女大学生月经失血量与机体铁营养状况评价

目的定量研究女大学生月经失血量,并对其铁营养状况进行评价。方法用简单随机抽样的方法抽取30名在校女大学生,用调查表收集一般信息。通过称量卫生巾在使用前后的重量,计算收集到卫生巾上的失血量,估计未收集到卫生巾上的失血量,两者相加得月经周期失血量。常规方法测量血中血红蛋白浓度、血清游离原卟啉与血清铁蛋白含量。采用双变量相关分析法分析月经失血量和铁营养状况之间的关系。结果女大学生平均月经周期持续天数为(4.5±1.4)天,平均失血量为(59.3±25.1)g,范围为24～110g。血清铁蛋白、游离原卟啉、血红蛋白的平均含量分别为(25.13±14.33)ng/ml、(0.06±0.01)μg/ml和(131.61±9.76)g/L,22.58%的女大学生处于铁减少期,无临床贫血者。月经失血量与血清铁蛋白含量呈负相关。结论女大学生月经失血量有很大的个体差异,临床上无贫血并不意味着铁营养状况良好,血清铁蛋白是反映机体铁营养状况的敏感指标。     

月经过多的病因与治疗进展

正常月经周期为21～35天1次,平均出血3～7天,以碱性正铁血红素法客观地测量每次的月经失血量平均为20～60 ml[1].月经过多是一主观症状,给一个正确的定义较为困难.通常月经过多(Menorrhagia)指月经周期规则,但经量过多,以碱性正铁血红素法客观地测定,每周期失血量超过80ml,经期过长,持续时间大于7天[2].月经过多在妇科是常见的就诊原因,绝经前有30%的妇女主观有月经过多的症状.     

三种长效避孕皮下埋植剂对妇女月经血量的影响

为探讨国产Ⅰ、Ⅱ型和Norplant皮下埋植剂对妇女月经血量的影响,对89例健康妇女按随机分配原则,埋植国产Ⅰ型、Ⅱ型和Norplant三种长效避孕皮下埋植剂,测定埋植前及埋植后3,6,12月月经失血量及血红蛋白。埋植前3组平均月经血量(MBL)分别为43.3±6.9ml,48.9±4.3ml,43.7±5.5ml,埋植后MBL在第3周期分别为32.8±13.2ml,24.8±5.5ml,19.7±9.3ml,在第12周期分别为23.9±5.9ml,40.8±10.4ml,25.9±6.0ml,明显低于埋前水平(P<0.05～P<0.001)血红蛋白在埋植后有上升趋势。本研究提示使用长效皮下埋植剂减少妇女月经血量,增加血红蛋白,可以作为妇女选用的高效节育避孕措施。     

妇女月经妊娠哺乳与失铁

妇女易发生缺铁和缺铁性贫血,这除有与一般病人所具有的原因之外,还有其特殊性。 一、月经失血:每毫升血含铁为0.5毫克,若每个月经周期失血30毫升,额外失铁就是15毫克,等于每天丢去0.5毫克。事实上妇女月经的失血量超过50—100毫升,甚至多达200毫升以上者并不少见。     

应用米索前列醇预防剖宫产术后出血的临床分析

目的:探索更有效控制产后出血的最佳办法。方法:在剖宫产术前进行产后出血的预测评分,有产后出血病理因素者,随机抽样分为两组,即实验组和对照组。对照组常规于胎儿娩出宫肌注射催产素,实验组在剖宫产术中除常规用药外,胎儿娩出清理完宫腔后,立即放置0.4mg米索前列醇于子宫腔底部,用药后2h再用相等剂量放置直肠5cm处,失血量用容量法和沙布、专用纸垫计量法,以24h内失血量为量,经统计学处理,用t检验的方法,检验其对预防剖宫产术后失血的效果。结果:2003年1月～2004年12月30日,有病理因素154例,实验组92例,术后2h失血量均值为(182.30±80.2)ml,24h(278.03±10.2)ml;对照组62例,术后2h失血量均值为(226.18±93.2)ml,术后24h(388.08±175)ml,术后2h和24hP值均<0.01,两组差异具有显著性。结论:米索前列醇预防剖宫产术后失血方法简单、安全,效果良好。     

农村回族妇女产后失血研究

本文调查研究了宁夏回族自治区五县一市573例农村回族妇女产后2小时内失血量,总失血量平均为202.15±7.25ml,呈偏态分布.分析了20多种影响产后失血的因素,主要原因为宫缩乏力,占71.38%.依次为软产道损伤,占13.45%;产程延长占4、83%;胎盘因素占2.76%.采取产后失血评分法预测产后失血,并对产后失血的防治进行了探讨.     

