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1.
目的 观察低频超声(20 kHz)辐照联合静脉注射微泡造影剂SonoVue对裸鼠人前列腺癌Du145移植瘤的抑瘤效应,并探讨其可能的抑瘤机制.方法 通过细胞移植和瘤块移植方法建立24只裸鼠人前列腺癌Du145移植瘤模型,随机分为超声微泡组、单纯超声组、单纯微泡组和对照组,每组6只.超声微泡组:尾静脉注射0.2 mL SonoVue的同时对瘤体行20 kHz超声辐照,辐照强度2 W/cm2,辐照2 min;单纯超声组:尾静脉持续缓慢推注生理盐水0.2 mL,同时超声辐照2 min;单纯微泡组:尾静脉持续缓慢推注SonoVue 0.2 mL同时行假照;对照组不做任何处理.各组均隔天治疗1次,共3次.治疗后测量瘤体大小,绘制瘤体生长曲线,计算抑瘤率.首次治疗后14 d剥离瘤体,通过光镜、电镜观察肿瘤组织病理改变.免疫组织化学法观察CD34阳性染色血管,计算肿瘤微血管密度(MVD),比较各组间MVD的差异.结果 24只裸鼠均成功植瘤.治疗后超声微泡组瘤体体积明显小于其他各组(P<0.05),抑瘤率为62.70%.HE染色观察超声微泡组瘤体组织大部分损伤坏死,电镜下超声微泡组肿瘤内微血管的内皮细胞损伤,线粒体肿大,基底膜断裂.超声微泡组瘤体内CD34阳性染色微血管数减少,其MVD值显著低于其他各组(P<0.05).结论 20 kHz低频超声辐照联合微泡造影剂SonoVue可有效抑制裸鼠人前列腺癌移植瘤的生长,其抑瘤机制是超声空化效应破坏肿瘤的微血管. 相似文献
2.
目的观察低频超声(20kHz)辐照联合静脉注射微泡造影剂SonoVue对裸鼠前列腺癌(Dul45)移植瘤的抑瘤效应,并探讨其可能的抑瘤机制。方法通过细胞移植和瘤块移植方法建立24只裸鼠前列腺癌Dul45移植瘤模型,随机分为超声微泡组、单纯超声组、单纯微泡组和对照组,每组各6只。超声微泡组:尾静脉注射0.2mLSonoVue的同时对瘤体行20kHz超声辐照,辐照强度200mW/cm2;单纯超声组:尾静脉注射生理盐水0.2mL,同时超声辐照2min;单纯微泡组:尾静脉注射SonoVue0.2mL同时行假照,各组均隔天1次,共3次,对照组不做任何处理。治疗后测量瘤体大小,绘制瘤体生长曲线,计算抑瘤率。首次治疗后14d剥离瘤体,通过光学显微镜、电子显微镜观察肿瘤组织病理改变。免疫组织化学方法观察CD34阳性染色血管,计算肿瘤微血管密度(microvesseldensity,MVD),比较各组间MVD的差异。结果24只裸鼠均成功植瘤。治疗后超声微泡组瘤体体积均数明显小于其他3组(P〈O.05),抑瘤率为62.7%。光学显微镜下超声微泡组瘤体组织大部分损伤坏死,电子显微镜下超声微泡组肿瘤内微血管的内皮细胞损伤,线粒体肿大,基底膜断裂。超声微泡组瘤体内CD34阳性染色微血管数减少,其MVD值显著低于其他各组。结论20kHz低频超声辐照联合微泡造影剂SonoVue可有效抑制裸鼠人前列腺癌移植瘤的生长,其抑瘤机制可能是通过超声空化效应破坏肿瘤的微血管实现的。 相似文献
3.
