新生儿硬肿症169例病因分析

<正> 我院新生儿病房近6年共收治新生儿硬肿症169例,现将其病因加以分析,以提供临床参考。1.临床资料1.1 一般资料 1996年1月至2001年5月共收治新生儿1856例,其中硬肿症169例,发生率为9％,以早产儿最多,占70.4％,发病时间从生后2小时至20天,以生后3天最多(94％),其中生后24小时内占60.9％,硬肿程度:轻度136例(80.5％),中度26例(15.6％),重度7例(3.9％),寒冷季节发病率为10.     

PICC在重度慢性阻塞性肺疾病患者的应用及护理

目的 探讨外周静脉穿刺置入中心静脉导管在重度慢性阻塞性肺疾病患者中的应用及观察有效护理方法.方法 选取我院住院重度慢性阻塞性肺疾病患者为研究对象,每组各100例,使用PICC途径的为A组,使用外周静脉留置针的为B组.A组采用PICC技术置管的护理方法;B组采用外周静脉留置针置管的护理方法.比较两组患者的并发症、置管时间等情况.结果 A组一次性穿刺成功90例（90％）,平均置管操作时间为（23.8±6.6）min,B组一次性穿刺成功92例（92％）,平均置管操作时间为（5.5±2.8）min.主要并发症如静脉炎、感染、导管阻塞、导管脱落等,A组6例（6％）出现并发症,B组13例（13％）出现并发症.A组留管时间为（12±1.5）天,B组留管时间为（5±1.0）天.结论 PICC在重度慢性阻塞性肺疾病患者置管中具有较高的成功率,可有效减少穿刺并发症的发生率,值得临床应用.     

辨证治疗产后恶露不绝52例

辨证治疗产后恶露不绝５２例浦城县医院（３５３４００）陈成妹福建省计划生育科研所（３５００１１）梁梅英１９９０年至１９９４年我们对５２例产后恶露不绝的患者采用中药治疗，疗效满意。现整理总结如下：１临床资料本组均为产后３周以上，恶露时多时少，淋漓不断的门...     

大Y染色体核型与生育异常的关系分析

目的分析大Y染色体核型与生育异常之间的关系。方法外周血淋巴细胞G显带技术检查生育异常男性患者除外染色体异常核型者474例，并与同期查体核型为46，XY的112例正常男性为对照组。结果共检出137例大Y染色体核型，发生率依次为少弱精患者41．67％、无精症患者36．84％、配偶孕早期胎停育患者27．76％、配偶不良分娩结局患者14．29％；与正常对照组发生率8．93％相比，前三种差异有显著性。结论大Y染色体核型与精子生成和配偶孕早期胎停育发生有关。     

新生儿硬肿症69例发生及发展原因分析

本文重点讨论新生儿硬肿症发生及发展,强调预防早产、窒息和低体温,防治感染和出血,降低本病的发生率。     

FISH技术在先天畸形胎儿基因诊断中的应用探讨

目的应用荧光原位杂交技术（FISH）研究先天畸形胎儿中先心病相关基因的表达缺失率。方法选取在北京大学人民医院产前诊断为胎儿先天畸形病例31例，其中心血管畸形16例，非心血管畸形15例。产前经脐带血穿刺留取胎儿血。选取同期正常新生儿12例作为对照组，分娩时留取脐血。应用间期FISH方法，检测畸形胎儿及正常新生儿的TUPLE1基因表达缺失率。结果正常新生儿组与先天畸形胎儿组TUPLE1基因表达缺失率分别为0％和35．48％，两组相比较差异有显著性（P〈0．05）。心血管畸形与非心血管畸形胎儿组的TUPLE1基因表达缺失率分别为43．75％及26．67％，两组比较，差异无显著性（P〉0．05）。结论TUPLE1基因因素是胎儿先天性畸形的重要病因。     

