宫腔镜下宫腔肌性粘连分离术临床研究

目的探讨官腔镜下官腔肌性粘连分离术的临床应用。方法回顾性地分析了2003年6月至2007年6月在我院接受官腔镜下官腔肌性-粘连分离术的34例病人的临床资料及随访结果。结果34例宫腔肌性粘连病人均成功地实施了官腔镜下粘连分离术,无一例发生并发症,术后随访6～40个月均有正常月经来潮,27例有生育要求者,19例获得妊娠。结论官腔镜下宫腔肌性粘连分离术是安全有效的,值得推广。     

宫腔镜联合腹腔镜检查不孕症168例分析

目的探讨宫、腹腔镜联合检查不孕症的诊断价值.方法回顾性分析1999年6月～2003年10月宫、腹腔镜联合检查168例不孕症的临床资料.结果宫腔镜检查发现异常宫腔79例（79/168,47.0%）,其中子宫内膜增生、内膜息肉46例（46/79,58.2%）.腹腔镜检查发现盆腔器质性病变99例,其中慢性盆腔炎、子宫内膜异位症和多囊卵巢共85例（85/99,85.9%）;宫、腹腔镜检均正常15例,均异常39例.宫腔镜下行输卵管通畅检查,输卵管单侧或双侧不通90例（90/168,53.6% ）;腹腔镜检查输卵管单侧或双侧不通78例（78/168,46.4%）.结论宫腔镜联合腹腔镜检查不孕症能够提供准确的诊断依据.     

宫腔电切镜治疗宫腔粘连32例临床分析

目的探讨宫腔电切镜分离宫腔粘连的效果。方法2001年1月～2003年12月对32例宫腔粘连采用宫腔电切镜进行粘连分离治疗。结果14例Ⅰ、Ⅱ度宫腔粘连分离至宫腔完全恢复正常。9例Ⅲ度宫腔粘连中6例可暴露出患侧输卵管开口。9例Ⅳ、Ⅴ度宫腔粘连中5例宫腔形状分离至恢复正常，但无法暴露出输卵管开口，1例子宫穿孔，腹腔镜手术修补，术后恢复良好。无水中毒、术后感染等并发症。27例月经异常25例(92．6％)术后月经正常，2例(7．4％)仍闭经。12例术前有不同程度周期性腹痛术后得到缓解。术后妊娠率42．9％(6／14)。结论宫腔镜分离粘连是一种安全、有效的方法。     

25例IUD及输卵管结扎与异位妊娠的临床分析

本文对我院收治的异位妊娠84例,其中带环异位妊娠20例,输卵管结扎术后合并异位妊娠5例,以及带环异位妊娠的发生率及其原因、误诊等进行了分析讨论。     

Intrauterine fetal death

Sadly, intrauterine fetal death is a common occurrence and one that all labour ward personnel should be trained to manage. Recent advances have improved the likelihood of identifying a cause. The key to this is a logical and methodical approach to investigation. Postmortem examination remains a critical aspect of investigation and labour ward teams require a clear understanding of the legal aspects of this. Sympathetic and supportive care of parents should respect parental wishes and allow choice wherever possible. However, maternal safety should also be a central aspect of this care.     

不同分娩方式妇女放置三种IUD的术时评价

目的:研究不同分娩方式妇女放置三种新型含铜宫内节育器(CulUD)的术时评价。方法:将观察对象按经阴道和经剖宫产的不同分娩方式分为两组,每组均随机放置CyneFix IN IUD、MCu功能性IUD和TCu380A IUD,记录两组放置不同种IUD的扩宫情况、置器疼痛反应和置器时间。结果:放置GyneFix IN IUD和TCu380A IUD在不同分娩方式组中扩宫率、痛觉评分、置器时间无显著差异(P>0.05)。放置MCu功能性IUD在剖宫产分娩组扩宫率为92.5％,显著高于阴道分娩组的33.3％(P<0.05);痛觉评分为8.62±0.82分,显著高于阴道分娩组(P<0.01);置器时间为(9.62±3.15)min,较另两种IUD置器时间显著延长(P<0.05)。结论:GyneFix IN IUD和TCu380A IUD置器术时扩宫率低、费时少,疼痛反应轻,不受分娩方式影响。     

