读祖国近世产科專著“达生篇”后的体会

“达生篇”是清康熙乙未年間(公元1715年),亟齋居士所著(朱顏氏在其所著“祖国古代在妇产科学方面的成就”一文中称“清代祁道九著“达生篇”)乃祖国近世产科之專書,流行至为广泛。其內容包括上下兩篇。上篇(上(巾夫)有原生、临产、試痛諸項,并附驗案。下篇(下(巾夫))有保胎,飲食,小产,产后,胎死腹中,胞衣不下,乳少諸項,并附格言,方药。讀后,首先感到古人对于“生产”是一种正常的生理机轉已有明确的認識,如原生項所謂:“生也者,天地自然之理。如目視而耳听,手持而足行,至平至易。”但同时又提出“然今之世,往往以难产聞者,得无以人事之失而損其天耶?!”則亦充分認識到处理不适当,对于产妇所造成的損害。     

应用阴道细胞学检查选择中医驗方治疗經閉的初步报告(附16例分析)

本文报告应用阴道细胞学检查选用中医验方及针刺疗法治疗经闭16例,其疗效达87.5％,并简单介绍祖国医学对月经,经闭的认识及其治疗原则。     

宫内节育器带尾丝与否对宫腔感染的影响

为了解宫内节育器(IUD)带尾丝与否对宫腔感染的影响,对51例放置宫内节育器者分带与不带尾丝二组进行了置器前后宫颈及宫腔分泌物的细菌学检查,共取标本314份,结果宫腔无1例细菌感染,表明健康妇女使用IUD(包括带尾丝者)避孕是安全的。     

OVIDUCT OCCLUSION BY INTRALUMINAL THREAD AND SILVER CLIPS

100 women ranging in age from 26-34 years were followed up for 4-21 months after undergoing sterilization by tubal occlusion using intraluminal threads and silver clips. The number of children/woman ranged from 1-5 with 80% having 2. 31 women underwent sterilization postmenstrually, 11 midmenstrually, 28 premenstrually, 12 after abortion, and 8 during lactation. The timing was unknown in 8 cases. The silver clips used were hook eye "db" shaped, 3 mm wide, .5 mm thick, and 70, 100, or 150 mg in weight. Local anesthesia, suprapubic small abdominal incision, and oviduct delivery were the usual procedures. The clips were placed where the tube is relatively straight and avascular, often near the isthmus or ampulla. No. 4 nylon thread was drawn through the tube and a silver clip was put on each tube and tightened until the threads could no longer be moved. The extra thread was snipped off about 3 mm from the clip. There were no pregnancies among 95 patients followed up. 18 patients had varying degrees of lumbago or leg pain and 1 complained of serious lower abdominal pain, especially after coitus. Pelvic examination in 74 patients showed 1 case of slight thickening in the right appendix region but no pelvic masses. Hysterosalpingography in 22 patients showed 1 case with incomplete occlusion on 1 side. The method is believed to be safe and suitable for use in smaller hospitals and outpatients. Reversibility has been demonstrated in rabbits.     

宫内节育器作用机制的动物实验研究

取四种异物(不锈钢、塑料、铜丝、硅胶)置于兔子宫内,观察异物对胚泡着床、宫腔内环境及子宫内膜局部组织的形态学的影响。结果:(1)凡四种不同异物所在处均无胚泡着床,(2)子宫腔洗液中蛋白氮、白细胞计数及其分类、免疫反应与血凝因子的变化无统计学意义,但发现蛋白氮含量与中性粒细胞成正相关;(3)经显微镜、扫描电镜、透射电镜观察,见内膜表面腺体的分泌物增多,形成之屏障覆盖于内膜表面。内膜表面有糜烂及溃疡面,并伴有白细胞浸润;(4)偶见内膜坏死、出血。提示异物抗生育的作用在于阻碍胚泡着床,而影响胚泡着床的原因则在于异物对局部引起的机械性压迫或刺激的组织反应。     

IUD对兔子宫胞液雌二醇受体和孕酮受体的影响

本实验观察了家兔子宫内放置两种IUD(不锈钢丝和铜丝制成)后子宫胞液雌二醇受体和孕酮受体(ER,PR)的变化,结果表明,增殖期ER和对PR无明显变化,而分泌期ER和PR在放置IUD以后则明显减少。以上结果提示,IUD的抗生育作用与分泌期,特别是着床前子宫胞液ER和PR的功能受到干扰可能有密切关系。     

ONO—802阴道栓剂在人流手术中扩张宫颈的效果观察

<正> 人工流产为节育的有效补救措施,传统采用硬性器械扩张宫颈时,虽大多能见效,但易导致宫颈内膜损伤,甚者宫颈裂伤,在目前尚无理想麻醉的情况下,不能防止受术者的痛苦。日本小野药品工业公司合成的前列腺素(PGE),衍生物Preglandin阴道栓剂(即ONO—802)具有使子宫收缩与宫颈管扩张的作用,可作为人工流产器械手术的辅助手段(1)本文介紹应用ONO—802对人工流产术时宫颈扩张的效果观察。     

轮廓胎盘及有缘胎盘

本文介绍轮廓胎盘及有缘胎盘118例临床分析,其发生率占住院分娩人数1.04%。介绍了临床现象,在讨论中对其形成原因略加阐述。值得提出的是本材料中有5例重复出现轮廓胎盘。     

对几种晚期人工流产(中期妊娠引产)方法的评价

目前,国内、外选用中期妊娠引产的方法很多,但各有利弊,现仅就常用者分述如下(操作部分略)。     

341例避孕环(宫內避孕器)临床观察

本人就我院資料結合文献分析討論子宫内避孕器之效果及其作用机制的目前理論。本组病例避孕环效果为96.67％,与一般相仿,但其环存在率较文献报导为差,主要为子宫内避孕环选用不适合及随防不够所致。建议今后在这方面须注意研究,在供应上应注意环的質料及大小。置环后的影响迄至目前观察并不显著,即使再孕,亦不致损害胎儿发育。但仍宜加强科研,对已提出之并发症情况,了解其因果或偶合关系,至于环之存在时間应视环之質料与大小是否适合(是否产生症状)而定。目前应用我国市售品(金属)以不超过三年为宜。最后認为子宫内避孕器适合我国广大妇女需要,尤其适合农村妇女应用,但必须做好宣传工作,并切实做到技术下放,为支援农业、促进社会主义建設事业,提供力量。