目的 探讨利用低频超声联合SonoVue微泡造影剂促进基因转染人前列腺癌裸鼠皮下移植瘤的可行性。方法 采用人前列腺癌PC-3细胞建立裸鼠皮下移植瘤模型,成瘤后随机分为空白组(仅注射生理盐水)、单纯质粒组(注射生理盐水和质粒混悬液)、低频超声组(注射生理盐水和质粒混悬液后超声辐照)和低频超声+微泡组(注射超声微泡造影剂和质粒混悬液后超声辐照)。超声辐照条件:功率3 W/cm2,占空比5:5,频率80 kHz,辐照10 min。基因转染3天后在激光共聚焦显微镜下观察各组绿色荧光蛋白表达情况,并分析其平均荧光强度;同时行常规病理检查,观察低频超声联合微泡辐照对组织的损伤程度。结果 4组中,仅低频超声+微泡组可见明显绿色荧光,与其他各组差异均有统计学意义(P均<0.05);空白组、单纯质粒组和低频超声组均未见明显绿色荧光。各组均未见明显组织损伤。结论 SonoVue微泡造影剂在低频超声辐照下能够安全有效地促进pEGFP基因转染进入人前列腺癌裸鼠皮下移植瘤组织内。 相似文献
4.
目的 探讨低频超声联合微泡造影剂促进增强型绿色荧光蛋白质粒(pEGFP)转染裸鼠人前列腺癌皮下移植瘤的可行性,并观察不同超声声强对转染率的影响。方法 BABL/c裸鼠30只建立人前列腺癌皮下移植瘤模型,然后随机分为单纯低频超声组和低频超声+微泡组2组,每组各15只。单纯低频超声组裸鼠分别经尾静脉注射质粒与0.9%氯化钠混悬液250μl(其中含pEGFP质粒50μg),低频超声+微泡组裸鼠分别经尾静脉注射质粒与微泡混悬液250μl(其中含pEGFP质粒50μg)。每组裸鼠再分为3个亚组,每组各5只,分别以声强为1、2、3 W/cm^2的超声(频率80 kHz,占空比50%)辐照10 min。超声辐照后第3天采用激光共聚焦显微镜观察各组绿色荧光蛋白表达情况并分析各组平均荧光强度,同时进行常规病理学检查。采用单因素方差分析比较单纯低频超声组及低频超声+微泡组平均荧光强度,进一步组间两两比较采用SNQ-q检验。结果 1、2、3 W/cm^2低频超声+微泡组平均荧光强度分别为23.75±2.54、30.25±1.67、59.60±2.03,均高于相对应的1、2、3 W/cm^2单纯低频超声组平均荧光强度14.04±1.35、14.66±0.98、14.32±1.20,且差异均有统计学意义(q值分别为18.26、14.12、13.88,P均<0.05);且随着超声声强的增加,低频超声+微泡组平均荧光强度也增高,且差异均有统计学意义(q值分别为15.33、17.81、13.79,P均<0.05),说明随着超声声强的增强,低频超声+微泡组转染率明显增高。单纯低频超声组均未见明显的绿色荧光。常规病理学检查显示各组均未对组织造成明显的损伤。结论 超声联合微泡造影剂能有效促进pEGFP质粒转染裸鼠人前列腺癌皮下移植瘤,而在一定范围内增高声强能提高转染率。 相似文献
5.
《中国超声医学杂志》2016,(8)
目的探讨超声辐照联合纳米微泡是否能增强阿霉素对小鼠H22移植瘤的抑制作用。方法将50只已建立皮下H22移植瘤模型的昆明雌鼠随机分为五组,即对照组、单纯阿霉素组(ADM)、阿霉素+纳米微泡组(ADM+NMB)、阿霉素+超声组(ADM+US)、阿霉素+纳米微泡+超声组(ADM+NMB+US),每组10只,隔天治疗1次,监测皮下肿瘤的生长情况,治疗5次,观察肿瘤细胞坏死情况,计数肿瘤组织微血管密度,并观察小鼠生存期,评价各种处理对肿瘤的抑制作用。结果相对于对照组,治疗组肿瘤生长延缓,小鼠寿命延长,肿瘤坏死面积增加,微血管密度减少(P0.05),而ADM+NMB+US组与其他治疗组相比,差异更显著(P0.05)。结论超声联合纳米微泡可增强阿霉素对小鼠H22移植瘤的抑制作用。 相似文献
6.
