功能失调性子宫出血应用子宫内膜诊刮术结合心理干预的疗效评价研究

目的探讨功能失调性子宫出血应用子宫内膜诊刮术结合心理干预的方法及效果。方法将2012年4月至2013年4月我院收治的功能失调性子宫出血患者62例,随机分为观察组31例(子宫内膜诊刮术结合心理干预)和对照组31例(单纯子宫内膜诊刮术),对两组的效果进行对比。结果两组的治愈率、复发率相比差异均具有显著性(P<0.05)。观察组患者治疗依从为28例(90.32%),对照组为19例(61.29%),两组的治疗依从性相比差异具有显著性(P<0.05)。结论功能失调性子宫出血应用子宫内膜诊刮术时有效的心理干预可以缓解患者心理状况,配合治疗和护理,促进康复。     

盐酸米诺环素软膏治疗慢性牙周炎的临床疗效分析

目的探讨盐酸米诺环素软膏治疗慢性牙周炎的临床疗效。方法选择于2011年11月至2012年11月在我院口腔门诊治疗的慢性牙周炎患者150例,将其分为观察组和对照组,每组75例,观察组采用常规治疗手段并辅用盐酸米诺软膏治疗,对照组给予常规治疗,观察对比两组患者的临床治疗效果。结果两组治疗后的菌斑指数(PLI)、牙周袋探诊深度(PD)、牙龈出血指数(SBI)与治疗前相比,均有明显改善,实验组改善程度更为明显(P<0.05)。结论使用常规治疗手段并辅以盐酸米诺环素软膏,对慢性牙周炎治疗效果明显,值得临床推广。     

剖宫产切口部位妊娠的治疗方法探讨

目的：探讨子宫动脉化学治疗栓塞术（uterine artery chemoembolization,UACE）联合清宫术（dilatation and curettage,D＆C）和静脉注射甲氨蝶呤（methotrexate,MTX）联合D＆C2种方法在治疗剖宫产切口部位妊娠（cesarean scar pregnancy,CSP）中的效果及适用情况。方法：回顾分析95例CSP患者的临床资料,其中75例患者采用UACE,术后行超声监护下D＆C（A组）;另20例患者采用MTX静脉用药,术后行超声监护下D＆C（B组）。比较2组患者住院天数、住院费用、术中出血量、胚囊大小变化、胚囊血流阻力指数（resistance index,RI）变化及相关的不良反应。结果：2组患者均取得良好的治疗效果。2组患者在住院天数、D＆C术中出血量方面的差异无统计学意义,但A组住院费用高于B组（P〈0.05）。A组、B组治疗后血β-人绒毛膜性腺激素（β-human chorionic gonadotropin,β-HCG）较治疗前显著降低（P〈0.01）,治疗后B组血β-HCG较A组高（P〈0.05）。治疗前A组胚囊大小显著大于B组（P〈0.01）;A组患者行UACE后RI较治疗前显著升高（P〈0.01）,B组患者行静脉MTX治疗后RI无明显变化。2组患者治疗后胚囊大小治疗前较均有所增大,但差异无统计学意义。A组患者术后发热率为60%。结论：UACE＋D＆C及MTX＋D＆C均能有效治疗CSP,对于胚囊较大者宜采用UACE＋D＆C;对于胚囊较小者可采用MTX＋D＆C,在取得满意疗效的同时可节省医疗费用。     

一例瘢痕妊娠行子宫动脉栓塞术后即行清宫术的护理

剖宫产子宫瘢痕妊娠(CSP)是指胚胎种植于子宫下段剖宫产复旧后子宫峡部瘢痕处的一种特殊而罕见的异位妊娠.一旦明确诊断,应立即选择适当的方法终止妊娠,以避免出现难以控制的阴道大出血.子宫动脉栓塞术( UAE)治疗子宫切口瘢痕妊娠具有安全性高、并发症少、止血迅速、恢复快且微创等优点,既保留了子宫的完整性,又保留其生育功能[1].我院于2011年9月对1例剖宫产后瘢痕妊娠患者,行子宫动脉栓塞术后即行清宫术治疗,经精心护理,效果满意.现将围术期护理体会报告如下.     