Sex and Intrauterine Position Influence the Size of the Gerbil Hippocampus

Sex differences in home range size and spatial ability are predictive of sex differences in the relative size of the hippocampus in rodents. Such differences in behavior and hippocampal volume are presumed to be, in part, the result of differences in perinatal exposure to hormones. We predicted from differences in the size of home ranges of male and female Mongolian gerbils (Meriones unguiculatus) in the wild that the hippocampus of male gerbils would be relatively larger than that of females. We examined the effect of prenatal hormonal influences on hippocampal size by comparing hippocampal volume of males and females from 2F and 2M intrauterine positions to that of randomly selected males and females. We found that, as predicted, randomly selected males had a significantly larger hippocampus, relative to telencephalon, than did randomly selected females. However, males and females from 2F and 2M intrauterine positions did not differ in relative hippocampal size. Possible explanations for the absence of a sex difference in hippocampal size in male and female gerbils from 2F and 2M intrauterine positions are discussed.     

胎儿泌尿系畸形介入性产前诊断

目的探讨胎儿泌尿系畸形的发生与染色体异常、宫内感染的关系.方法在超声介导下对56例泌尿系畸形胎儿抽取脐带血行染色体核型分析,同时采用多聚酶联反应 (polymerase chain reaction,PCR)方法检测TORCH宫内感染.结果①5例胎儿染色体异常,染色体异常率为8.93%,除1例异常核型为单纯泌尿系畸形外,其余4例均合并有其他器官异常;②胎儿脐血检测发现巨细胞病毒(cytomegalovirus,CMV)感染5例,风疹病毒(rubella virus,RV)感染2例,弓形体(toxoplasma,TOX)感染2例,单纯疱疹病毒 (herpes simplex virus,HSV)感染2例,宫内TORCH感染发生率为19.64%.结论染色体异常是引起胎儿泌尿系畸形的重要原因之一,对所有泌尿系统畸形胎儿应行染色体核型分析;而某些宫内感染,尤其是CMV感染,可能引发胎儿泌尿系统畸形.     

妊娠17～37周胎儿可溶性白介素2受体和NK细胞含量的变化

目的：探讨妊娠17～37周正常和宫内感染时胎儿外周血可溶性白介素2受体（Soluble interleuldn-2 receptor，sIL-2R）和自然杀伤细胞（Natural killer，NK）含量的变化。方法：超声引导下行脐带穿刺术，收集129例胎儿外周血，包括97例正常对照组胎儿血，32例宫内感染组（单纯疱疹病毒感染、弓形虫感染、风疹病毒感染）胎儿血，采用双色免疫荧光标记流式细胞仪技术测定胎JLPF周血NK细胞百分率，双抗体夹心酶联免疫吸附试验测定胎JLPF周血中sIL-2R的含量，分析生理状态下胎儿外周血NK细胞、sIL-2R的状况和宫内感染时NK细胞和sIL-2R含量的变化。结果：妊娠17—37周胎儿外周血NK细胞、sIL-2R含量不随孕周改变，r（NK）=-0．03，P〉0．05；r（sIL-2R）=0．167，P〉0．05，宫内感染时NK细胞含量减少，sIL-2R含量增多，与正常对照组相比差异有显著意义；t（NK）=4．29，P〈0．01；t（sIL-2R）=-5．833，P〈0．01。结论：妊娠17—37周胎儿外周血有一定量的NK细胞和sIL-2R存在，但机体免疫功能仍不完善，宫内感染时机体容易出现免疫抑制状态。