自然流产患者蜕膜组织中TNF-α,MMP-9的表达

目的通过检测自然流产患者蜕膜组织中TNF-α,MMP-9表达,探讨二者与自然流产发生的关系。方法采用免疫组化SABC法测定30例自然流产与20例同期正常早孕要求行人工流产患者蜕膜组织中TNF-α,MMP-9的表达。结果流产组蜕膜组织中TNF-α,MMP-9阳性表达率分别为86.7%,83.3%,高于对照组(13.3%,P=0.006;16.7%,P=0.005),两组蜕膜组织中二者的表达有显著性差异,P0.05。结论自然流产患者蜕膜组织中TNF-α,MMP-9的表达增高,提示TNF-α,MMP-9在自然流产的发生中起重要作用。     

自制新型自动式扩张钳在会阴缝合中的应用效果研究

目的:探讨我院自行设计的一种新型自动式扩张钳在妊娠会阴切开缝合手术中的应用效果。方法:选取2011年5月~2012年4月我院行会阴左侧切开缝合手术产妇380例为研究对象,随机等分为试验组与对照组,对照组采用传统会阴缝合法;试验组应用我院自制新型自动式扩张钳撑开阴道进行会阴缝合。结果:两组产妇会阴切口愈合情况、切口缝合时间、切口疼痛持续时间、产后坐起哺乳时间和住院时间比较差异具有统计学意义(P0.05)。结论:采用新型自动式扩张钳行会阴切口缝合有利于缩短缝合时间,减轻产妇术后早期疼痛,缩短产妇产后坐起哺乳时间,值得临床推广应用。     

宫颈捆扎联合X形子宫缝扎术治疗剖宫产产后出血的研究

目的：探讨剖宫产术中宫颈捆扎联合X形子宫缝扎术治疗剖宫产产后出血的效果。方法：将40例剖宫产术中发生产后出血的患者随机分为实验组（20例）和对照组（20例）。实验组行宫颈捆扎联合X形子宫缝扎术;对照组行＂8＂字缝合,结扎双侧子宫动脉,宫腔填塞纱条。结果：实验组在平均出血量、平均手术时间、子宫切除、产褥病率方面明显优于对照组,差异有高度统计学意义（P〈0.01）;两组无一例因血液循环不良或再出血而行二次手术或子宫切除。结论：宫颈捆扎联合X形子宫缝扎术具有操作简单、止血迅速、安全易行等优点,治疗剖宫产产后出血效果显著。     

血清可溶性晚期糖基化终末产物受体水平与妊娠期高血压疾病的相关性研究

目的 探讨妊娠期高血压疾病患者血清可溶性晚期糖基化终末产物受体(sRAGE)水平变化,分析sRAGE水平变化与妊娠期高血压疾病的关系.方法 HE染色并在光镜下观察妊娠期高血压疾病孕妇胎盘组织的病理特征;采用双抗体夹心酶联免疫吸附法检测75例妊娠期高血压疾病孕妇(包括33例妊娠期高血压和42例子痫前期)及55例正常孕妇血清sRAGE水平.结果 HE染色可见妊娠期高血压疾病孕妇胎盘细胞滋养细胞增生,合体滋养细胞结节增多,基底膜增厚,基底纤维素样坏死,绒毛间质水肿,绒毛内血管减少,蜕膜组织内螺旋动脉管壁增厚,管腔狭窄,蜕膜组织可见纤维素样坏死和炎细胞浸润.妊娠期高血压疾病孕妇血清8RAGE水平[(287.6土36.5)ng/L]明显低于正常孕妇[(312.8±53.7)ng/L](P<0.01),子痫前期孕妇血清sRAGE水平[(281.9±19.7)ng/L]明显低于妊娠期高血压孕妇[(293.6±20.3)ng/L](P<0.05).结论 HE染色病理诊断证实妊娠期高血压疾病存在血管内皮细胞损伤.妊娠期高血压疾病孕妇血清sRAGE水平明显降低,可能参与了妊娠期高血压疾病血管内皮损伤的病理生理过程,测定血清sRAGE水平有可能作为预测妊娠期高血压疾病的临床指标之一.

Abstract：

Objective To investigate the changes of serum soluble receptor for advanced glycation end products(sRAGE)in patients with hypertensive disorder in pregnancy,and analyze the relationship between serum sRAGE and hypertensive disorder in pregnancy.Methods Seventy-five patients with hypertensive disorder in pregnancy including 33 gestational hypertension cases and 42 eclampsism cases,55 normal control were selected.Morphologic changes of placenta were analyzed by means of HE staining.ELISA method was used to determine the level of serum sRAGE.Results Placentomes of cytotrophoblastic cells,nodule of syneytiotrophoblast,thickening of basement membrane,fibrinoid necrosis,villus interstitial edema,reduction in vascularity of villus were much more frequently seen in hypertensive disorder in pregnancy.There were also fabric hyperplasy of hehcine artery,narrow lumina,fibrinoid neerosi and inflammatory cell infiltrating in the uterine decidua in hypertensive disorder in pregnancy.The level of serum sRAGE was significantly decreased in patients with hypertensive disorder in pregnancy[(287.6±36.5)ng/L]when compared with normal controls[(312.8±53.7)ng/L](P<0.01).In hypertensive disorder in pregnancy,the level of serum sRAGE in patients accompanied with eclampsism[(281.9±19.7)ng/L]was lower than that in patients accompanied with gestational hypertension[(293.6±20.3)ng/L](P<0.05).Conclusions HE staining of the placenta showed vascular endothelial damage is the pathogenic basis of hypertensive disorder in pregnancy.The level of serum sRAGE is significantly decreased in patients with hypertensive disorder in pregnancy,it may be contributed to the pathogenesis and development of hypertensive disorder in pregnancy.The level of serum sRAGE may be helpful in predicting hypertensive disorder in pregnancy.     

欣母沛、葡萄糖酸钙和缩宫素联合预防剖宫产产后出血疗效观察

目的探讨欣母沛、10%葡萄糖酸钙和缩宫素联合应用预防剖宫产产后出血的效果。方法选取394例剖宫产患者随机分为3组,缩宫素组110例,卡孕栓组138例,欣母沛联合10%葡萄糖酸钙及缩宫素组（以下简称联合组）146例。测量各组剖宫产术中、术后2小时内及术后2～24小时出血量,分析各组之间的差异。结果测得剖宫产术中出血,缩宫素组（312.52±50.24）ml,卡孕栓组（270.38±72.15）ml,联合组（220.46±45.52）ml,联合组剖宫产术中出血量明显少于缩宫素组和卡孕栓组（P〈0.05）;测得剖宫产术后2小时内出血量,缩宫素组（183.36±47.53）ml,卡孕栓组（157.24±60.43）ml,联合组（103.35±72.54）ml,联合组剖宫产术后2小时内出血量明显少于缩宫素组和卡孕栓组（P〈0.05）;测得剖宫产术后2～24小时出血量,缩宫素组（96.21±45.53）ml,卡孕栓组（75.68±60.43）ml,联合组（68.57±72.58）ml,联合组剖宫产术后2～24小时出血量明显少于缩宫素组和卡孕栓组（P〈0.05）。结论欣母沛联合10%葡萄糖酸钙及缩宫素能更好地预防剖宫产术中及术后出血,且用药方便、安全、有效。