妊娠期附件肿瘤临床分析

目的:总结妊娠期附件肿瘤的临床特征及诊治经验。方法:回顾性分析2009 年01月至2019年06月我院诊断及治疗的43例妊娠期卵巢肿瘤患者的临床资料。结果:我院10 年共收治妊娠期卵巢肿瘤患者43 例,院内检出率为1.4/1 000 次分娩。其中卵巢成熟性囊性畸胎瘤18例,卵巢浆液性囊腺瘤11例,输卵管浆液性囊腺瘤2例, 卵巢子宫内膜异位囊肿9例,卵巢sertoli leydig细胞瘤（中分化）1例,卵巢交界性黏液性囊腺瘤1例,卵巢黏液细胞癌1例。孕期常见的并发症如卵巢肿瘤蒂扭转出现的急腹症需急诊手术探查。孕期行腹腔镜手术12例,开腹手术5例,保守治疗26例。新生儿出生42 例,足月产40例,早产2例,流产1例,无不良结局。结论:妊娠合并附件肿瘤患者应警惕并发症的发生,孕期进行手术干预安全可行。     

腹腔镜与开腹手术治疗早期子宫内膜癌的临床对比分析

目的：探讨早期子宫内膜癌（ endometrial carcinoma ,EC）腹腔镜分期手术与传统开腹手术的临床疗效及应用价值。方法华西第二医院妇产科2010年1月至2012年12月收治256例早期EC手术患者,手术病理分期为IA～II期。其中腹腔镜分期手术152例（腹腔镜组）,开腹分期手术104例（开腹组）,对比分析两组术中术后情况。结果两组患者手术时间、术中清扫淋巴结数目及术后导尿管留置时间差异均无统计学意义（ P＞0.05）;而腹腔镜组术中出血量、盆腹腔引流量、术后镇痛药物使用率、肛门排气时间、术后住院时间及术后并发症发生率均明显少于开腹组,差异有统计学意义（ P＜0.05）。结论腹腔镜手术相较于开腹手术具有微创价值,是治疗早期EC有效、可行的术式。     

低危妊娠滋养细胞肿瘤化疗后月经模式的变化及生育结局的随访调查#br#

Objective?To follow up and investigate the changes in menstrual pattern and reproductive outcomes after chemotherapy for low-risk gestational trophoblastic neoplasia (LRGTN). Methods?A total of 132 LRGTN patients in our hospital were selected and received chemotherapy. According to the chemotherapy regimen, the patients were divided into the Act-D group and the EMA/CO group. The menstrual pattern changes after chemotherapy and the pregnancy status 2 years after chemotherapy were followed up. The outcome was followed up. Results?The menstrual onset of patients mostly recovered after the completion of the second course of treatment and before the start of the third course (28.03%), within 6 months after chemotherapy (31.82%), and 7~12 months after chemotherapy (30.30%). After chemotherapy, most (71.97%) patients had a decrease in menstrual blood volume, 23.48% had normal menstrual blood volume, most (68.18%) had no change in menstrual cycle, and 22.73% had shortened cycle which returned to normal within 16 months after chemotherapy. The proportion of patients without change in menstrual cycle was significantly higher in Act-D group than in EMA/CO group (P<0.05). 59 patients had the desire of fertility and 31 patients were pregnant, including 25 with full-term delivery, 4 with premature infants (all conceived at 1 year after the end of chemotherapy), and 2 with induced labor (conceived within 1 year after the end of chemotherapy). There was no significant difference in pregnancy rate and pregnancy outcomes between the two groups (P>0.05). Conclusions?Most patients with LRGTN regain menstruation within 1 year after chemotherapy, and menstrual blood volume reduction is more common. EMA/CO chemotherapy has a greater impact on menstrual cycle than Act-D chemotherapy, but the reproductive outcomes are good.     

成都市608名社区妇女宫颈癌认知、态度、行为调查

目的了解成都市部分社区妇女对于宫颈癌知识的认知、态度、行为(KAP)及相关影响因素,为成都市社区妇女宫颈癌健康教育提供依据。方法抽取成都市6个社区妇女共计654例,采用自制问卷进行调查,有效问卷608例,应用SPSS13.0软件统计处理。结果 608例调查对象中仅有27.3%知晓HPV(人类乳头瘤病毒)感染是宫颈癌的高危因素,87.3%认为宫颈癌可以预防;85.2%认为有性生活的妇女应该每年做妇科检查;66.6%曾主动了解过宫颈癌相关知识;22.2%参加过宫颈癌筛查。调查对象宫颈癌知识得分偏低,为(13.82±3.401)(-8～10)分;单因素分析显示不同经济状况、文化程度、年龄、职业、单位体检是否包括宫颈癌筛查以及是否参加过宫颈癌筛查等组间得分差异有统计学意义(P﹤0.05);多元线性回归显示,对得分影响最大的变量从大到小依次为:单位体检中是否包括妇科检查、务农、经济状况、是否参加过宫颈癌筛查、文化程度、企事业单位员工及年龄。结论调查对象对宫颈癌的认知程度偏低,特别是对宫颈癌筛查相关知识、HPV与宫颈癌的关系了解不全面;有预防宫颈癌的意识,但缺乏实际行动。     

低危妊娠滋养细胞肿瘤化疗后月经模式的变化及生育结局的随访调查CSCD

目的 随访调查低危妊娠滋养细胞肿瘤(LRGTN)化疗后月经模式变化情况及其生育结局。方法 选取2015年8月至2018年8月中国人民解放军空军军医大学第一附属医院收治的132例LRGTN患者,均接受化疗,按照化疗方案,将患者分为Act-D组与EMA/CO组,随访调查患者化疗后月经模式变化及化疗后2年妊娠情况,并对其妊娠结局进行跟踪调查。结果 患者月经来潮大多恢复于第2疗程完成至第3疗程开始前(28.03%)、化疗后6个月内(31.82%)、化疗后第7~12个月(30.30%);患者化疗后大多数(71.97%)出现过月经量减少,月经量正常占23.48%,大部分患者(68.18%)月经周期无变化,周期缩短占22.73%,于化疗后16个月内全部恢复正常;Act-D组月经周期无变化患者比例明显高于EMA/CO组(P <0.05);59例有生育要求,最终31例获得妊娠,其中有25例足月分娩与4例早产儿(均在化疗结束1年后受孕),2例引产(在化疗结束1年内受孕);两组妊娠率及妊娠结局比较差异均无统计学意义(P>0.05)。结论 绝大部分LRGTN患者月经会在化疗后1年内复潮,月经量减少较为常见,EMA/CO化疗较Act-D化疗对患者月经周期影响较大,生育结局均良好。