异位妊娠50例临床分析

异位妊娠是妇产科最常的急腹症之一。近年来发病率有逐年升高趋势。自 1987年诊治异位妊娠 3例 ,占同期诊治妊娠数的 0 .2 4%。 1996年诊治异位妊娠 8例 ,占同期诊治妊娠数的 1.5 3 % ,比例升高了 1.2 9%。为提高对异位妊娠的认识 ,争取早诊断、早治疗 ,回服分析了 1987年 1月～ 1996年 12月期间收治的异位妊娠 5 0例 ,并就其发病率 ,病因、诊断和处理等问题进行了讨论。1　临床资料与方法1.1　发生率 :自 1987年 1月～ 1996年 12月 10年期间共收治收异位妊娠 5 0例 ,同期分娩总数为 83 79例 ,异位妊娠与分娩总数之比为 1∶468,各年的发生率…     

氨甲喋呤及米非司酮联合应用治疗异位妊娠的疗效

异位妊娠是妇科常见急腹症之一,近年来随着年轻未育患者的增加,异位妊娠保守治疗能够保留输卵管功能就显得尤为重要。随着血B-HCG检测及彩超技术水平的提高,异位妊娠早期诊断率明显提高。从而为异位妊娠的药物保守治疗提供了有利的条件。我院自2007年～2011年收治的早期异位妊娠患者共118例,分别对应用氨甲喋呤及米非司酮60例患者及单用氨甲喋呤58例患者的治疗效果进行比较。现报告如下:     

163例特殊部位异位妊娠的诊治分析

目的 探讨特殊部位异位妊娠的临床特征、误诊原因及诊疗方法.方法 对解放军总医院2007年1月-2012年6月诊治的163例特殊部位异位妊娠患者的临床特征、分类、术前诊断、误诊率、治疗及转归情况进行回顾性分析.结果 特殊部位异位妊娠占同期异位妊娠的14.82％(163/1100),术前诊断率49.7％,误诊率50.3％.163例中宫颈妊娠8例,腹腔妊娠3例,剖宫产术后瘢痕妊娠37例,宫角妊娠44例,输卵管间质部妊娠54例,腹膜后妊娠1例,卵巢妊娠15例,子宫肌壁间妊娠1例.结论 特殊部位异位妊娠临床表现不典型,诊断较困难,应提高对特殊部位异位妊娠的认识,以便及时诊治,减少误诊以及由此带来的严重后果.     

超声造影与彩色多普勒超声诊断异位妊娠的对比研究

目的对比研究超声造影与彩色多普勒超声诊断异位妊娠的临床效果。方法回顾性分析2011年8月～2013年2月我院收治的100例异位妊娠患者的临床资料。结果 100例中,手术病理证实为异位妊娠的88例,经腹腔镜及刮宫病理证实宫内孕12例。超声造影诊断异位妊娠的敏感性为98.2%,特异性为80.0%,准确性为96.0%;彩色多普勒超声诊断异位妊娠的敏感性为86.2%,特异性为53.3%,准确性为81.4%,超声造影诊断异位妊娠的敏感性、特异性、准确性均明显比彩色多普勒超声高（P〈0.05）。结论超声造影比彩色多普勒超声诊断异位妊娠具有较好的临床效果,值得推广。     

异位妊娠235例临床分析

异位妊娠是妇科常见急腹症之一,如处理不当,可产生严重后果,甚至死亡。传统的异位妊娠多采用开腹输卵管切除手术。近年来随着腹腔镜技术的广泛普及,阴式彩超、血HCG结果快速而准确的报告,使得腹腔镜手术及药物保守治疗在异位妊娠的早期诊断治疗中逐渐取代了传统的开腹手术。现就本院2007年1月-2007年12月收治的异位妊娠235例做回顾性分析,探讨腹腔镜手术及药物保守治疗在异位妊娠诊治中的价值。     

异位妊娠293例临床病理分析

异位妊娠是妇科常见急腹症之一,其中以输卵管妊娠最常见,特殊部位的异位妊娠,由于临床症状不典型,常不易确诊。现将我院2006年1月至2009年12月诊治的293例异位妊娠的临床病理特征作一回顾性分析,以探讨其临床病理特点,减少误诊。     

60例重症异位妊娠抢救成功的护理探讨

目的探讨重症异位妊娠抢救、治疗、护理成功的护理体会。方法对我院2005年7月至2008年6月救治的60例重症异位妊娠临床资料进行分析。结果60例重症异位妊娠患者全部抢救治疗成功，100％痊愈出院。结论及时、准确的病情观察是抢救治疗重症异位妊娠取得成功的前提条件；迅速、及时地建立静脉通道，及时补充血容量，迅速作好术前一切准备工作，是抢救治疗重症异位妊娠取得成功的关键；术后生命体征的观察、作好基础护理、感染的预防、合理的营养，亦是抢救治疗重症异位妊娠取得成功必不可少的环节。     

宫内节育器伴发异位妊娠10例报告

宫内节育器的使用,在世界上已有50余年的历史。这些年来由于造节育器所用的材料的改进,合并症逐渐减少,但随使用日益广泛,在临床所遇在带节育器期间异位妊娠的病例亦明显增多。我院于1972年元月至1978年12月收治带节育器的异位妊娠患者10例,占同时期53例异位妊娠患者18.8％,平均每5.5例异位妊娠中就有1例是带节育器患者。带节育器异位妊娠常常使患者及医生着眼于有宫内节育器而在诊断方面造成错觉。异位妊娠是危及患者生命健康的外科急腹症,临床工作中应给于足够的重视及警惕。     

异位妊娠诊断中腹部和阴道B超的诊断效果比较

目的比较异位妊娠诊断中腹部和阴道B超的诊断效果。方法选取2011年7月至2012年8月收治的疑似异位妊娠患者98例,随机分为腹部B超组及阴道B超组,并分别采用腹部及阴道B超进行异位妊娠诊断,比较诊断效果。结果阴道B超组确诊45例异位妊娠（91．8％）,腹部B超组确诊37例异位妊娠（75．5％）,阴道B超组异位妊娠确诊率高于腹部B超组,且差异具有统计学意义（X^2=4．78,P〈0．05）。结论在异位妊娠诊断中阴道B超较腹部B超有更高确诊率,建议在临床诊断中推官应用。     

超声引导下局部注射无水乙醇联合米非司酮治疗未破裂型异位妊娠27例分析

异位妊娠是妇产科常见的急腹症,近年来,异位妊娠的发生率呈上升的趋势。随着血清人绒毛膜促性腺激素（β-HCG）测定敏感性的提高,阴道超声的广泛应用,早期异位妊娠的诊断更加准确,保守治疗已成为发展趋势。能否采取非手术治疗,最大限度地保留生育能力,此问题日益令人瞩目。国外有采取非手术方法治疗早期异位妊娠的报道。我站2005年1月～2008年2月对27例患者经超声引导下局部注射无水乙醇联合米非司酮保守治疗未破裂型异位妊娠,取得了满意的效果,现报道如下。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.