宫内节育器应用者月经失血量的研究

本文对宫内节育器(IUD)应用者月经失血量(MBL)进行了研究。测定月经血量最普通的方法为碱性正铁血红蛋白技术,首先由Hallberg和Nilsson叙述,并由Shaw进行改进。在西方多数国家,未避孕的妇女,月经血量平均正常值是32ml。在中国研究报告健康妇女MBL的正常值在45～57ml之间,而在日本是50～56ml。各种类型的不正常出血可以发生在带IUD者,即:(a)月经失血量的改变;(b)月经间期失血;(c)月经持续时间延长。在用李普斯曲IUD和其他不含药的IUD,在放置后24个月MBL平均     

放置宫内节育器妇女用抗溶纤维蛋白和抗前列腺素制剂治疗,减少月经失血的比较

最近已证实使用前列腺素合成抑制剂治疗月经过多及因节育器引致的月经失血过多是有效的。作者在带器出血妇女比较了抗溶纤维蛋白制剂—凝血酸(Tranexamic acid TA)和前列腺素合成抑制剂-二氯苯胺苯乙酸钠,(Diclofenac sodiumDS)治疗月经失血过多的效果。31名带器妇女由于月经出血严重要求治疗。经测定月经血量证明17名妇女失血量高于80ml。另4名为70～80ml。19名妇女中18名使用含铜节育器已至少一年,1名妇女使用惰性节育器10年。对19名妇女进行了连续5个月经周期的研究,2个周期口服 TA1.5g 每日三次,连续5天;2个周期是一     

性变态的行为治疗

本文采用厌恶疗法治疗20例性变态患者,取得满意效果。现报告如下。1 临床资料1.1 一般资料20例均为男性,其中露阴癣10例,窥阴癖5例,恋物癖4例,兼有窥阴、恋物癖1例。年龄16岁～38岁,平均24.8岁±4.2岁;发病年龄12岁～34岁,平均20.4岁±3.5岁;病程1年～13年,平均6.8年±2.1年;婚姻:已婚5例,未婚15例;文化:大学2例,高中11例,初中7例。     

妇女婚前妊娠的心理健康状态分析

本文通过分析妇女婚前妊娠的心理健康现状和妊娠结局 ,呼吁全社会的医务工作者、教育工作者和家长都行动起来 ,加强对青少年的教育 ,做好保护人类生殖健康的工作。1　材料和方法1·1　 1997年 7月～ 10月来我院门诊就诊的非计划早孕妇女共 30 0例 ,其中未婚妇女妊娠 148例 ,年龄 16～ 2 7岁 ,平均 2 0 15± 2 4岁 ;已婚妇女妊娠 152例 ,年龄 2 3～ 4 2岁 ,平均 2 7 3± 3 7岁 ;职业为干部、工人、农民和无业人员 ,受教育程度为高中以上 132例 ,初中以下 168例 ,少数仅上小学一、二年级或未受过教育。1·2　方法　均有停经史 ,常规妇科检查…     

Tranexamic acid reduces blood loss during and after cesarean section: A double blinded,randomized, controlled trial

ObjectiveTo evaluate the efficacy of tranexamic acid in reduction of blood loss during and after cesarean section.MethodsWomen included in the current double blinded, randomized, controlled trial were recruited from women attending for elective cesarean section and randomized into two groups; study group: received tranexamic acid with induction of anesthesia plus 10 IU of oxytocin injection after delivery of the baby. Control group: received only oxytocin 10 IU injection after delivery of the baby.ResultsTwenty four hours post-operative hemoglobin level was significantly higher in study group (11.2 ± 1.5 mg/dL) compared to control (9.6 ± 1.2 mg/dL), also 24 hours post-operative hematocrit was significantly higher in study group (30.2 ± 6.6) compared to control (29.2 ± 2.8). Calculated total blood loss from placental delivery till end of cesarean section was significantly less in study group compared to control (369.5 ± 198.0 versus 606.8 ± 193.0 mL; respectively), also, calculated vaginal bleeding during first 6 hours post-operative was significantly less in study group compared to control (85.0 ± 30.7 mL versus130.8 ± 49.3 mL, respectively). The incidence of post-partum hemorrhage was significantly less in study group compared to control (31.1% versus 63.2%; respectively), also the need for iron replacement therapy was significantly less frequent in study group compared to control (0.9% versus 6.6%, respectively).ConclusionsTranexamic acid can be used safely to reduce blood loss during cesarean section. Reduced blood loss after tranexamic acid was associated with improvement of post-operative hemoglobin, hematocrit and with reduction of post-partum need for iron replacement.     

