Air Embolism Death of a Pregnant Woman Secondary to Orogenital Sex

Air embolism produced by vaginal insufflation is an unusual but potentially lethal consequence of sexual activity, especially in the pregnant patient. Reported here is the case of a young pregnant woman who presented to the ED in full cardiac arrest, with little history to explain her condition. Despite aggressive resuscitative measures, the patient died, but her infant son was delivered via perimortem cesarean section and survived. A high level of suspicion for air embolism should be maintained for young women who unexpectedly develop cardiac arrest, particularly during sexual activity. Air embolism patients may require vigorous medical resuscitation, hyperbaric oxygen therapy, or surgical intervention to survive. The emergency physician should be familiar with the indications for perimortem cesarean delivery in the third-trimester patient presenting to the ED with cardiac arrest.     

晚期产后出血问题的探讨(附52例临床分析)

本文对52例晚期产后出血病例进行了分析,结果认为晚期产后出血与感染密切有关;在处理上诊断性刮宫仍是重要措施之一,并提出对存在感染因素的产妇,术前、产前应用抗菌素预防感染.在剖宫产过程中,可用含抗生素的溶液冲洗宫腔,以达到预防感染的目的。     

第2产程剖宫产术对母婴的影响

本文对我院近 4年来第 2产程 (以下简称 2程 )剖宫产 6 1例进行回顾性分析。资料表明 :第 2产程剖宫产术易合并羊水污染及术时并发症 ,新生儿Apgar氏评分低 ,术后并发症高于对照组 (P <0 .0 5 ) ,提示第 2产程剖宫产术比一般头位急症剖宫产术对母婴不利 ,其并发症的发生与第 2产程的延长相关 (P <0 .0 1) ,故应把握时机尽量减少宫口开全后施行剖宫产。     

剖宫产术中大出血填塞纱条止血53例临床分析

目的观察宫腔填塞纱条对剖宫产术中大出血的止血效果。方法剖宫产术中大出血患者53例,常规处理方法无效后,采用宫腔填塞纱条止血,术中宫体注射缩宫素。以同期剖宫产50例为对照组,采用宫体注射缩宫素20U。结果53例经宫腔填塞纱条后,52例能迅速控制出血,有效率98.1%。与对照组比较,两组术后24h出血量、术后5d、42d子宫径线和无显著差异(P>0.05)。结论宫腔填塞纱条治疗剖宫产术中大出血有积极作用。     

产后出血48例临床分析

目的：探讨产后出血发生的病因及防治措施。方法：对2004—2005年48例产后出血的临床资料进行分析。结果：发病原因依次为：子宫收缩乏力、子宫颈撕裂伤、子宫切口的撕裂、胎盘因素。结论：针对出血主要原因，应采取快速、有效的止血方法，加强产程的观察及产前的预测，减少产后出血的发生率。     

连续切片加免疫组化染色法在乳腺癌微灶转移检测中的应用

目的：推荐一种检测恶性肿瘤微灶转移的方法。方法：应用连续切片的免疫组化法回顾研究50例乳腺癌的淋巴结微灶转移情况，将结果与常规病理切片法进行配对资料的卡方检验，并统计微灶转移率。结果：常规病理切片法的转移灶检出率为30％，连续切片的抗细胞角蛋白免疫组化法的转移灶检出率为50％，二者间差异有显著性。连续切片法发现的微灶转移率为28．5％。结论：对于肿瘤的微灶转移的发现，连续切片的的免疫组化法更有优势，它是一种敏感的检测微灶转移的方法。     

胎盘早期剥离31例临床分析

目的：探讨胎盘早期剥离(早剥)的发病因素、临床表现及治疗。方法：回顾性分析31例胎盘早剥的临床资料、治疗及预后。结果：胎盘早剥的发生率为0．8％，机械性因素17例(54．8％)，妊娠高血压综合征引起的13例(41．9％)，以中重度为主。临床症状主要以腹痛、阴道流血为多见，分别为64．5％、54．8％，但有部分病例仅表现胎动消失或胎死子宫内，术前确诊较困难。临床类型轻重比例相近，病理类型以隐性和混合性多见，分别为45．2％、51．6％。分娩方式以剖宫产为主(83．9％)，围生儿死亡率54．8％。结论：胎盘早剥的发病因素以机械性因素和中重度妊娠高血压综合征为多见，临床表现以腹痛、阴道流血多见，围生儿病死率高，应做好孕期保健工作，积极推行孕期健康教育。     

全程责任制助产的临床意义

目的:了解为产妇提供产时"全程责任制助产"的个性化服务,对产妇妊娠结局的影响,以及对提高产科护理质量的意义.方法:将114例住院分娩的初产妇随机分为"全程组"与常规待产组(对照组),"全程组"是指在导乐的基础上实行一名助产士专门为一名产妇提供全过程(宫口开大2cm至产后2h)的服务和指导.结果:"全程组"与对照组的产程时间、分娩方式、产后出血率,均有显著性差异(P＜0.05).结论:"全程"责任制助产有利于提高产科质量,护理满意度调查平均达98%,值得推广应用.     

End-to-side anastomosis of rat carotid artery: comparison of different types of section and shape of the terminal end

Summary In 50 rats, different types of end-to-side carotid artery anastomoses were compared. In one technique, a longitudinal split in the long axis of the vessel was performed to enhance the diameter of the anastomosis. This theoretical advantage was not confirmed in this series. The clamping time, anastomoses time, and tamponade time were increased significantly when compared with a simple, slightly oblique end-to-side anastomosis. This study highlighted that the most simple type of end-to-side anastomosis gave less bleeding, achieved a quicker water-tight anastomosis and decreased the risk of late problems.     

One-stage versus two-stage lymph node dissection after investigation of sentinel lymph node in cutaneous melanoma: a comparison of complications, costs, hospitalization times, and operation times

The aim of the study was to evaluate whether complication rate, costs, operation times, and hospitalization times differed in two different patient groups: in group 1, frozen section analysis of the sentinel lymph node and lymph node dissection were carried out in the same operation. In group 2, normal investigation of the sentinel lymph node and lymph node dissection were done in a second operation. One hundred thirty-five patients with cutaneous melanoma were included. Hospitalization times, costs, complication rates, and operation times of two-stage and one-stage lymph node dissection of the draining area after detection of metastases in the sentinel lymph node were retrospectively compared. Lymph node metastasis in the sentinel lymph node was found in 23 patients. In 11 patients, removal of the sentinel lymph node and dissection of the lymph node basin was performed in the same operation. In 12 patients, a two-stage procedure was the treatment of choice. Operation times were not different in the two groups (p=0.87) while two-stage operation patients were hospitalized significantly longer (14.2 ± 9.7 vs 23.9 ± 24 days; p=0.01) and costs were significantly higher (7,836.90 ± 2,397.95 Swiss francs vs 5,279.40 ± 1,994.90 Swiss francs). In addition, more complications were found in the two-stage group.