长效避孕针醋酸甲孕酮的临床效果分析

目的 探讨长效避孕针醋酸甲孕酮（ＤＭＰＡ）的避孕效果。方法 自愿使用ＤＭＰＡ避孕的育龄妇女１０３例，每３个月深部肌肉注射ＤＭＰＡ１５０ｍｇ，为期１年。结果 共使用１０８９个妇女月，未采用其它避孕措施，无一例妊娠，避孕有效率１００％；１年因症停用率、累积续用率分别为１８．７５％和７８．２８％。结论 ＤＭＰＡ是一种高效、简便、可接受性较高的避孕措施。     

醋酸甲孕酮的安全性和不良反应

醋酸甲孕酮（Ｄｅｐｏ－ｍｅｄｒｏｘｙｐｒｏｇｅｓｔｅｒｏｎｅａｃ－ｅｔａｔｅ，ＤＭＰＡ）是一种每３月肌注１次的长效孕激素避孕针，因其长效、高效、安全、副反应小且使用简便，现有９０多个国家９００多万妇女接受这一避孕方式~〔１〕。１９９２年ＤＭＰＡ经美国食品和药品管理委员会（ＦＤＡ）正式批准成为美国国内唯一获准使用的长效避孕针，中国于１９９４年经国家卫生部批准正式引入ＤＭＰＡ，现已开展全国较大范围的引入性临床研究。本文就ＤＭＰＡ的安全性及常见副反应作一回顾性综述。１安全性ＤＭＰＡ与乳腺及女性生殖器肿…     

顺铂、阿霉素治疗晚期肺癌76例临床观察

１９８９年１月～１９９４年１２月，我科采用顺铂、阿霉素组成ＭＤＦ、ＣＡ０、ＣＡＰ、ＥＰ方案分别治疗晚期肺癌７６例，有效率ＭＯＦ组为２５％～３０％，ＣＡＯ组４０％，ＣＡＰ组４４．４％～５０％，ＥＰ组为５４．５％～８０％，ＥＰ组优于其它组。全组消化道反应轻微，除１例白细胞下降０．９×１０９／Ｌ外，余骨髓反应轻微。     

置速率控制膜型控释消炎痛和止血芳酸IUD者经血外周血中ACP AKP含量变化

对置速率控制膜型控释消炎痛（ＩＭ）和止血芳酸（ＡＭＣＭ）宫内节育器（ＩＵＤ）妇女月经血和外周血中酸性磷酸酶（ＡＣＰ）、碱性磷酸酶（ＡＫＤ）含量进行分析测定，同时对月经血量进行观察。结果表明，置器后１、３、６周期月经血量分别比置器前下降２３．８０％、３０．６６％、２６．２３％。置器后１、３、６周期月经血中和置器后第６周期的外周血中ＡＣＰ含量与置器前比较差异无显著意义（Ｐ＞０．０５）。ＡＫＰ含量外周血中置器前后差异无显著意义（Ｐ＞０．０５），而经血中含量置器后１、３、６周期分别与置器前比较均显著降低（Ｐ＜０．０１）。提示ＩＭ─ＡＭＣＭＩＵＤ能够减少月经血量，且避孕效果高，副作用少，是一种新型速率控制膜型控释药物的ＩＵＤ。     

长效避孕针醋酸甲孕酮的临床效果分析

目的探讨长效避孕针醋酸甲孕酮（DMPA）的避孕效果。方法自愿使用DMPA避孕的育龄妇女103例，每3个月深部肌肉注射DMPA150mg，为期1年。结果共使用1089妇女月未采用其他避孕措施，无1例妊娠，避孕有效率100％；1年因症停用率、累积续用率分为18．95和78．28每百妇女年。结论DMPA是一种高效、简便、可接受较高的避孕措施。     

