剖宫产术后硬膜外镇痛产妇血及初乳中吗啡含量的监测

目的　监测剖宫产术后硬膜外镇痛产妇血及初乳中的吗啡含量 ,探讨微量吗啡对新生儿的影响。　方法　选择剖宫产术的产妇 10 0例 ,分为实验组和对照组各 5 0例 ,两组均为连续硬膜外麻醉 ,穿刺点选择 L1 ～ L3,麻醉药为 2 %利多卡因 15～ 2 0 m l,在手术结束时 ,实验组将吗啡缓慢注入硬膜外管 2 mg然后拔管。于术后 1h取产妇的静脉血 3m l,采集产妇术后 3、6 h尿样及术毕 6～ 12 h采集新生儿尿样 3m l;在产后 4 8h内收集产妇的初乳 3～ 5 m l。　结果　观察组 96 % (48/ 5 0 )的镇痛效果较对照 16 % (8/ 5 0 )明显 ,差异有显著性 (P<0 .0 5 ) ,观察组血吗啡浓度 <5～ 118μg/ m l,初乳吗啡浓度 <5～ 30 .4μg/ L ,产妇尿 92 %呈阳性 ,新生儿尿 13.3%呈阳性。两组产妇和新生儿的生命体征比较差异无显著性。　结论　剖宫产术后硬膜外腔应用吗啡镇痛 ,产妇哺乳对新生儿没有影响 ,是安全可行的。     

警惕子宫内膜异位症

子宫内膜异位症多发生于生育年龄的妇女，以25-45岁女性居多，是引起盆腔疼痛及不孕的主要原因之一。[编者按]     

卵巢瘤样病变破裂误诊25例

<正> 卵巢瘤样病变破裂所引起的急腹症往往与宫外孕破裂、急性阑尾炎、以及妇产科其它急腹症症状相似,临床上常有误诊。术前如能明确诊断对治疗有很大帮助。现将我院近8年来收治的25例经术后病理证实的卵巢瘤样病变破裂所致急腹症进行分析与探讨。 1 临床资料 1.1 一般资料:本组25例,年龄最小16岁,最大44岁,误诊时间最长3天,最短8小时,25例均经手术后病理检查确诊,全部治愈。 1.2 临床表现:本组25例均以腹痛为首诊症状,其中突发性下腹痛17例,转移性下腹痛5例,阵发性下腹痛3例。伴随症状恶心呕吐12例,发热7例,休克3例,阴道出血2例,有停经史者7例。化验检查     

卵巢非赘生性肿瘤破裂所致急腹症32例诊断分析

卵巢非赘生性肿瘤破裂引起的急腹症往往与宫外孕破裂、急性阑尾炎,以及妇产科其他急腹症症状相似,临床上常有误诊。现将我院近8年来收治的32例经术后病理证实的卵巢非赘生性肿瘤破裂所致急腹症进行分析与探讨。     

腹腔镜子宫切除术中预防输尿管损伤方法探讨

目的:探讨腹腔镜子宫切除术中避免输尿管损伤的方法。比较3种方法处理子宫动脉的手术效果。方法:将57例患子宫良性疾病腹腔镜子宫切除术者分3组:组1:常规组。组2:膀胱镜输尿管置管组。组3:游离输尿管组。比较用3种不同方法处理子宫血管的效果及其术后情况。结果:均顺利完成手术,无术中术后并发症,手术时间组3少于组1和组2,P值=0.005,差异有显著性;术时出血量3组无显著性差异,3组术后排尿时间差异无显著性P=0.978,组2术后血尿出现率及持续时间高于1、3组,差异有统计学意义,P<0.001,术后病率亦较高,P<0.05,差异有显著性。结论:采用游离盆腔段输尿管和子宫血管的方法可有效地避免输尿管损伤,并且不增加手术时间及术中出血量。术后亦能如期恢复。但需要术者对盆腔输尿管及血管解剖熟悉并且有熟练的腹腔镜手术技巧。     

