Effect of pulsating local negative pressure with oxygen on bioelectrical activity of the uterus in pregnant albino rats with intrauterine streptococcal infection

Bloodborne intrauterine streptococcal infection of albino rats during pregnancy (implantation, placentation) leads to disturbances of uterine bioelectrical activity which are restored to normal by treatment with pulsating local negative pressure together with periodic administration of oxygen.Moscow Regional Research Institute of Obstetrics and Gynecology and Department of Normal Physiology, Patrice Lumumba Peoples' Friendship University, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR V. D. Timakov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 85, No. 5, pp. 528–531, May, 1978.     

《2020 ACOG实践简报:孕龄≤70 d药物流产(No.225)》解读

药物流产(MA)是早孕期避孕失败的补救措施,主要药物为米非司酮和米索前列醇,二者联合使用,可使早孕期孕妇完全终止妊娠率达到90%。但是,MA导致的患者阴道流血时间长、量多,甚至阴道大流血,而需采取急诊刮宫术治疗等,尚未被彻底解决。如何安全、有效终止早孕期妊娠,保护女性生殖健康是目前国内外该领域的研究重点。美国妇产科医师学学会(ACOG)发布的《2020 ACOG实践简报:孕龄≤70 d药物流产(No.225)》对早孕期孕妇终止妊娠,具有重要指导作用。笔者拟就该简报对MA用于孕龄≤70 d孕妇的临床效果评估,MA用药方案、禁忌证、适应证,MA前咨询和检查,MA疼痛管理,MA后观察、预防性抗菌药物使用、随访管理、避孕措施9个方面基于循证医学推荐进行解读。     

米非司酮配伍米索前列醇在中期妊娠引产中的应用

为了探讨米非司酮配伍米索前列醇在中期妊娠引产中的疗效 ,观察组 68例用米非司酮配伍米索前列醇引产 ,对照组 60例用利凡诺引产 ,观察两组从规律宫缩至胎儿娩出时间 .结果 :观察组从规律宫缩至胎儿娩出时间孕 2 0周前及孕 2 0周后分别是 ( 6 5± 0 5 2 )h和 ( 7 6± 0 4 8)h均比利凡诺组的 ( 13 2± 2 4 )h和 ( 11 1± 0 3 )h明显缩短 (P <0 0 5 ) ;而且孕 2 0周后观察组胎盘胎膜完全排出率 ( 3 8 8% )明显高于对照组 ( 2 0 % ) (P <0 0 5 ) .结论 :米非司酮配伍米索前列醇用于中孕引产具有安全有效、简便易行、无严重副作用的优点 ,是一种值得推广、使用的方法 .     

产科急症子宫切除术16例分析

回顾分析近12a产科急症子宫切除术16例,16例均为子宫出血,其中剖宫产13例,阴道产3例,子宫出血的主要原因是各种胎盘异常,其发生与多次流产及宫腔操作史有关,阴道产后子宫切除失血量往往多于剖宫产者,提示在产后血失代偿期经导迅速治疗处理后,子宫出血仍不能有效控制,应当机立断行子宫切除术,以挽救产妇的生命。     

新生儿硬肿症播散性血管内凝血和肺出血的研究及其临床意义

目的 :探讨不同病情硬肿症播散性血管内凝血 (DIC)的出凝血功能改变 ,为合理治疗提供理论依据。方法 :比较观察组 10 0例和对照组 5 0例 5项出凝血指标检测结果。结果 :观察组不同病情之间比较 :凝血酶原时间 ,3P试验 ,血小板计数和外周血红细胞形态无显著性差异 (P均 >0 0 5 ) ;试管法凝血时间比较 ,有显著性差异 (P <0 0 5 )。观察组与对照组 5项指标比较有非常显著性差异 (P <0 0 1)。结论 :新生儿硬肿症存在播散性血管内凝血的出凝血功能改变 ,病情越重改变越明显 ,越易合并DIC、肺出血 ,病死率也越高 ,硬肿症早期血液多呈现高凝状态 ,DIC的晚期多呈现低凝状态。早期肝素治疗 ,不仅可改变血液的出凝血状态 (高凝状态 ) ,而且是防治DIC ,肺出血 ,提高治愈率的有效途径。治疗硬肿症加强综合支持疗法 ,尤其是维持内环境稳定纠正酸中毒切不可忽视 ,否则肝素在酸性环境中灭活失效     

