改良盆底重建术应用于女性盆底脱垂效果分析

目的评价改良盆底重建术和经阴全子宫切除（TVH）＋阴道前后壁修补术治疗盆腔脏器脱垂的临床效果。方法研究组40例,包括研究1组（TVH＋改良盆底重建术）20例,研究2组单行改良盆底重建术10例,研究3组（子宫切除术后POP行改良盆底重建术）10例;对照组40例。结果①手术时间、术中出血量、平均住院时间,术后保留尿管时间及术后并发症发生率研究1组与对照组无明显差异（P〉0．05）;②术后临床疗效比较：4组患者出院前测评POPQ,分度均为。度或Ⅰ度。术后对照组阴道长度较术前明显缩短,研究组阴道长度则较术前无明显变化（P〈0．05）随访：研究组1例,复发率为2．5％,对照组4例复发（10％）,（P〈0．05）;研究组3例出现性交不适,对照组7例诉性生活质量下降（P〈0．05）。结论改良的盆底重建术是治疗盆腔脏器脱垂的有效术式,加强盆底组织,手术简单、安全、微创。     

改良盆底重建术应用于女性盆底脱垂效果分析

Objective TO investigate the clinical results of improved pelvic floor reconstruction and TVH add vaginal anterior and posterior wall repair. Methods The study group including the first group consist of 20 TVH add improved pelvic floor reconstruction, the second group consist of 10 improved pelvic floor reconstruction and the third group consist of 10 improved pelvic floor reconstruction after hysterectomy. And 40 in the contrast group. Results ①The first group has no significant difference with the contrast group in operation time, blood loosing, hospital time, postoperative catheter retention time, and complication rate. ②The POP-Q indexings of 4 groups are all 0-1 degrees. The vaginal length of the contrast group are shortening preoperative to postoperative. But the study group has no significant difference. Following The first study group has 1 recurrence with the rate 2.5%,and the contrast group has 4 recurence with the rate 10%. There are 3 patients in study group with sexing discomfort and 7 in contrast group. Conclusion The improved pelvic floor reconstruction is the effective surgical method to treat pelvic organ prolapse which can strengthen the pelvic organ. The method is simple, safe and invasive.     

PF方案新辅助化疗治疗巨块型宫颈癌30例分析

目的：探讨术前PF方案新辅助化疗对巨块型宫颈癌的近期疗效。方法：我院经病理确诊的30例Ⅰb2～Ⅱb期巨块型宫颈癌，采用PF方案动脉化疗1疗程后手术，观察近期疗效。结果：术前新辅助化疗可提高手术切除率，对腺癌和鳞癌的有效率基本相同。结论：术前新辅助化疗可提高巨块型宫颈癌的近期疗效；PF方案对腺癌的有效率较高，具有重要的临床意义。     

米非司酮联合利凡诺尔及小水囊用于瘢痕子宫中期引产效果分析

目的观察有剖宫产史妇女中期妊娠引产中应用米非司酮联合利凡诺尔及小水囊方法的安全性与有效性。方法选择妊娠10-16周有剖宫产史孕妇160例,B超提示子宫瘢痕愈合良好,其中A组80例采用米非司酮与利凡诺尔联合较小水囊宫腔内羊膜腔外引产方法;B组80例采用米非司酮联合利凡诺尔羊膜腔内注射方法终止妊娠,观察两组的引产效果及安全性。结果A组从引产至分娩时间（引流产时间）、总产程明显短于B组（P〈0．05）;24h流产率远高于B组;产时出血量及产后2h出血量A、B两组间差异无统计学意义（P〉0．05）;术后病率两组间差异无统计学意义（P〉0．05）,两组均未见子宫破裂、宫颈裂伤等并发症发生。结论米非司酮联合利凡诺尔及较小水囊用于愈合良好的瘢痕子宫中期妊娠引产安全有效。     

诊断性刮宫术在早期异位妊娠诊断中的作用

目的 探讨诊断性刮宫术对临床早期异位妊娠患者诊断的作用,以协助异位妊娠的诊治.方法 对于临床就诊的早期可疑异位妊娠患者,近期无生育要求的,在丙泊酚静脉麻醉下行诊断性刮宫术.术后行HE染色病理检查,根据患者病理情况确诊异位妊娠者,根据血β-HCG行MTX治疗或观察随访.结果 病理诊断早孕5例,葡萄胎1例,异位妊娠62例;早期异位妊娠患者经保守治疗及观察,仅3例出现了异位妊娠破裂,手术治疗,有生育要求的2例患者保留了生育功能,出血均少于400 ml.结论 诊断性刮宫术在早期异位妊娠诊断中是一项操作简便、微创、费用低廉的操作,易于掌握,尤其在基层医院值得推广.     

瘢痕子宫中期妊娠引产3种方法比较

目的探讨终止瘢痕子宫中期妊娠的最佳方法。方法60例瘢痕子宫妊娠14～28周患者随机分3组,分别采用利凡诺羊膜腔注射,利凡诺配伍米非司酮及米非司酮配伍米索前列醇3种方法,观察流产时间、清宫率及阴道流血量。结果米非司酮配伍利凡诺流产时间短,清宫率低（P〈0.01）,阴道流血量少（P〈0.01）。结论米非司酮配伍利凡诺用于终止14～28周瘢痕子宫中期妊娠疗效好,可减少宫腔手术,患者痛苦小,对机体损伤轻、恢复快。     

14卷6期疑难病案讨论选登

一、诊断：双子宫畸形,阴道斜隔。二、诊断分析：阴道斜隔为阴道发育异常的一种,多伴有双子宫双宫颈畸形。隔膜起于两个宫颈之间,向远侧端偏离中线斜行,与阴道外侧壁融合,形成一侧阴道腔为盲端。隔膜完全闭锁,隔后的子宫与外界及对侧子宫完全隔离,经血积聚在隔后的...     

恶性滋养细胞肿瘤误诊30例分析

恶性滋养细胞肿瘤主要包括侵蚀性葡萄胎及绒毛膜癌，可通过血液转移到全身，依次为肺、阴道、脑及肝等。由于其多与妊娠有关且临床表现复杂多样，极易误诊。正确及时的诊断处理，对提高患者生活质量，改善预后具有十分重要的价值。现就14a中收治的经临床及病理确诊的侵蚀性葡萄胎及绒毛膜癌患者中误诊的30例做一分析。报告如下：     

改良盆底重建术应用于女性盆底脱垂效果分析

Objective TO investigate the clinical results of improved pelvic floor reconstruction and TVH add vaginal anterior and posterior wall repair. Methods The study group including the first group consist of 20 TVH add improved pelvic floor reconstruction, the second group consist of 10 improved pelvic floor reconstruction and the third group consist of 10 improved pelvic floor reconstruction after hysterectomy. And 40 in the contrast group. Results ①The first group has no significant difference with the contrast group in operation time, blood loosing, hospital time, postoperative catheter retention time, and complication rate. ②The POP-Q indexings of 4 groups are all 0-1 degrees. The vaginal length of the contrast group are shortening preoperative to postoperative. But the study group has no significant difference. Following The first study group has 1 recurrence with the rate 2.5%,and the contrast group has 4 recurence with the rate 10%. There are 3 patients in study group with sexing discomfort and 7 in contrast group. Conclusion The improved pelvic floor reconstruction is the effective surgical method to treat pelvic organ prolapse which can strengthen the pelvic organ. The method is simple, safe and invasive.