子宫更需体贴呵护

王娟红，正值中年，是一家外企的部门经理，最近3个月以来老是感到腰酸乏力，有的时候感到下腹有下坠的疼痛感，月经周期也没有以前那样规律．白带也增多了，整天头昏脑胀的，严重影响了自己的工作效率。尤其是最近一次来月经，不仅量多而且持续有半个多月。刚开始的时候，她并没有在意，以为是自己太累的原因，找了一个老中医开了几服止血，补血的药方．吃药后．血是止住了，     

腹腔镜诊治不孕症58例分析

<正> 为探讨腹腔镜在不孕症诊治的作用,本文对58例不孕症患者腹腔镜诊治结果进行分析。 1 临床资料 1.1 一般情况:我院自1994年12月至1997年12月在电视腹腔镜下对经临床诊断为不孕症的女性患者     

Chinese Medicine Improves Postoperative Quality of Life in Endometriosis Patients: A Randomized Controlled Trial

Objective:To investigate the effect of Chinese medicine(CM) and Western medicine(WM) on quality of life(QOL) after conservative surgery for endometriosis.Methods:A total of 320 patients with endometriosis were randomized into two groups by using random block design,CM group(160 cases,activating blood circulation and removing blood stasis treatment based on syndrome differentiation) and WM group(160 cases,gonadotropin-releasing hormone agonist or gestrinone treatment) after conservative surgery.Treatment was given for 3-6 months(according to the revised American Fertility Society scoring system stage),and the World Health Organization QOL-BREF(WHOQOL-BREF) was applied to patients before and after treatment to assess QOL.Results:There were 136 cases in the CM group and 141 cases in the WM group completing therapy.In the CM group,the use of the WHOQOL-BREF showed that the physical,psychological and environmental scores post- treatment were significantly higher than those at pre-treatment(P<0.05),and for 12 items(pain and discomfort, energy and fatigue,sleep and rest,mobility,activities of daily living,work capacity,negative feelings,health and social care:accessibility and quality,participation in and opportunities for recreation/leisure activities,appetite, QOL score,overall health status and QOL),the difference in scores was significant(P<0.05).In the WM group,4 items(pain and discomfort,opportunities for acquiring new information and skills,QOL score,overall health status and QOL) had significantly different scores post-treatment compared with those at pre-treatment(P<0.05).Before treatment,the QOL in the two groups of patients showed no significant difference(P>0.05).After treatment,the scores for physical health in the CM group were significantly higher than those of the WM group(P<0.05) and the scores of 4 items(mobility,activities of daily living,sexual activity,QOL score) in the CM group were significantly higher than those in the WM group(P<0.05).Conclusions:CM and WM treatment could improve the QOL of patients with endometriosis after conservative surgery.CM treatment is more effective than WM.     

腹腔镜与开腹子宫肌瘤剔除术比较

目的探讨腹腔镜与开腹子宫肌瘤剔除术的疗效及其临床应用价值。方法回顾分析2003年10月至2004年9月复兴医院妇产科收治的53例腹腔镜下子宫肌瘤剔除术和40例开腹子宫肌瘤剔除术的临床资料。结果手术均顺利完成,无术中及术后并发症。腹腔镜肌瘤剔除术后患者排尿、排气时间及术后病率均小于开腹组,开腹肌瘤剔除组的手术时间短于腹腔镜组,且其剔除肌瘤数大于腹腔镜肌瘤剔除组,差异有统计学意义(P<0.01)。结论腹腔镜下子宫肌瘤剔除术具有创伤小、恢复快等优点,是一种安全有效的手术方法,而开腹子宫肌瘤剔除术更适用于病情复杂的病例,术者应根据患者的病情正确选择手术方式。     

腹腔镜诊治不孕症58例分析

目的：通过腹腔镜明确不孕症的病因并进行相应治疗。方法：对临床确认不孕症者５８例进行腹腔镜检查及治疗,部分病例术中联合使用宫腔镜。结果：镜下确诊多囊卵巢１４例,子宫内膜异位症１８例,贫腔炎症１７例,梗阻１６例,结核２例,子宫肌瘤５例,正常盆腔１例,子宫畸形２例,宫腔粘连２例,子宫陈旧瘢痕１例。结论：腹腔镜可提高不孕症的确诊率。多囊卵巢、盆腔粘连、子宫内膜异位症等进行下治疗比开腹手术损伤小、术后恢复快。联合使用宫腔镜可同时治疗宫腔疾患。