目的了解20 k Hz超声辐照Sono Vue微泡联合化疗药顺铂(DDP)、丝裂霉素(MMC)、5-氟尿嘧啶(5-FU)对裸鼠肝癌移植瘤细胞增殖和凋亡的作用。方法肝癌Hepa G2细胞株注射48只裸鼠皮下,两周后成瘤,平均分成4组:对照组、超声组、化疗组、超声联合化疗组。对照组不采取任何处理。超声组裸鼠尾静脉注射声诺维微泡0.2 ml,低频超声(20k Hz,2 W/cm~2,占空比40%,每次1 min,隔天,共2周)辐照肿瘤。化疗组裸鼠尾静脉每次注射DDP(1 mg/kg)、MMC(0.5 mg/kg)及5-FU(5 mg/kg),隔天,共2周。超声联合化疗组,先进行2周超声辐照,后进行2周化疗。治疗结束,每组随机处死6只裸鼠,取标本。TUNEL检测肿瘤组织细胞凋亡,免疫组化检测Ki-67蛋白表达,电镜观察微血管结构。其余每组6只裸鼠继续饲养,记录最终生存时间。结果四组肿瘤细胞凋亡率分别为:0.08±0.05、0.43±0.11、0.47±0.11及0.79±0.11。超声+化疗组与对照组比较,t=13.41,P0.0001;与超声组比较,t=5.81,P=0.0021;与化疗组比较,t=3.63,P=0.0151。四组肿瘤组织Ki-67积分分别为:3.67±0.52、3.17±0.75、3±0.89、1.67±1.03。超声+化疗组与对照组比较,t=3.46,P=0.018;与超声组比较,t=2.7,P=0.0429;与化疗组比较,t=2.67,P=0.045。电镜显示:超声组、超声联合化疗组肿瘤微血管破裂,红细胞漏出组织间隙。对照组、化疗组肿瘤微血管壁清晰,无缺损。超声联合化疗组裸鼠生存期较长(χ~2=29.37,P0.0001)。结论低频超声辐照微泡联合化疗药物,可促进裸鼠肝癌组织细胞凋亡,抑制肿瘤细胞增殖。 相似文献
7.
目的 观察高机械指数超声造影对结肠癌肝转移的影响.方法 经大鼠脾注入结肠癌Lovo细胞,制备肝微小转移灶动物模型,分为对照组、微泡+超声辐照组、单纯超声辐照组和单纯微泡组.使用超声造影剂SonoVue(1 ml/kg),经大鼠尾静脉注射后,进行超声间歇辐照2 min(频率1.5 MHz,机械指数1.7),10 d后处死大鼠,观察肝转移肿瘤数目、大小、病理学改变及其超微结构的改变.结果 对照组、单纯辐照组及单纯微泡组之间的转移率差异无统计学意义(P>0.05);透射电镜可见单纯辐照组及单纯微泡组肿瘤细胞核大,胞浆和胞核比例减小,线粒体较多,未见肿胀,与对照组无明显差异.而微泡+超声辐照组肿瘤的数目及大小明显低于对照组,差异有统计学意义(P<0.01),肿瘤周围脾组织微血管有大量血栓形成;透射电镜可见肿瘤细胞线粒体明显肿胀,内皮细胞间缝隙连接增宽.结论 高机械指数超声造影对结肠癌肝转移有明显抑制作用. 相似文献
8.