骨髓增生异常综合征ras癌基因产物P21免疫细胞化学的分析

目的 探讨ＭＤＳ患者ｒａｓ－ｐ２１的表达及其急性白血病转化的关系。方法 应用ｒａｓ－ｐ２１单克隆抗体免疫细胞化学的分析法。结果 ２５例骨髓增生异常综合征（ＭＤＳ）患者中有８例这阳性，占３２．０％。其中５例Ｐ２１阳性的ＭＤＳ患者发生急性白血病（ＡＭＬ）转化，中位数存活期为２１个月。１７例Ｐ２１阴性的ＭＤＳ患者者除了３例未治疗，１例ＡＭＬ转化，Ｐ２１转阳性外，其余１３例在１２－６０人内均未发现ＡＭＬ转     

肝动脉灌注化疗药物治疗晚期肝癌67例

作者采用Ｓｅｔｄｉｎｇｅｒ技术，经肝动脉插管灌注５－Ｆｕ、ＡＤＭ、ＭＭＣ、ＰＤＤ治疗晚期肝癌６７例。全部患者症状改善、疼痛减轻或消除；肿瘤有不同程度缩小，ＡＦＰ，ｒ－ＧＴ有不同程度下降。本组ＣＲ８．９％，ＰＲ２３．８％，Ｓ３８．８％。生存３个月以上者９７％，半年以上４３．７％，一年生存率为２７％，副作用轻微，不失为治疗晚期肝癌的有效方法。     

经导管肝动脉灌注化疗及栓塞术治疗原发性肝癌110例临床分析

原发性肝癌１１０例（Ⅱ期５２例，Ⅲ期５８例）．采用Ｓｅｌｄｉｎｇｅｒ插管法，肝动脉造影后，使用Ａｄｒｉａｍｙｃｉｎ、Ｅ—Ａｄｒｉａｍｙｃｉｎ或ＤＤＰ，５—Ｆｕ，Ｍｉｔｏｍｙｃｉｎｃ与碘化油混合成悬液栓塞肿瘤血管，最后用明胶海绵条栓塞肝动脉主干或分支。治疗后症状改善，疼痛减轻或消除，肿瘤缩小，ＡＦＰ、　－ＧＴ、ＡＫＰ及ＬＤＨ含量均有不同程度下降，生存＞３月９０％，６月６０．９％，１２月２６．４％，２４月７．３％．     

糖尿病酮症酸中毒伴肝脏缶害28例临床分析

糖尿病酮症酸中毒（ＤＫＡ）是糖尿病（ＤＭ）的严重急性并发症之一。目前以肝损害为主要观察指标的文献尚无报道，故现收集我院１９９３年５月～１９９８年５月资料完整的ＤＫＡ住院病例６０例，作ＤＫＡ伴肝脏损害的临床分析。１临床资料１．１一般资料：ＤＫＡ病人６０例，男２５例，女３５例。年龄１８～７０岁。ＤＭ病程半天～２０＋年。１型ＤＭ１２例，２型ＤＭ４８例。死亡１２例。１．２　ＤＫＡ伴肝损害按以下标准诊断１.２．１　ＤＭ诊断及分型按１９８５年ＷＨＯ修定标准。１．２．２ＤＫＡ诊断：血糖增高，尿糖及尿酮均强阳性…     

TCu380A和带铜宫型节育器与TCu220C的临床效果比较

采用顺序随机分配法观察了３００例农村经产妇放置ＴＣｕ３８０Ａ和带铜宫型节育器（ＵＣＤＣｕ３００ＩＵＤ）的避孕效果、副反应和可接受性，并与目前较为理想的ＴＣｕ２２０Ｃ作对照．使用２４个月，随访率为１００％．结果表明：ＴＣｕ３８０Ａ和ＵＣＤＣｕ３００ＩＵＤ累积妊娠率分别为１．０％和２．０％，对照组（ＴＣｕ２２０Ｃ）为１．０％；脱落率顺序为２．０％、０．０％和１．０％；因症取出率依次为２．０％、３．０％及１．０％；继续存放率分别为９５．０％、９５．０％和９７．０％，上述各组间结果均无显著性差异（Ｐ＞０．０５）．证实三种ＩＵＤ均符合ＷＨＯ标准，易于农村推广使用．     

