宫腔手术致子宫穿孔30例分析

宫腔手术是临床常施手术，虽然简便易行，但其手术特点是凭术者的经验及感觉操作，加之子宫位置、质地不同，操作如有不慎，容易发生子宫穿孔，若处理不当则可发生严重后果。现将我站1995年1月-2006年12月期间宫腔手术致子宫穿孔30例作一回顾性分析，讨论穿孔原因、诊断和治疗有关问题，以便吸取教训，减少并发症发生。     

放射治疗骨转移癌42例临床分析

Objective To analyze the effect of pain control with radiotherapy in bone metastases from malig-nancies. Methods A total of 72 lesions in forty-two cases with bone mestastases were received 6my X ray. The con-ventional radiotherapy was performed in 28 lesions in the way of 200cGy/fraction,5 fracties/week,total dose of 3000 ～5000cGy. The hypofractionation radiotherapy was.performed in 44 lesions in the way of 400cGy/fracfion,3 frac-tions/week,total dose of 2400～3600cGy. Results Overal pain relief rate was 90.28%, there were no significant differences between the two groups(P 0.05). The pain relief of hypofractionation radiotherapy was faster than anoth-er. Conclusion Radiotherapy is a very effective way to relieve pain in bone metastases from malignacies.     

无创血红蛋白监测在脊柱融合术中的应用研究

目的探讨无创血红蛋白浓度(SpHb)监测与动脉血气分析血红蛋白浓度(Thbc)监测在脊柱融合术中的准确性及影响因素,旨在明确SpHb监测能否用于指导术中输血。方法全麻下行择期脊柱融合术的成年患者53例,ASAⅠ~Ⅲ级。于切皮前、植骨融合、手术结束和出血量每超过400ml即刻,记录SpHb、Thbc、静脉血常规血红蛋白浓度、手术时间、术中出血量、末梢灌注指数(PI)、MAP、CVP、体温、输注液体种类及总量。结果用一致性检验、回归分析和非参数检验进行统计分析。结果 SpHb与血红蛋白浓度的一致性弱于Thbc与血红蛋白浓度的一致性;SpHb与血红蛋白浓度成正相关(r=0.77,P0.01),Thbc与血红蛋白浓度成正相关(r=0.89,P0.01);SpHb与血红蛋白浓度、Thbc与血红蛋白浓度差值的平均值分布差异有统计学意义(P0.01)。出血量、输注胶体、PI对SpHb监测的准确性有影响(P0.05)。结论 SpHb监测总体上能反映体内血红蛋白浓度的变化趋势,可为临床有创测定血红蛋白浓度的采血时机提供参考。其准确性受众多因素影响,其在指导术中输血中的应用宜与动脉血气分析或静脉血常规测定相结合。     

放射治疗骨转移癌42例临床分析

Objective To analyze the effect of pain control with radiotherapy in bone metastases from malig-nancies. Methods A total of 72 lesions in forty-two cases with bone mestastases were received 6my X ray. The con-ventional radiotherapy was performed in 28 lesions in the way of 200cGy/fraction,5 fracties/week,total dose of 3000 ～5000cGy. The hypofractionation radiotherapy was.performed in 44 lesions in the way of 400cGy/fracfion,3 frac-tions/week,total dose of 2400～3600cGy. Results Overal pain relief rate was 90.28%, there were no significant differences between the two groups(P 0.05). The pain relief of hypofractionation radiotherapy was faster than anoth-er. Conclusion Radiotherapy is a very effective way to relieve pain in bone metastases from malignacies.     