北京地区52例女性不孕不育患者染色体核型及临床分析

目的对809例女性不孕不育患者进行染色体核型及临床分析,探讨染色体畸变与表型的效应关系,分析女性不孕不育患者染色体异常检出率及异常类型和频率分布。方法外周血淋巴细胞培养,常规染色体G显带400带分析。结果809例女性不孕不育患者中52例存在染色体核型异常,其中常染色体结构异常35例,占67．31％;性染色体数目异常12例,占23．07％;性染色体结构或功能异常5例,占9．62％。52例患者反复自然流产、多次胎停育29例,占55．77％,畸形儿分娩史6例,占11．54％,女性生殖器发育不全17例,占32．69％。其染色体异常涉及3、4、6、7、8、9、10、13、14、15、21、22和X、Y等。结论染色体畸变是不育的重要因素,久治不愈的不孕不育患者应检查染色体以排除染色体畸变的可能。     

46,XX,t（4;6）携带者3次流产一例

病例：女，30岁，汉族。结婚两年流产3次。3胎均在70天左右，无诱因流产。夫妇非近亲婚配，孕期无患病及有毒、有害接触史。家族中无类似病史。     

妊娠合并极重度血小板减少26例临床分析

Objective To investigate the etiology and perinatal outcome of pregnancies complicated with extremely severe thrombocytopenia [ at least two times of platelets count (PLT) < 10 × 109/L during pregnancy]. Methods Clinical data, including basic information, etiology, management and outcomes of pregnant women with extremely severe thrombocytopenia, admitted to Peking University People's Hospital from January 2004 to March 2009, were retrospectively collected. The management of these cases varied according to different etiology and the symptoms: (1) PLT were maitained > 20 × 109/L and hemoglobulin> 70 g/L in those women without spontaneous bleeding; (2) PLT transfusion would be required when PLT< 10 × 109/L or bleeding occur and RBC would be supplied when hematocrit <25% and hemoglobulin <70g/L; (3) Hemoglobulin should be > 70 g/L and PLT >30 × 109/L before cesarean section or delivery;(4) Predinisone and/or intravenous immunoglobulin G (IVIG) would be given in women complicated with idiopathic thrombocytopenic purpura (ITP) when PLT < (20-30) × 109/L or bleeding. PLT would be given if all the above management were failed, or PLT < 10 × 109/L, or bleeding. Women without bleeding would be closely monitored and delivery would be planned. Results (1) Twenty-six cases were identified among 9302 deliveries during the study period (0.28%), with an average of maternal age of 29. Seventeen were diagnosed before conception and 9 during pregnancy. Among the 26 women, half received regular prenatal check in our hospital and the average gestations at diagnosis was 24 weeks and the other half without regular prenatal visits and the average gestations at diagnosis was 32 weeks. Etiology was identified in 24 out of the 26 women, including 14(54%) ITP, 5 myelodysplastic syndrome (MDS), 4 chronic aplastic anaemia(CAA) and 1 systemic lupus erythematosus (SLE). (2) Management: All of the 26 women received blood products. Among the 14 ITP cases, 6 received predinisone and IVIG and 8 only took predinisone. Nine of the 26 patients (35%) had pregnant complications, among which 6 (6/9) were preeclampsia. The overall average gestation at delivery was 36 weeks. Only 2 delivered vaginally with the average blood loss of 83 ml and 23 cesarean sections were performed with the average blood loss of 410 ml. (3) Perinatal outcomes:There were 26 perinatal babies, among which 1 died intrauterine and 25 were born alive (12 preterm infants). The average birth weight was 2877 g. Neonatal severe thrombocytopenia presented in 2 newborns whose mother complicated with ITP. Conclusions The main cause of extremely severe thrombocytopenia during pregnancy is ITP, managed mainly by predinisone and IVIG, followed by CAA and MDS, which may require supportive treatment. Pregnancy complicated with extremely severe thrombocytopenia is not an indication of termination. Better maternal and fetal outcomes can be achieved through proper treatment based on the etiology, intensive care in prevention and management of complications and cesarean section.