醋酸甲羟孕酮针剂在哺乳期妇女避孕中的应用

目的:寻求哺乳期妇女运用醋酸甲羟孕酮(DMPA)避孕的最佳投药剂量。方法:将受试对象分为DM-PA组和未使用DMPA的产后哺乳期妇女,排除不符合研究标准者,纳入研究对象共319例,DMPA150mg组83例,100mg组80例,75mg组81例,未使用DMPA组75例,DMPA组每3个月深部肌肉注射1次,共4次。结果:非DMPA组避孕成功率为80.00%,150mg与100mgDMPA组避孕成功率均为100.00%,75mg组成功率为98.77%,3个不同剂量DMPA组避孕成功率均显著高于非DMPA组(P<0.01),但3组间差别无统计学意义(P>0.05)。发生的副反应中,点滴出血75mg组为4.94%,明显低于150mg组的16.87%(P<0.05)和100mg组的10.00%(P<0.05)。结论:75mgDMPA用于哺乳期妇女避孕不影响其有效性,且可减少副反应发生率,可作为我国哺乳期妇女运用DMPA避孕的最佳投药剂量。     

Injectable contraception

When deciding on the choice of a contraceptive, it is necessary to determine whether the method is to be permanent or reversible. If permanent, then the menstrual irregularities, the weight gain, headaches and subjective side effects of depot medroxyprogesterone acetate (DMPA) would suggest that it is not the most appropriate contraceptive for use up to the onset of menopause. Indeed there would be difficulty, given the frequent incidence of amenorrhea, in determining when this had occurred. If the contraception required is to be reversible, then it would be essential to inform the women that, provided she is of proven fertility, her chance of becoming pregnant after the use of DMPA is severely limited for 12 months after her last injection, and that she will have a conception rate of 75% by 15 months and 95% by 24 months. Very few women planning further pregnancies would tolerate that sort of delay in return of fertility, which makes the reliable spacing of their pregnancies impossible. DMPA seems not be the most appropriate agent for permanent contraception, for nulliparous women, for lactating women, or for women planning to space their pregnancies as accurately as possible. Sensitive discussion and accurate information on the advantages, disadvantages and relative reliability of all the available methods of contraception (hormonal, chemical, mechanical, barrier, and natural methods) should enable the woman, in consultation with her sexual partner and her medical practitioner, to choose the method most appropriate to her current and future needs. On the basis of the most recent information about DMPA, it is doubtful that DMPA will ever be the most appropriate choice.     

Effect of prolonged use of injectable hormonal contraceptives on blood pressure and body weight

The study was undertaken to determine the effect of prolonged use of injectable hormonal contraceptive on blood pressure and body weight in young women. Two hundred volunteers were selected for the purpose. Of them, one hundred and forty were taking injectable hormonal contraceptive, DMPA for 3 to 5 years uninterruptedly. Rest forty subjects served as control using no contraceptive steroid. Blood pressure, systolic as well as diastolic, was measured by sphygmomanometer. Body weight was measured by weighing machine. It was observed that there were insignificant (P>0.05) elevations of systolic and diastolic blood pressure from DMPA use. But body weight of the experimental subjects was significantly (P <0.05) increased in comparison to that of the control.     

Effects of prolonged use of injectable hormonal contraceptive on serum lipid profile

The current study was carried out to determine serum levels of total cholesterol, triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in human female volunteers taking injectable hormonal contraceptives. For this purpose, 200 (two hundred) subjects with age range of 20-35 years were selected. Out of them, 140 (one hundred and forty) were experimental subjects and 60 (sixty) were control. Women without hormonal contraceptive were selected as the subjects of control group. The experimental subjects were taking injectable hormonal contraceptive, DMPA (depo-medroxyprogesterone acetate) for 3-5 years uninterruptedly. The mean serum total cholesterol and mean serum triacylglycerol levels of the DMPA users were significantly (P0.05). The mean serum LDL-cholesterol level of the subjects of DMPA users was significantly (P<0.05) elevated in comparison to that of the control.     