月经过多诊刮后置曼月乐的疗效价值

目的:探讨月经过多诊刮后置曼月乐的疗效价值。方法:2008年6月～2009年10月在两家医疗机构选择有排卵型月经过多患者90例,接受3种治疗方式,对所有病例治疗后进行为期1年的随访,记录其治疗效果。结果:共71例有随访结果,其中接受诊断性刮宫同时置入曼月乐(A组)、月经第4～7天直接置入曼月乐(B组)、单纯诊断性刮宫(C组)3种方式的患者分别为24、22、25例。PBAC评分在第1、2、3、6、12月3组差异均有统计学意义(P<0.05);血红蛋白在第1、2、3、6月差异无统计学意义,12月则显示差异有统计学意义(P<0.05)。点滴状出血发生率在第1、2、3、6月3组间差异均有统计学意义,B组的发生率一直最高,A组次之,C组发生率最低。结论:曼月乐治疗有排卵型月经过多可有效减少月经量,提高血红蛋白且患者满意度较好。结合诊断性刮宫可准确诊断导致月经过多的器质性病变,值得在临床推广。     

A practical guide to the evaluation of benign endometrial conditions in biopsy and curettage material

Sampling of the endometrium, via biopsy or dilation and curettage, is an important diagnostic tool in a wide variety of clinical scenarios, ranging from infertility and abnormal uterine bleeding to cancer surveillance in high-risk populations. This review describes the most common methods for endometrial sampling used currently and discusses the issue of specimen adequacy from an evidence-based perspective. It also focuses on select benign conditions involving the endometrium in the setting of abnormal uterine bleeding, ranging from anatomic/structural lesions to patterns indicative of a dysfunctional menstrual cycle. The topic of endometrial sampling evaluation in the context of recurrent pregnancy loss is also discussed, with insights on documentation of endometrial changes during the ovulatory phase and the diagnosis of endometritis.     

A prospective randomized control trial comparing medical and surgical treatment for early pregnancy failure

A prospective randomized control trial was designed to assess the effectiveness of single dose, 800 microg misoprostol administered p.v. compared with surgical evacuation for the treatment of early pregnancy failure. A total of 80 women with a diagnosis of early pregnancy failure were randomized to study (vaginal misoprostol) and control (surgical curettage) groups. Success of treatment, side-effects as assessed during, immediately after and 10 days after treatment, and patient satisfaction were compared. Intravaginal misoprostol was successful in 82.5% (33 out of 40) of the patients. None of the control group patients required a repeat evacuation. The number of patients who experienced significant abdominal pain following treatment did not differ between the groups. The duration of pain was shorter in the control group; however, they required more analgesics during this short period. The number of patients with significant vaginal bleeding, the duration or severity of bleeding did not show any significant difference between the groups. All 33 patients in the study group who had successful treatment expressed satisfaction, whereas only 58% of the control group did so. In conclusion this randomized control study demonstrated the efficacy and safety of the administration of 800 microg of misoprostol p.v. for the management of early pregnancy failure.     

术前子宫内膜癌分段诊刮和B超诊断

目的 :评估分段诊刮和B超诊断子宫肌层受侵在处理子宫内膜癌中的价值。方法 :对 2 10例子宫内膜癌术前分段诊刮标本和术后子宫切除标本行病理检查并进行比较分析 ,同时B超检查子宫肌层受侵情况与术后病理对照。结果 :分段诊刮 2 10例中 16 2例临床诊断宫颈受侵 ,术后病理证实其中的 12 4例受侵。临床诊断符合率76 .5 4 % ,假阳性率 2 3.4 6 %。B超显示肌层受侵 4 8例 ,术后病理证实 4 6例 ,符合率 95 .83%。结论 :分段诊刮有局限性。必要时术中冰冻切片予以纠正。B超诊断子宫内膜癌肌层受侵 ,准确率高 ,经济、实用。术前制定子宫内膜癌治疗方案 ,特别是拟行腹膜后淋巴结清扫时 ,应将分段诊刮和B超诊断结合起来考虑更为合理     

The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus

BACKGROUND, AIMS: This study was designed to explore the effect of periodontal therapy on glycemic control in persons with type 2 diabetes mellitus (DM). METHODS: 36 patients with type 2 DM (treatment group) received therapy for adult periodontitis during an 18-month period. A 36-person control group was randomly selected from the same population of persons with type 2 DM who did not receive periodontal treatment. RESULTS: These groups were well matched for most of the parameters investigated. During the nine-month observation period, there was a 6.7% improvement in glycemic control in the control group when compared to a 17.1% improvement in the treatment group, a statistically significant difference. Several parameters that could confound or moderate this glycemic control were explored. These included the treatment of non-dental infections, weight and medication changes. No moderating effect was associated with any of these variables. However, there were too few subjects in the study to have the statistical power necessary to assess these possible moderators of glycemic control. CONCLUSIONS: We interpret the data in the study to suggest that periodontal therapy was associated with improved glycemic control in persons with type 2 DM.