腹腔镜辅助阴式子宫切除术与腹腔镜筋膜内子宫切除术比较的研究

目的: 探讨腹腔镜子宫切除术(laparoscopichysterectomy, LH) 适应症、手术要点及临床应用价值。方法: 自2003年4月~2004年10月对77例因各种妇科良性疾病而需行子宫切除者, 根据子宫大小、术中评分及是否保留宫颈分别采用腹腔镜筋膜内子宫切除术(classicintrafacialSEMMhysterectomy, CISH) 和腹腔镜辅助阴式子宫切除术(laparoscopicassistedvagi nalhysterectomy, LAVH), 观察其手术时间、平均出血量及术后恢复情况。结果: 39例行CISH的患者中, 38例顺利完成, 成功率38 /39 ( 97. 44% ) ; 1例中转开腹手术, 中转率1 /39 (2 .56% ); 平均手术时间134±26. 28min; 平均出血量118. 5±21 .23ml;平均住院时间为6. 5±0 .61d。38例行LAVH的患者中, 37例顺利完成, 成功率37 /38 ( 97 .36% ); 1例中转开腹手术, 中转率1 /38 (2 .64 % )。平均手术时间120 .2±26. 61min; 平均出血量122 .7±31 .25ml; 平均住院为6. 3±0 .73d。结论: CISH具有手术时间短、出血少、恢复快的优点, 保持了盆底、阴道和宫颈外鞘的完整性, 是目前较理想的治疗良性子宫疾病的方法之一。而LAVH则拓宽了阴式子宫切除的适应症, 提高手术效果, 可避免开腹, 减少手术创伤。     

学龄前儿童缺铁性贫血的研究——Ⅱ.铁剂及维生素C和铁强化固体饮料的治疗效果

我们对北京市托幼机构中贫血儿童,每人每日分别给以10、20及30mg的元素铁的铁剂,二个月后血红蛋白、红细胞数及血球压积均有非常显著的增加;给以维生素C亦有显著的治疗作用。饮用铁强化固体饮料三个月后,贫血及正常儿童的血红蛋白含量,红细胞数及血球压积增加非常显著,证实此种固体饮料对学龄前儿童缺铁性贫血有明显的防治作用。     

生育对妇女体质指数和肥胖发生率的影响

目的 本研究利用2002年中国居民营养与健康状况调查数据,分析了不同阶段女性体质指数和肥胖率,以探讨中国成年女性肥胖的预防措施.方法 采用多阶段分层整群随机抽样的方法 ,在全国31个省、自治区、直辖市进行调查.本研究抽取20～30岁育龄女性,分为3组,包括未婚(2474名)、已婚未育(10 816名)和已婚生育(4103名)的女性,共计17 393名.结果城市未婚女性、已婚未育和已婚生育的女性平均体重分别为(53.7±9.0)kg、(57.6±9.4)kg和(54.5±8.5)kg,其中未婚女性、已婚生育女性的平均体重显著高于已婚未育女性(t=12.25,P<0.0001;t=8.32,P<0.0001).城市未婚女性、已婚未育和已婚生育的女性平均体质指数分别为(21.1±3.3)kg/m2、(22.8±3.4)kg/m2和(22.0±2.9)ks/m2,其中已婚未育、已婚生育女性的平均体质指数显著高于未婚女性(t=14.88,P<0.0001;t=5.76,P<0.0001).农村未婚女性、已婚未育和已婚生育的女性平均体重分别为(52.3±7.8)kg、(55.3±8.6)kg和(52.8±8.1)kg,其中未婚女性、已婚生育女性的平均体重显著高于已婚未育女性(t=11.67,P<0.0001;t=14.15,P<0.0001);农村未婚女性、已婚未育和已婚生育的女性平均体质指数分别为(21.2±2.8)kg/m2、(22.5±3.1)kg/m2和(21.8±3.0)kg/m2,其中已婚未育、已婚生育女性的平均体质指数显著高于未婚女性(t=13.80,P<0.0001;t=5.34,P<0.0001);城市未婚女性的低体重率(18.1%)高于已婚未育、已婚生育女性(7.3%和9.1%)(与已婚未育比较χ2=113.69,P<0.0001;与已婚生育比较χ2=29.65,P<0.0001),而已婚未育女性超重肥胖率(32.7%)显著高于未婚女性(14.4%)(χ2=28.257,P<0.0001).农村未婚女性的低体重率(12.36%)显著高于已婚未育女性(6.73%)(χ2=50.040,P<0.0001);而已婚未育女性超重率(22.4%)显著高于未婚女性(12.3%)和已婚生育女性(15.4%)(与未婚比较χ2=69.119,P<0.0001;与已婚生育比较χ2=69.866,P<0.0001);已婚生育女性超重肥胖率随产后时间的延长呈下降趋势.结论 已婚生育女性体重滞留是产生成年女性肥胖的重要原因,然而已婚未育女性的体重变化值得重视.     

