子宫输卵管造影与宫腹腔镜联合探查诊断输卵管通畅性的对比研究

目的探讨高压恒速子宫输卵管造影(hysterosalpingography,HSG)与宫腹腔镜联合检查在诊断输卵管通畅性中的意义。资料与方法回顾性分析36例不孕症患者的HSG资料。均先后行HSG和宫腹腔镜联合探查,间隔时间<1个月。依据诊断标准评价输卵管的通畅性及宫腔、盆腔异常表现。结果 36例共计71支输卵管,HSG通畅30支,阻塞41支,腹腔镜通畅35支,阻塞36支,两者结果一致56支。HSG敏感性为86.1%,特异性为71.4%,阳性似然比3.01,阴性似然比0.19,准确性为78.9%;两组诊断结果比较差异无统计学意义(χ2=0.71,P=0.302),吻合强度差异有统计学意义(k=0.577,P=0.000)。结论 HSG可有效、廉价、快速检查输卵管通畅性,可作为输卵管性不孕检查的首选筛查方法 。     

通液诊疗仪碘水加压法子宫输卵管造影的临床应用

目的 探讨通液诊疗仪碘水加压法子宫输卵管造影(HSG)的临床价值.方法 对103例不孕患者行HSG检查,对比剂为48％碘海醇,采用通液诊疗仪,逐渐增加子宫腔内压力,对阻塞输卵管行压力钝性疏通,疏通后行输卵管通液术.结果 子宫输卵管正常17例,子宫异常6例,80例共151条输卵管阻塞,128条获管腔再通,再通率达84.8％,其中左侧输卵管开通的平均压力为24 kPa,对比剂进入盆腔的平均压力为25.3 kPa;右侧输卵管开通的平均压力为28.4 kPa,对比剂进入盆腔的平均压力为28.6 kPa;压力达50 kPa以上仍未开通的23条.开通后手推通液阻力明显下降45例、轻度下降30例、不下降5例.术中出现静脉逆流3例,局部疼痛56例,少量阴道流血50例,无盆腔感染或输卵管穿孔发生.结论 通液诊疗仪碘水加压法HSG能清楚显示子宫及输卵管通畅情况,对阻塞输卵管能有效地进行压力疏通,同时具有压力量化、简单易行、安全可控等特点,值得推广应用.     

子宫输卵管造影与腹腔镜输卵管检查输卵管性不孕症的临床分析

目的探讨子宫输卵管造影(hysterosaipingography,HSG)与腹腔镜输卵管检查在诊断输卵管性不孕症中的效果。方法对68例输卵管性不孕症患者(136条输卵管)进行子宫输卵管造影与腹腔镜输卵管检查,将两种方法对输卵管通畅性的检查结果进行对比分析。结果腹腔镜下美蓝通染液试验(CLP)结果显示本组68例患者的136条输卵管中输卵管通畅84条,输卵管通而不畅26条,输卵管阻塞26条。以CLP检查结果作为对照进行对比分析发现输卵管造影在输卵管通畅性检查结果方面与CLP比较无明显差异。输卵管造影与腹腔镜输卵管在判断输卵管梗阻部位比较中差异无统计学意义(X~2=0.48,P0.05)。结论 HSG操作便捷、费用低廉,能较好的反映子宫输卵管全貌及梗阻部位,可以作为输卵管性不孕症检查的初筛;腹腔镜检查是诊断输卵管通畅性的"金标准",两者联合是诊断输卵管性不孕症的最佳方法。     

宫腔镜联合腹腔镜治疗输卵管性不孕78例临床分析

目的:探讨宫、腹腔镜联合手术治疗女性输卵管性不孕的临床价值.方法:回顾性分析输卵管性不孕患者78例患者的临床资料,了解受孕情况.结果:宫、腹腔镜联合检查比子宫输卵管碘酒造影准确率高,盆腔粘连和输卵管阻塞是不孕的主要原因.术后随访,术后二年妊娠率占51%.结论:宫、腹腔镜联合手术治疗输卵管性不孕具有安全、有效、痛苦少、恢复快的优点,值得推广.     