食管静脉曲张出血3种治疗方法的成本效果分析

目的　对比 3种疗法治疗食管静脉曲张出血 (EVB)的临床成本 /效果。方法　 98例EVB分为 3组 ,36例给予垂体后叶素 (0 .2～ 0 .4u·min-1,共 2d)联用硝苯啶 (垂体组 )、30例给予施他宁 (2 5 0 μg·h-1,共 2d) (施他宁组 ) ,32例给予硬化剂治疗 (硬化剂组 ) ,并对 3组成本和效果进行分析。结果　垂体组、施他宁组和硬化剂组 2 4h内有效止血分别为 32例 (88.89% )、2 7例 (90 .0 0 % )和 2 8例 (87.5 0 % ) ,各组间比较无显著差异 (P >0 .0 5 ) ;平均输血量垂体组与硬化剂组、施他宁组与硬化剂组间比较均差异性显著 (P <0 .0 5 ) ;3d和 7d再出血率各组间比较无明显差异 (P >0 .0 5 ) ;成本 /效果比值 (C/E)垂体组明显低于施他宁组和硬化剂组 (P <0 .0 5 )。结论　垂体后叶素联用硝苯啶不但安全有效 ,相比更经济 ,应为治疗EVB紧急止血的一线药物     

药物终止10～16周妊娠的临床研究

目的：探索终止10－16周妊娠的药物引产方法。方法：将近两年来我院妊娠10－16周的健康妇女机随分布两组,A组：42例,米非司酮50mg Tid*2d,d3晨口服米索前列醇600ug,4h一次,最多3次,B组：42例,经阴羊腔内插管注入雷夫诺尔100mg引产,结果：A组成功率为92．9％,B组成功率为76．2％,结论：口服米非司酮配米索前列醇能较好的终止10－16周妊娠。     

山区妇女绝经后阴道出血临床及病理分析

目的 对湖北省恩地区妇女绝经后阴道出血患者进行病因分析,探讨预防措施。方法 对155例绝经后阴道出血     

药物流产不全延迟处理54例临床分析

目的　探讨药物流产不全的原因及诊治方法。方法　收集药物流产后阴道出血达 1月以上而未行治疗者 ,根据B超等协助诊断 ,予以清宫后治愈。结果　 5 4例全部行清宫术 ,刮出物病检均为机化变性绒毛组织 ,部分伴炎性反应。清宫后阴道出血停止。结论　对于药物流产后阴道出血时间过长者 ,应及早明确诊断 ,及时行清宫术。     

Risk of Gastrointestinal Bleeding With Extended Use of Nonsteroidal Anti-Inflammatory Drug Analgesia After Joint Arthroplasty

BackgroundChronic nonsteroidal anti-inflammatory drug (NSAID) use is associated with gastrointestinal bleeding via inhibition of endogenous mucosal protection and platelet aggregation. This study aimed to determine whether extended NSAIDs after joint arthroplasty is associated with increased risk of gastrointestinal bleeding.MethodsThis was a retrospective study examining 28,794 adults who underwent joint arthroplasty by one of 50 surgeons from 2016 to 2018. Episodes of gastrointestinal bleeding within 90 days postoperatively were identified prospectively. Postoperative medications were reported directly by patients with electronic questionnaires. The primary analysis was performed using binary logistic regression.ResultsA total of 74 (0.26%) episodes of gastrointestinal bleeding occurred within 90 days (median 8 days) postoperatively. Of 5086 patients with complete data included in the primary analysis, 59.6% had used NSAIDs with median duration of 2 weeks (interquartile range, 0-6 weeks). Patients with gastrointestinal bleeding were significantly older (71.3 vs 67.0 years), required longer hospitalizations (2.1 vs 1.5 days), and more commonly had a history of peptic ulcers (10.8% vs 0.9%). However, there was no positive association between NSAID use and gastrointestinal bleeding. In fact, the odds of gastrointestinal bleeding were lower in patients taking NSAIDs. Gastrointestinal bleeding was associated with anticoagulants, antiplatelet agents, and, to a lesser extent, aspirin.ConclusionNSAIDs were not associated with gastrointestinal bleeding and may be prescribed safely for a majority of patients after joint arthroplasty. The greatest odds of gastrointestinal bleeding occurred in patients with peptic ulcer disease and those who received antiplatelet and anticoagulation agents. Increasing age and bilateral surgery were also associated with gastrointestinal bleeding.Level of EvidenceLevel III.