瑞芬太尼与芬太尼用于腹腔镜胆囊切除术观察

目的：观察瑞芬太尼和芬太尼用于腹腔镜胆囊切除术的术中维持效果。,方法：随机抽取择期行腹腔镜胆囊切除术病人80例,分为瑞芬太尼组（R组）、芬太尼组（F组）两组各40例。记录两组入室后、插管时、气腹后、解剖胆囊三角、缝皮、吸痰拔管时血压、心率的变化及术后清醒情况。结果：R组术中血压较平稳,术后苏醒迅速;F组术中血压偏高的比率高,术后苏醒比R组迟。结论：瑞芬太尼较芬太尼更适用于腹腔镜下胆囊切除术。     

放射治疗骨转移癌42例临床分析

Objective To analyze the effect of pain control with radiotherapy in bone metastases from malig-nancies. Methods A total of 72 lesions in forty-two cases with bone mestastases were received 6my X ray. The con-ventional radiotherapy was performed in 28 lesions in the way of 200cGy/fraction,5 fracties/week,total dose of 3000 ～5000cGy. The hypofractionation radiotherapy was.performed in 44 lesions in the way of 400cGy/fracfion,3 frac-tions/week,total dose of 2400～3600cGy. Results Overal pain relief rate was 90.28%, there were no significant differences between the two groups(P 0.05). The pain relief of hypofractionation radiotherapy was faster than anoth-er. Conclusion Radiotherapy is a very effective way to relieve pain in bone metastases from malignacies.     

放射治疗骨转移癌42例临床分析

Objective To analyze the effect of pain control with radiotherapy in bone metastases from malig-nancies. Methods A total of 72 lesions in forty-two cases with bone mestastases were received 6my X ray. The con-ventional radiotherapy was performed in 28 lesions in the way of 200cGy/fraction,5 fracties/week,total dose of 3000 ～5000cGy. The hypofractionation radiotherapy was.performed in 44 lesions in the way of 400cGy/fracfion,3 frac-tions/week,total dose of 2400～3600cGy. Results Overal pain relief rate was 90.28%, there were no significant differences between the two groups(P 0.05). The pain relief of hypofractionation radiotherapy was faster than anoth-er. Conclusion Radiotherapy is a very effective way to relieve pain in bone metastases from malignacies.     

放射治疗骨转移癌42例临床分析

Objective To analyze the effect of pain control with radiotherapy in bone metastases from malig-nancies. Methods A total of 72 lesions in forty-two cases with bone mestastases were received 6my X ray. The con-ventional radiotherapy was performed in 28 lesions in the way of 200cGy/fraction,5 fracties/week,total dose of 3000 ～5000cGy. The hypofractionation radiotherapy was.performed in 44 lesions in the way of 400cGy/fracfion,3 frac-tions/week,total dose of 2400～3600cGy. Results Overal pain relief rate was 90.28%, there were no significant differences between the two groups(P 0.05). The pain relief of hypofractionation radiotherapy was faster than anoth-er. Conclusion Radiotherapy is a very effective way to relieve pain in bone metastases from malignacies.     

三维适形放疗治疗食管癌的疗效观察

目的 观察食管癌三维适形放疗的疗效及急性毒副反应.方法 28例食管癌患者接受三维适形放射治疗,处方剂量60～64 Gy/30～32次,200 Gy/次,1次/d,5次/周.评价疗效及急性毒副反应.结果 全组完全缓解（CR）10例,部分缓解（PR）15例,无变化（NR）3例,总有效率（CR＋PR）为89.3%;1、2年局部控制率和生存率分别为：75.0%,60.7%和71.4%,46.4%.急性放射性肺炎0级14例,1级8例,2级5例,3级1例;急性放射性食管炎0级5例,1级14例,2级7例,3级2例.结论 三维适形放射治疗食管癌安全有效,能否提高远期生存率有待进一步观察.     

吉妮宫内节育器避孕效果观察

目的：探讨频繁脱落节育器的妇女使用吉妮宫内节育器（IUD）的效果和副作用。方法：选择有多次脱落并要求放置宫内节育器的育龄妇女576例,随机分为观察组和对照组,观察组放置吉妮宫内节育器,对照组放元宫型宫内节育器,并于放置后6个月、18个月进行随访。结果：18个月末观察组带器妊娠1.6%,脱落率1.6%,因症取出率2.6%;对照组带器妊娠率3.3%,脱落率9.3%,因症取出率3.3%。两组对比脱落率差异有统计学意义（P〈0.05）。结论：吉妮宫内节育器脱落率低,避孕的安全性和可接受性好,尤其适用于宫腔大、宫口松、反复脱落者。