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【Abstract】?Objective?To evaluate the safety and effectiveness of laparotomic and laparoscopic tubal anastomosis, and evaluate the influencing factors of pregnancy rate. Methods?The clinical data of 356 ligation patients who underwent tubal anastomosis in the First Affiliated Hospital of Zhengzhou University from March 2012 to October 2017 were analyzed retrospectively, including 85 cases of laparotomy and 271 cases of laparoscopy. The differences of perioperative status and postoperative pregnancy rate between the two groups were analyzed, and the independent influencing factors of postoperative pregnancy rate were analyzed. Results?①There was no significant difference in operation time, postoperative fever and exhaust time between the two groups (P>0.05), but laparoscopic bleeding was less[(18.1±12.1) ml, (33.4±22.1) ml], and the pain score was lower[(3.6±0.9), (4.5±0.9) score], duration of hospital stay was shorter[(5.9±0.6) d, (7.1±0.7) d](P<0.05). 2 cases of laparotomic group had abdominal wall incision infection, cases of laparoscopic group all healed well. The cost of laparotomic group was lower than that in laparoscopic group[(9 524±881), (12 903±1 162) yuan](P<0.05).② There was no significant difference in the patency rate of intraoperative anastomosis, residual tube length and ectopic pregnancy rate between the two groups (P>0.05). The uterine pregnancy rate two years after anastomosis was higher in laparoscopic group (76.4%) than in laparotomic group(61.2%)(P<0.05). The postoperative gestation time of the laparoscopic group was (7.6±4.9) months, and the postoperative gestation time of the open group was (8.3±5.3) months, with no statistically significant difference(P>0.05).③ Anastomotic procedure (OR=1.847, 95%CI: 1.028~3.320, P=0.040), age (OR=3.673, 95%CI: 1.690~7.984, P=0.001), multiple pelvic operation history (OR=3.092, 95%CI: 1.650~5.796, P=0.000), and length of residual tube (OR=4.716, 95%CI: 2.552~8.714, P=0.000) were independent factors influencing intrauterine pregnancy rate after anastomosis. There was no significant correlation between body mass index (BMI), length of ligation, method of ligation and site of ligation and pregnancy rate. Conclusion?Compared with open surgery, laparoscopic tubal anastomosis is a better treatment option for patients with tubal ligation. Anastomosis mode, age, history of multiple pelvic surgeries and length of remaining fallopian tubes were the influencing factors of pregnancy rate after anastomosis. 相似文献
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目的 探讨颈椎外伤后发热的原因及其处理方法。方法 回顾性分析了298例颈椎外伤患者的临床资料。结果经调查发现298例患者中发热患者87例,占全部病例的29.2%,其中坠积性肺炎17例,泌尿系感染12例,褥疮感染5例,伤口感染5例,脑膜炎3例,植物神经功能紊乱20例,药物热15例,贫血2例及吸收热8例。颈椎外伤患者并发发热的发生率与脊髓损伤程度有关。结论 颈椎外伤患者发热的发生与坠积性肺炎、泌尿系感染、褥疮感染、伤13感染、脑膜炎、植物神经功能紊乱、药物热、贫血及吸收热有关,及时查明发热原因,采取相应措施可避免病情加重。ASIA运动评分与颈椎外伤患者发热的发生有相关性。 相似文献
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目的探讨脐血促酰化蛋白(ASP)水平与胎儿生长发育关系。方法选择大于胎龄儿(OGA)、适于胎龄儿(GA)和小于胎龄儿(YGA)各30人,检测脐血、母血和羊水ASP水平,分析脐血ASP与胎儿生长发育各指标、血脂、胰岛素、瘦素和脂联素等的相关性。结果 OGA、GA、YGA的脐血ASP水平分别为(40.6±1.38),(36.7±1.76),(33.8±1.73)mg/L,3组比较差异有统计学意义(F=133.341,P0.001);3组新生儿血脂各指标水平比较差异均无统计学意义(F≤3.086,P0.05);脐血ASP水平与新生儿出生体质量、身长、体质指数(BM I)、腰围、腰臀比、胰岛素、瘦素、脐血甘油三酯水平呈正相关(r≥0.653,P0.001),与脐血脂联素水平呈负相关(r=-0.785,P0.001),与母血和羊水ASP水平、胎盘重量无关(r=0.064,1.173,-0.236,P0.05)。结论促酰化蛋白参与胎儿生长发育调节,脐血ASP水平可反映胎儿的生长发育状况。 相似文献
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会阴侧切术是产科的常见手术之一 ,但术后大多数产妇有不同程度的会阴疼痛 ,有的排尿困难等 ,这些并发症的发生除了与修复方法和术者技术有关以外与缝合材料也有一定的关系 ,现将我院应用可吸收缝线对会阴侧切术行皮内缝合术的观察结果报告如下。1 资料与方法1.1 临床资料 我院自 1998年 6月至 12月 ,应用英国Dcyanamid公司生产的 2~ 0消毒多股编织可吸收缝线 (DEX OW ) ,皮内缝合会阴侧切创口 10 6例作为观察组 ,并随机抽取同期会阴侧切创口传统缝制羊肠线及丝线缝合 83例作为对照组进行比较。1.2 方法 两组产妇均采用… 相似文献
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目的探讨剖宫产术中出血的有效防治措施。方法对2008年1月——2010年11月400例有剖宫产指征且有产后出血高危因素者,随机分为卡前列素氨丁三醇组、缩宫素组各200例,前者在胎儿娩出后立即宫底注射卡前列素氨丁三醇,后者注射缩宫素,比较2组术中及产后2、24h内的出血情况,结果2组共32例发生难治性产后出血,1例凶险型前置胎盘大面积植入,1例胎盘早剥合并弥漫性血管内凝血患者2例因病情需要立即行子宫切除外,其余30例均使用B—Lynch缝合术。卡前列素氨丁三醇组产后出血发生率明显低于缩宫素组(P〈0.01),产后2、24h出血量明显减少(P〈0.01)。结论卡前列素氨丁三醇可有效地预防产后出血;对难治性出血患者应用B—Lynch缝合术亦可取得较好的止血效果 相似文献
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腰椎间盘突出症是指腰椎间盘变性,纤维环破裂,髓核组织突出,刺激或压迫马尾神经根所引起的一种综合征。好发年龄20岁。50岁,男性多于女性,腰椎间盘突出症以突出物的大小分为膨出、突出和脱出三种类型,临床上以腰痛伴或不伴有下肢放射痛为主要症状。腰椎间盘突出症临床上采用手术治疗和非手术治疗两种方法,手术治疗因其难度大,费用高,不作为首选治疗方法,临床上多采用非手术治疗的方法。在非手术治疗中,护士应给予患者必要的指导,使患者能积极主动地配合治疗和护理,以尽快康复。 相似文献