Concentration Changes of MedroxyprogesteroneAcetate in Serum and Milk in Lactating Woman Who Used Depo Geston

Objective To determine the concentration changes of medroxyprogesterone acetate （MPA） in serum and milk in the Chinese lactating women who used Depo Geston Methods Ten postpartum and breastfeeding women received an injectable contraceptive of Depo Geston （depo medroxyprogesterone acetate, DMPA, 150 mg/ampoule）. Serum and milk samples were collected in the 1^st, 2^st, 4^th, 6^th, 8^th 10^th and 12^th week after contraceptive injection. The concentrations of medroxyprogesterone acetate （MPA） in serum and milk were determined by radioimmunoassay. Results The highest MPA concentration in serum was observed at the 1^st week and then the level of serum MPA decreased obviously at the 2^na and 4^th week. After the 4^th week, the decline of serum MPA level slowed down. The concentration of milk MPA reached the highest level at 1^th week. But at the 2^nd week the average level of MPA in milk dropped by half The MPA concentration in the milk was changed in the range of 5.2-8.3 ng/mL in the following 10 weeks. During observation, the average ratios of concentration and area under curve （AUC） in milk/serum were both 0.55. There was a wide variation in MPA concentrations and ratios of milk/serum between subjects. Conclusion MPA concentrations maintained a certaim level at the 12^th week after DMPA injection. However, whether mather＇s intake of DMPA during feeding period has effect on children＇s growth, espcially pubertal growth, deserves further studies.     

Successful pregnancy soon after oral contraceptive-associated malignant hypertension

A woman who developed malignant hypertension while taking a very low oestrogen oral contraceptive underwent an uncomplicated pregnancy conceived 3 months later. Her BP was well controlled with propranolol alone.     

A Muhicentered Clinical Trial of the Long-acting Injectable Contraceptive Depo Provera in Chinese Women

This study was an open trial where 1994 subjects each received Depo Provera injectable contraceptive every three months for one year and were observed a total of 20,294.3 woman months.At the time of observation,only one accidental pregnancy had occurred giving a use-effectiveness rate of 99.94% and a cumulative continuation rate of 72.8%.There were no significant adverse effects on weight and bolld pressure.The main side effects were spotting,prolonged bleeding,and amenorrhea and these were alsothe main reasons of discontinuation.Complaints related to bleeding problems gradually decreased and complaints of amenorrhea increased with continued use. In lactating women,side effects occurrence rate was lower and continuation rate was higher in comparison with non-lactating women.Users did not report any effect on milk secretion.The results of this study confirm that Depo Provera is a very effective contraceptive method.With appropriate counseling and medical support,high acceptability and continuation rate can be achieved. Depo Provera is especially suitable for lactating women and could become a popular contraceptive method for lactating Chinese women.     

B超介导下穿刺诊断与治疗卵巢巧克力囊肿

目的 探讨B超介导下囊肿穿刺术对卵巢巧克力囊肿的诊断价值和治疗意义。方法 对52例临床诊断巧克力囊肿患者在B超下行肿囊穿刺术，以囊液性状和涂片病理作出诊断，同时对部分诊断囊肿者囊腔内注入甲孕酮。随访12个月以上。结果 经穿刺术校正诊断7例（13．46％）。穿刺术使患者近期症状缓解率达100％，甲孕酮可使复发率显著减低。复发病例可行第二次穿刺术并加甲孕酮治疗仍有效。结论 B超下的囊肿穿刺术是对卵巢巧克力囊肿的一种可行的微创性诊断与治疗方法，甲孕酮囊腔内给药和术后维持治疗能有效地控制症状和促使异位病灶萎缩。