Influence of dietary and socio-demographic factors on the iron status of married adolescent girls from Indian urban slums

To explore the influence of dietary factors of iron bioavailability and socio-demographic conditions on blood iron status of married adolescent girls (MAG), a cross-sectional study was conducted in 173 MAG (15–19 years old) from urban slums near Pune city, India. Diet was assessed by two random 24-h recalls. The age, weight, height, education, family size, income, physical work, and number of days of menstrual loss were recorded. Fasting blood was analyzed for hemoglobin and serum ferritin. Mean intakes of micronutrients were 40–75% less than the recommended dietary intakes for Indian adolescent girls. High intake of phytates (171±6 mg/day) and low intakes of vitamin C (25±1 mg/day) resulted in low bioavailable iron intakes. The mean bioavailable iron intake was 0.76±0.3 mg/day, which is one-half of the basal iron requirement of adolescent girls. The prevalence of iron deficiency (serum ferritin<12 µg/l) was 25.1%, and anemia (hemoglobin <12 g/l) was seen in 46.4% of MAG. A multiple regression model adjusted for energy intake indicated that intakes of β-carotene and riboflavin were associated with hemoglobin (P<0.001) and those of zinc, riboflavin and thiamin associated with serum ferritin (P<0.01). Multiple regressions including socio-demographic factors revealed that the family size, number of menstrual days lost and total bioavailable iron intake were the influencing factors for low iron status. In conclusion, there is a need to increase intakes of vitamin C and other micronutrients of the MAGs and to improve iron bioavailability through diet modifications.     

The medical abortion experiences of married and unmarried women in Tunis, Tunisia

CONTEXT: The study explores the social dimensions of abortion in Tunisia and offers evidence supporting the provision of medical abortion to special populations, such as young and unmarried women. METHODS: For this study we recruited 222 women (unmarried: n = 101, married: n = 121) at three clinics in Tunis, Tunisia, from April 1999 to March 2001. All eligible women who consented to participate were administered a simplified regimen of medical abortion consisting of 200 mg oral mifepristone + 400 microg oral misoprostol 2 days later either at home or in the clinic. RESULTS: Our results demonstrate that unmarried women (94.8%) are as likely as married women (94.1%) to have a successful abortion using this regimen. We noted a strong initial preference for home administration of misoprostol among both groups (unmarried: 73.3%, married: 80.2%), which grew even stronger after the procedure. Women indicated that home administration is desirable because transportation to the clinic is expensive (32.7%), home administration is more confidential (26.3%), easier and more convenient (12.8%). Both groups expressed a high degree of satisfaction with the method. CONCLUSIONS: Medical abortion with the option of home administration of misoprostol is safe and feasible for special populations; such as unmarried women in Tunisia.     

广州市天河区流动人口生殖健康现状调查

目的了解广州市天河区流动人口的生殖健康现状。方法采用匿名问卷的形式对广州市天河区1244例15～45岁流动人口的生殖健康知识、态度、行为以及主要生殖健康问题进行横断面调查。结果获取有效问卷1206份。受调查的流动人口平均年龄为29.82岁;文化程度主要是初中及以下(58.1%);职业以工人、商贸餐饮业和社会服务业为主(80.6%);流动人口对受孕知识知晓率不高,正确率仅占44.9%,已婚人群正确率远高于未婚人群(P<0.05);流动人口对艾滋病3种传播途径回答正确率为56.4%,非传播途径回答正确率为33.5%;已婚人群和未婚人群对计划生育服务政策知晓率分别为69.0%和42.6%(P<0.05);已婚人群进行生殖健康咨询的比例高于未婚人群(P<0.05);未婚女性和男性在避孕措施上主要选择使用避孕套(分别占75.2%和89.1%);绝大多数已婚女性(94.0%)和已婚男性(93.9%)采取的前三位避孕措施为宫内节育器、输卵管结扎、避孕套。结论流动妇女对生殖健康相关知识及政策了解不足,自我保健意识薄弱。积极采取有效措施提高流动已婚妇女的生殖健康认知水平是迫切需要解决的问题。     

