肚皮舞操与产褥操对产妇后期体形的影响

目的探讨产后肚皮舞操与产褥操对产妇体形及盆底肌张力恢复的效果。方法对102例志愿参与的顺产产妇,于产后第2天开始进行产褥操锻炼,每1～2天增加1节,共七节,到全部掌握。产后4周末,随机将产妇分为产褥操组和肚皮舞操组。于产后8周末、16周末随访产妇的腰围、臀围、腹部皮褶、体质量指数和盆底肌张力恢复指标。结果两组产妇8周末体形客观状态和盆底肌张力指标比较,差异无统计学意义(P>0.05),而两组产妇16周末体形客观状态和盆底肌张力恢复指标比较,差异有统计学意义(P<0.05)。结论产后后期肚皮舞操比产褥操能更好的恢复产妇的体形和盆底肌张力。     

蒲药灌肠液辅助血府逐瘀胶囊综合治疗气滞血瘀型慢性盆腔炎的临床试验

目的 研究蒲药灌肠液辅助血府逐瘀胶囊综合治疗气滞血瘀型慢性盆腔炎的临床疗效,为其临床应用提供科学依据。方法 气滞血瘀型慢性盆腔炎患者122例,随机分为对照组和试验组。对照组口服血府逐瘀胶囊,试验组口服血府逐瘀胶囊同时辅助蒲药灌肠液治疗,2个疗程后比较2组治疗效果。结果 试验组愈显率为69.4%,总有效率为93.6%;对照组愈显率为43.3%,总有效率为81.6%;两组比较差异有统计学意义（P<0.05）。试验组在改善中医证候和局部体征方面,降低高切全血黏度、血浆黏度和红细胞积压方面优于对照组,差异有统计学意义（P<0.05）。结论 蒲药灌肠液辅助血府逐瘀胶囊综合治疗气滞血瘀型慢性盆腔炎,可以明显提高治疗效果,且能改善患者血液流变性,值得临床推广。     

桂枝茯苓胶囊联合西药治疗慢性盆腔炎患者疗效分析及对炎症因子的影响

目的 分析桂枝茯苓胶囊联合西药治疗慢性盆腔炎患者疗效及对患者炎症因子的影响.方法 慢性盆腔炎患者70例随机分为研究组与对照组各35例.研究组采用桂枝茯苓胶囊联合西药治疗,对照组仅采用西药治疗.两组患者治疗疗程均为3个月经周期.结果 研究组治疗总有效率(94.29％)高于对照组(68.75％),差异有统计学意义(P＜0.05).研究组患者治疗后血清IL-10[(27.62±4.67)μg/L]高于对照组[(18.42±3.46)μg/L],CRP[(5.42±1.27) mg/L]和TNF-α[(1.56±0.34) pg/ml]低于对照组[(8.13±1.76) mg/L,(2.65±0.54) pg/ml],差异有统计学意义(P＜0.05).研究组不良反应发生率(5.71％)低于对照组(25.71％),差异有统计学意义(P＜0.05).研究组随访6个月复发率(2.86％)低于对照组(34.29％),差异有统计学意义(P＜0.05).结论 桂枝茯苓胶囊联合西药治疗慢性盆腔炎患者疗效显著,且能够增加血清IL-10含量和降低CRP、TNF-α含量,且未见严重用药不良反应、复发率低.     

临床药师参与盆腔脓肿腹腔镜术后抗感染会诊

目的: 通过参与妇科盆腔脓肿腹腔镜术后抗感染来增强临床药师的临床药学服务能力。方法: 了解病例基本资料情况, 分析术后感染的致病菌, 选择适当抗感染药, 并跟踪患者用药情况至出院。结果: 通过分析, 得出此病例为厌氧菌及革兰阴性杆菌(包括大肠埃希菌、铜绿假单胞菌等)感染为主, 选用哌拉西林舒巴坦及替硝唑治疗后, 血常规正常, 体温正常, 出院。结论: 临床药师可运用药物相关知识给临床提供有价值的药学服务。     

