariate analysis. An accurate diagnosis of BV from urine was obtained in this population by a combination of qPCRs for Megasphaera type 1 and Prevotella spp. The same two bacteria remained significantly associated with BV in a multivariate model after adjusting for the other five species. There was no statistically significant difference between the sensitivities and specificities of BV diagnosis by molecular methods performed on swabs and FVU samples. A linear regression analysis showed good agreement between bacterial loads from swabs and FVU, but Prevotella spp. could be detected in high numbers in a few FVU samples without being present in swabs. This method will allow diagnosis of BV in studies where only urine has been collected and where detection of BV is considered relevant.     

80例慢性乙型病毒性肝炎的临床五项检验分析

目的 对慢性乙型病毒性肝炎的临床五项检验进行分析,为临床提供参考依据.方法 随机选取2013年12月至2014年12月经我院诊断并治疗的慢性乙型病毒性肝炎患者80例,分别检查患者的乙肝表面抗原(HBsAg)、e抗原(HBeAg)、病毒表面抗体(抗-HBs)、e抗体(抗-HBe)及核心抗体(抗-HBc)的含量.结果 HBsAg阳性率为91.25％,HBeAg阳性率为56.25％,抗-HBs阳性率为16.25％,抗-HBe阳性率为72.50％及抗-HBc阳性率为78.75％;大三阳比率为41.25％,小三阳比率为21.25％.P均＜0.05,均具有统计学意义.结论 在临床对慢性乙型肝炎患者进行乙肝五项指标的普查,并针对病情及时采取相应有效的防治措施是至关重要的.     

床旁超声预测慢性乙型肝炎患者胃镜检查围麻醉期误吸风险的临床价值

目的 研究床旁超声检查仰卧位下胃窦评估围麻醉期慢性乙型肝炎患者误吸风险的临床价值。方法 选择我院接受常规胃镜检查的慢性乙型肝炎患者200例,依据胃镜所见胃内容物性质将患者分为固体组与液体组,利用四个表判断床旁超声定性分组可靠性;按照收集胃液量,将胃镜判定液体组患者分为空腹组（≤0.8 ml/kg）与非空腹组（＞0.8 ml/kg）,比较胃窦横截面积（CSA）组间差异。结果 200例患者中,胃镜分组固体组17例（床旁超声分组固体组7例,非固体组10例）,液体组183例（床旁超声分组固体组2例,非固体组181例）,床旁超声诊断胃内含有固体内容物的阳性预测值与阴性预测值分别为77.78%和94.76%,诊断符合率94.00%。胃镜液体组中含空腹组160组和非空腹组23例,床旁超声测量胃窦CSA组间差异显著[（4.83±1.04）cm2 vs （5.90±1.60）cm2,P＜0.01]。结论 床旁超声检查仰卧位下胃窦可准确判断慢性乙型肝炎患者胃内容物情况,指导临床麻醉医生评估围麻醉期误吸风险。     

超声与X线诊断肠梗阻的临床分析

回顾性分析60例经由手术证实的肠梗阻患者的临床资料,全部患者在术前均行超声检查和X线检查。超声定性、定位以及病因诊断符合率均高于X线,差异均具统计学意义(P0.05);超声对肠腔积液明显肠梗阻的检出率88.24%高于对照组的70.59%,差异均具有统计学意义(P0.05)。与X线相比,超声在肠梗阻性质、定位以及发生原因中的诊断符合率均更高,且其对于肠腔积液明显肠梗阻的敏感性更强,对临床诊断肠梗阻具有重要价值,因此值得临床积极推广应用。