药物流产后加服生化丸对缩短阴道出血时间的临床观察

目的:探讨生化丸缩短药物流产后阴道出血时间的疗效。方法:118例早孕妇女使用米非司酮及米索前列醇流产,观察组孕囊排出后加服生化丸。结果:两组完全流产率及药物流产后阴道流血时间有显著差异(P<0.05)。结论:生化丸可提高完全流产率,缩短药物流产后阴道流血时间。     

剖宫产术中大出血35例分析

目的：讨论剖宫产术中大出血的原因及防治措施。方法：于1995年1月至2005年1月期间,共1986例剖宫产术中,大出血≥1000ml者35例(1.76％),对其临床资料进行回顾性分析。结果：在输血输液的基础上,缝合子宫下段伤口断裂1例,止血有效；双手挤压子宫体和催产素20u子宫体注射34例,6例患者止血有效；Ⅰ号可吸收性肠线“8”字缝合子宫壁28例,23例患者止血有效；子宫动脉上行支结扎术5例,3例患者止血有效；子宫次全切除术2例止血均有效。结论：子宫收缩乏力是导致剖宫产术中大出血的首要原因。治疗应在促进子宫收缩、清理胎盘及胎膜、必要时结扎子宫动脉上行支、甚至行子宫切除术。     

马齿苋配伍益母草治疗药物流产后阴道流血113例分析

目的:回顾性分析马齿苋配伍益母草(又称缩宫灵)在治疗药物流产(药流)后阴道流血的疗效.方法:门诊药流后阴道流血的妇女286例,将其分成3组:观察1组服缩宫灵,观察2组单服益母草;3组为对照组不加任何药物,比较3组阴道流血的情况.结果:观察1、2组完全流产率高于对照组,阴道流血量少于对照组,阴道流血时间短于对照组,有统计学差异(P＜0.01).观察1组阴道流血量及阴道流血时间与观察2组比较,差异有统计学意义(P＜0.01),但两组完全流产率相近,差异无统计学意义(P＞0.05).3组不良反应比较无差异(P＞0.05).结论:缩宫灵可减少药流后阴道流血量,缩短流血时间,不加重不良反应,提高药流成功率.     

南京地区22家医院2001年～2003年降糖药应用分析

目的:分析南京地区22家医院2001年～2003年降糖药的应用情况及用药趋势.方法:用金额排序法统计3年来降糖药的主要品种的应用情况,分析临床用药趋势.结果:降糖药的用药金额逐年上升;胰岛素制剂中,合资品种占明显优势的市场分额;口服降糖药中,阿卡波糖用药金额占据第1位;格列美脲、瑞格列奈、罗格列酮的构成比逐年跳跃增长;二甲双胍的用药频度最大,日均费用最低.结论:降糖药的需求量逐年递增;市场需求潜力巨大,合资品种、进口品种受到医生和患者的青睐.开发不同作用机制的质优、方便、价廉的降糖药物,将会有良好的市场前景.     

我院住院患者麻醉药品应用情况调查与分析

目的:了解我院麻醉药品的应用情况.方法:收集我院2000年～2003年住院患者麻醉药品应用情况,进行分析.结果:我院住院患者麻醉药品的DDDs和销售金额逐年增加,其中,吗啡控释片的DDDs和销售金额最大,杜冷丁的用量仍然较高.结论:麻醉药品的应用中存在不合理现象,亟待改进.     

小剂量阿司匹林诱发上消化道出血的临床分析

目的:总结口服小剂量阿司匹林(Aspirin,ASP)诱发上消化道出血的临床特点及防治对策。方法:调查同期非食道静脉曲张性上消化道出血患者380例(402例次),根据出血前是否正在服用ASP分为两组:ASP组38例(出血42例次)与非ASP组342例(出血364例次),回顾性分析两组间的临床特点。结果:ASP组上消化道出血患者,平均年龄(64.5±5.4)岁,高于非ASP组(43.5±16.5岁),胃溃疡和胃黏膜病变的发生比例(69.1%)高于非ASP组(26.70%)(P<0.01),57.1%的患者出血前有诱因。出血量、Hb两组间无差异,止血时间(平均3.7d)长于非ASP组(平均2.3d)(P<0.05)。结论:口服小剂量ASP是老年患者上消化道出血的主要原因之一,其中胃部病变发生比率较高,止血所需时间较长,口服ASP时加强胃粘膜的保护、控制诱因有望预防上消化道出血的发生。     

Embolization for gastrointestinal hemorrhages

Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18–89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications. Received: 21 June 1999; Revised: 24 August 1999; Accepted: 28 September 1999     

Evaluation and management of lower gastrointestinal bleeding

Lower gastrointestinal bleeding (LGIB) is a common cause of presentation to the emergency department and hospital admissions. The incidence of LGIB increases with age and the most common etiologies are diverticulosis, angiodysplasia, malignancy and anorectal diseases. Foremost modality for evaluation and treatment of LGIB is colonosopy. Other diagnostic tools such as nuclear scintigraphy, computed tomography, angiography and capsule endoscopy are also frequently used in the workup of LGIB. Choice of treatment modality depends on the hemodynamic status of the patient, rate of bleeding, expertise and available resources. We present a comprehensive review of the evaluation and management of LGIB.     

宫腔镜检查在诊断异常子宫出血中的临床价值

目的:探讨宫腔镜检查在诊断异常子宫出血中的临床价值。方法:回顾性分析因异常子宫出血行宫腔镜检查,同时在宫腔镜下进行相应治疗和子宫内膜定位活检的287例患者资料。结果:287例异常子宫出血患者的宫腔镜诊断与病理组织学诊断总符合率为80.84%,其中子宫黏膜下肌瘤100.00%、子宫内膜息肉96.83%、子宫内膜增生68.42%、子宫内膜炎77.27%、萎缩性子宫内膜100.00%、子宫内膜癌100.00%。结论:宫腔镜能直接清晰地观察宫腔内及宫颈管的形态与结构,具有诊断性刮宫和超声检查不可比拟的优点,是诊断异常子宫出血的金标准。