慢盆逐瘀汤对大鼠慢性盆腔炎血清前白蛋白及病理学的影响

目的:研究慢盆逐瘀汤对慢性盆腔炎(chronic pelvic inflammatory disease,CPID)大鼠血清前白蛋白(Prealbumin,PAB)及病理组织形态学的影响。方法:用混合菌接种法诱导大鼠CPID动物模型,其中假手术组仅打开腹腔,不注射混合菌,实验结束后取子宫肉眼观察后进行病理组织学检查,并以ELISA法检测大鼠PAB的浓度。结果:模型组病理形态学显示慢性炎症改变,慢盆逐瘀汤各剂量组及妇科千金胶囊组对大鼠子宫病理形态学较模型组都有不同程度的改善,而各组大鼠PAB的浓度无显著性差异(P>0.05)。结论:慢盆逐瘀汤对大鼠CPID模型有理想的治疗效果,但尚不能确定慢盆逐瘀汤对CPID大鼠模型PAB有影响,亦不能明确CPID动物模型与其之间存在必然联系。     

Clinical presentation of fibroids

Uterine fibroids, the most common tumours in women of reproductive age, are asymptomatic in at least 50% of afflicted women. However, in other women, they cause significant morbidity and affect quality of life. Clinically, they present with a variety of symptoms: menstrual disturbances including menorrhagia, dysmenorrhoea and intermenstrual bleeding; pelvic pain unrelated to menstruation; and pressure symptoms such as a sensation of bloatedness, increased urinary frequency and bowel disturbance. In addition, they may compromise reproductive function, possibly contributing to subfertility, early pregnancy loss and later pregnancy complications such as pain, preterm labour, malpresentations, increased need for caesarean section, and postpartum haemorrhage. Large fibroids may distend the abdomen, which may be aesthetically displeasing to many women. Abnormal bleeding occurs in 30% of symptomatic women, and abnormal bleeding, bloating and pelvic discomfort due to mass effect constitute the most common symptoms. The incidence of fibroids is highest in Black women, who tend to have multiple and larger fibroids, and more symptomatic fibroids at the time of diagnosis. The prevalence of clinically significant myomas peaks in the perimenopausal years and declines after the menopause. It is not known why some fibroids are symptomatic while others are quiescent. The size, number and location of fibroids undoubtedly determine their clinical behaviour, but research has yet to correlate these parameters with clinical presentation of the fibroids.     

Post-voiding residual volume in 154 primiparae 3 days after vaginal delivery under epidural anesthesia

OBJECTIVES: To use 3-dimensional ultrasonography (3D-US) to determine the frequency of post-voiding residual volume (PVRV) > or =100 mL in primiparae 3 days after receiving epidural anesthesia for vaginal delivery. Potential relationships between day-3 PVRV > or =100 mL and obstetrical-pediatric parameters, especially those possibly implicated in post-obstetrical bladder dysfunction, were examined. STUDY DESIGN: We recruited 154 primiparae who vaginally delivered term singletons following uncomplicated pregnancies in the maternity unit of a French teaching hospital. All women had been systematically catheterized 2-h postpartum to measure precisely the volume of urine retained. On the morning of discharge (day 3), when the patient felt the urge to urinate, her 3D-US pre-voiding bladder volume was determined with BladderScan (BVI-3000), then her spontaneously voided urine was collected to accurately quantify its volume and 3D-US was repeated immediately to evaluate the PVRV. PVRV > or =100 mL on day 3 was considered pathological. RESULT: Among these 154 women, 88 (57%) felt the need to urinate and 97 (63%) had a retained volume > or =500 mL at 2-h postpartum. On day-3 postpartum, the median [range] volumes for the entire cohort were: 426.7 [158-999.7] mL 3D-US-measured pre-voiding, 350 [15-1000] mL collected by spontaneous urination, 82.2 [5.3-433.3] mL 3D-US-determined post-voiding; PVRV exceeded 100 mL for 55 (36%). According to our univariate analysis, no factor considered was able to predict PVRV > or =100 mL on day 3. CONCLUSION: Our observations confirmed the existence of PVRV > or =100 mL on day 3 in more than one-third of these primiparae who delivered vaginally under epidural anesthesia. No obstetrical-pediatric factor could be implicated in this bladder dysfunction. Therefore, we recommend frequent and systematic non-invasive 3D-US monitoring of all postpartum patients at least until day 3 to avoid excessive urine retention.