目的 通过超声微泡靶向破坏的方法,选择Survivin作为靶点对短发夹状RNA干扰质粒(pSIREN/S3)进行转染,探讨其对裸鼠移植瘤微血管形成和细胞凋亡的影响.方法 将荷瘤裸鼠分为对照组、超声辐照诱导质粒组及超声微泡靶向破坏诱导质粒组,对组织样本行组织学检查,测定微血管密度(MVD),以末端脱氧核苷酸转移酶标记法(TUNEL)定量检测分析荷瘤裸鼠模型肿瘤组织的凋亡指数(AI).结果 超声微泡靶向破坏诱导质粒组的MVD明显减少,AI明显升高,与对照组及超声辐照诱导质粒组比较,差异均有统计学意义(P<0.05).结论 超声微泡靶向破坏联合pSIREN/S3质粒敲除Survivin,能使肿瘤组织中血管生成减少,明显诱导细胞凋亡,为恶性肿瘤基因治疗领域的一个新方法. 相似文献
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目的 探讨超声辐照携带促黄体生成素释放激素类似物(LHRHa)的靶向微泡能否增强顺铂(DDP )对人卵巢癌裸鼠腹腔移植瘤的抑制作用.方法 利用LHRH受体阳性的人卵巢癌耐药细胞A2780/DDP建立裸鼠腹腔移植瘤模型.将30只荷瘤鼠随机分成6组,即DDP+靶向微泡+超声组(Ⅰ),DDP+普通微泡+超声组(Ⅱ),DDP组(Ⅲ ),靶向微泡+超声组(Ⅳ),靶向微泡组(Ⅴ)和生理盐水对照组,Ⅰ~V组为实验组.处理结束后记录肿瘤个数,剖取瘤块称湿质量,计算抑瘤率;对肿瘤及主要脏器进行病理组织学检查;免疫组化SP法检测肿瘤组织中基质金属蛋白酶-9 (MMP-9)的表达.结果 各组的肿瘤个数、质量和MMP-9表达均有差异(P<0.01),其中,工组的抑瘤率最大,其肿瘤个数、质量和MMP-9表达均显著低于其他4个实验组(P<0.05)和对照组(P<0.01).结论 超声辐照LHRHa靶向微泡能显著增强DDP对卵巢癌移植瘤的抑制作用. 相似文献
10.
目的研究微泡造影剂与超声辐照是否能提高绿色荧光蛋白质粒在人肝癌细胞HepG2中的转染率。方法将培养的HepG2细胞分为四组:第一组为对照组;第二组以脂质体转染;第三组加入微泡造影剂SonoVue并予以超声辐照;第四组加入脂质体和微泡造影剂SonoVue并予以超声辐照.将合有绿色荧光蛋白报告基因的真核表达质粒pEGFP-N1转染人肝癌细胞HepG2,24小时后以荧光显微镜观察人肝癌细胞HepG2中的绿色荧光蛋白表达情况,并用流式细胞仪测算转染率。结果脂质体转染组与微泡造影剂+超声辐照组有显著性差异(P〈0.05)。脂质体+微泡造影剂+超声辐照组与微泡造影剂+超声辐照组有显著性差异(P〈0.01)结论微泡造影剂和超声辐照协同脂质体能提高目标基因在肝癌细胞内的转染率。 相似文献
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D Neumeier W Prellwitz U Würzburg M Brundobler M Olbermann M Just H-JKnedel H Lang 《Clinica chimica acta; international journal of clinical chemistry》1976,73(3):445-451
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. 相似文献
12.
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. 相似文献
13.
《Minimally invasive therapy & allied technologies》2013,22(5-6):408-415
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. 相似文献
14.
15.
Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts 总被引:1,自引:0,他引:1
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. 相似文献
16.
Cameron Crandall MD Lenora Olson MA Lynne Fullerton MA David Sklar MD Ross Zumwalt MD 《Academic emergency medicine》1997,4(4):263-267
Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs. 相似文献
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs. 相似文献
17.
Toxicity of naturally occurring purine deoxyribonucleosides 总被引:2,自引:0,他引:2
18.
《Journal of pain & palliative care pharmacotherapy》2013,27(4):5-18
Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events. 相似文献
19.
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. 相似文献
20.
《Journal of pain & palliative care pharmacotherapy》2013,27(1):48-52
ABSTRACTThe Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine. 相似文献