子宫输卵管声学造影对不孕症的应用分析

目的探讨经阴道子宫输卵管声学造影对不孕症患者输卵管通畅情况的诊断价值。方法回顾分析119例经阴道超声行子宫输卵管声学造影（SSG）和腹腔镜检查的病例资料。结果子宫输卵管声学造影诊断输卵管内部通畅情况的总符合率为84.3%;诊断盆腔粘连的灵敏度为96.3%。结论经阴道子宫输卵管声学造影具有无创、简便、有效等优点,可作为不孕症输卵管通畅性检查的首选。     

子宫输卵管造影与子宫腹腔镜检查诊断女性不孕症的对比分析

目的探讨输卵管通液治疗仪子宫输卵管造影(HSG)对女性不孕症的诊断价值。方法 116例经临床与病理证实的女性不孕症患者均经HSG和子宫-腹腔镜(H-LSC)检查。对获自上述两种技术的资料,进行了对比性分析。结果在116例中,H-LSC发现导致不孕的各种病变111例(95.7%),其中检出率较高的几种病变是盆腔炎性粘连(n=87),输卵管炎性阻塞(n=85),子宫肌瘤(n=14),多数患者有两种或以上病变并存;HSG发现导致不孕的各种病变107例(92.2%),HSG对输卵管炎性阻塞的检出(n=106)高于H-LSC,而对盆腔炎性粘连(n=51)和子宫肌瘤(n=2)的检出低于H-LSC。本组HSG诊断女性不孕症的敏感性、特异性、准确性、阳性预测值以及阴性预测值分别为96.4%,80%,56.9%,93.9%以及69.2%。结论 H-LSC和HSG在诊断女性不孕症中各有所长,总体来说,H-LSC优于HSG,但二者不能相互取代而是应优势互补。HSG联合H-LSC检查是目前诊断女性不孕症的最佳方案。     

子宫输卵管造影与腹腔镜联合诊断双侧输卵管结核1例

女,36岁,因未避孕未孕近2年来我院就诊。子宫输卵管造影（HSG）示：宫腔正常,双侧输卵管显影至伞端．壶腹部边缘毛糙,形状不规整,伞端弥散局限,对比剂呈环状,内为充盈缺损呈团状负影（见图1）。诊断为输卵管周围粘连（输卵管结核待查）。胸透报告：双肺结核（部分陈旧性）。2009年2月腹腔镜探查盆腔,双侧输卵管迂曲,僵硬,     

输卵管性不孕的X线诊断与腹腔镜对照(附34例分析)

目的：通过子宫输卵管造影和腹腔镜检查的对照,提高对输卵管性不孕的Ｘ线诊断。方法：输卵管不孕症患进行了输卵管造影和腹腔镜检查,将其结果进行比较。结果：子宫输卵管造影;输卵管各部阻塞１５支,通而不畅２１支,输卵管未通１５支,输卵管积水９支,输卵管通畅７支。     

子宫输卵管造影在女性不孕症中的应用

目的:探讨子宫输卵管造影(HSG)对于女性不孕的诊断价值.方法:收集经临床宫腹腔镜和(或)手术病理证实的219例女性不孕患者,回顾性分析其子宫输卵管造影的X线表现.结果:219例中,宫腔疾患113例(51.60％),包括子宫发育不良及畸形者32例;宫腔粘连26例;宫腔息肉13例;子宫黏膜下及肌壁间肌瘤29例;子宫肌腺症11例;宫颈功能不全2例;输卵管疾患101例(46.12％);生殖系统结核5例(2.28％).结论:子宫输卵管造影是诊断女性不孕的重要检查方法.     

腹腔镜联合宫腔镜对输卵管阻塞性不孕的疗效

目的观察腹腔镜联合宫腔镜治疗输卵管阻塞性不孕的疗效。方法将67例输卵管阻塞性不孕患者随机分为两组。实验组32例采用开腹手术诊治。而对照组35例采用腹腔镜联合宫腔镜诊治。观察两组患者输卵管再通率及妊娠率的差异。结果试验组输卵管阻塞数为59条。输卵管再通56条（94．9％）;输卵管未通3条（5．1％）;对照组输卵管阻塞数为63条。输卵管再通47条（74．6％）;榆卵管未通16条（25．4％）;试验组发生妊娠23例（71．9％）;未妊娠9例（28．1％）;对照组发生妊娠14例（40．0％）;未妊娠21例（60．0％）;试验组妊娠率高于对照组,有统计学差异（P〈0．05）。结论腹腔镜联合宫腔镜治疗输卵管阻塞性不孕疗效显著。其能显著提高患者输卵管的再通率。进而增加患者受孕的机会,妊娠率较高。     

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.