Available dietary iron intakes of a selected sample of pre- and postmenopausal canadian women

Available iron, total iron, heme and non-heme iron intakes of 100 premenopausal women (mean age±SD=30.3±6.1 years) and 96 postmenopausal women (mean age+SD=67.2±6.6 years) living in a University Community and consuming self-selected diets, were calculated from three day dietary record data. Dietary iron levels were also determined by instrumental neutron activation analysis of one day food composites collected by the subjects. No significant differences were observed between the total dietary iron, heme and non-heme iron intakes of the two groups. Calculated mean dietary iron levels were 12.09±3.52 and 11.75±3.24 mg per day for the pre- and postmenopausal women, respectively. Highly significant positive correlations (p<0.001) were noted between the nalyzed intakes of iron and those calculated from the corresponding record day. Mean daily available iron intakes calculated using Monsen et al's model assuming 500 mg iron stores for the pre-and post menopausal women were: ?0.92±0.34 mg and 0.88±0.31 mg respectively; and 1.28±0.48 mg for the premenopausal group, if 250mg iron stores are assumed. Seventythree percent of the premenopausal women and 30% of the postmenopausal subjects had calculated available iron intakes, assuming 500mg iron stores, which did not meet the recommended estimated requirements for absorbed iron. Assuming 250mg iron stores for the premenopausal women, 41% failed to meet this estimate.     

妊娠早期巨细胞病毒活动性感染患者可溶性白细胞介素-2受体水平与病毒宫内感染的关系

目的: 探讨巨细胞病毒活动性感染的早期妊娠妇女外周血可溶性白细胞介素 -2受体 (SolubleInterleukin-2Receptor, sIL-2R) 水平与巨细胞病毒 (cytomegalovirus, CMV) 宫内感染的相关性。方法: 应用酶联免疫吸附试验和逆转录聚合酶链反应方法筛查出巨细胞病毒活动性感染孕妇 134例, 测定其外周血中sIL-2R水平, 并通过超声影像动态观察其子代生长发育情况直至终止妊娠, 流产、引产或分娩后检测子代标本确定有无宫内感染。结果: 134例研究对象中, 足月分娩者 77例,妊娠结局不良者 10例, 获得子代标本者 64例, 其中 21例CMVDNA阳性, 其母体外周血sIL-2R平均水平 258 41±15 44U/ml, 43例无宫内传播者母体外周血sIL-2R平均水平 188 41±21 35U/ml, 两者差异具有统计学意义 (t=2 52, p=0 02)。10例妊娠结局不良者孕妇外周血sIL-2R平均水平 (223 66±25 15U/ml) 高于 77例足月分娩孕妇 (166 67±18 17U/ml)。结论: 巨细胞病毒活动性感染的早期妊娠妇女外周血中sIL-2R水平与病毒宫内传播有一定相关性, 出现流产、死胎等异常妊娠结局者外周血sIL-2R水平具有升高趋势。     

sTfR和SI对诊断妊娠妇女早期贫血的意义

目的:比较可溶性血清转铁蛋白受体(soluble transferrin receptor,sTfR)和血清铁(serumiron,SI)诊断妊娠期缺铁性贫血的灵敏度和特异度。方法:应用Orion Diagnostica IDeA sTfRIT试剂盒,采用可溶性转铁蛋白受体微粒子增强投射免疫分析法测定其血清可溶性转铁蛋白受体(sTfR)及血清铁值(SI)。结果:50例贫血孕妇的sTfR平均值是(3.011±2.026)mg/L,高于临界值2.3mg/L(P<0.05),属于贫血范围;SI的平均值是(10.704±3.462)μmol/L,属于正常范围。50例正常孕妇的sTfR平均值是(2.047±0.803)mg/L,小于2.3mg/L(P<0.05),属于正常范围;SI的平均值是(18.542±4.835)μmol/L,属于正常范围。贫血孕妇的sTfR水平明显高于正常孕妇(P<0.01),SI水平明显低于正常孕妇(P<0.01)。sTfR及SI测定妊娠妇女缺铁性贫血的灵敏度分别是80%和30%,特异度分别是84%和94%。结论:在诊断孕妇缺铁性贫血中,sTfR和SI的特异度都比较高,但sTfR测定比SI测定灵敏度高且能对孕妇是否缺铁作出正确判断,特别是在亚临床贫血期,sTfR可作为诊断妊娠期早期缺铁性贫血的敏感指标。