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����һ���� Ȫ 《中国实用外科杂志》2019,39(3):223-225
妊娠期甲状腺癌的诊治是目前甲状腺疾病诊治的热点和难点问题之一。妊娠期发现甲状腺癌对临床医生和孕妇都是一个极大的挑战,应通过多学科协作,尽快明确诊断,全面、合理的评估孕妇和胎儿的情况,选择最合适的治疗和随诊方式,避免对孕妇和胎儿产生副反应,维持正常孕期,获得最佳的治疗效果。 相似文献
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腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠疗效分析 总被引:1,自引:0,他引:1
目的 探讨腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠疗效及对内分泌的影响.方法 选择2011年1月至2015年12月剖宫产瘢痕妊娠患者57例,其中A组32例患者给予超声引导下清宫术治疗,B组25例患者给予腹腔镜下子宫双侧动脉阻断术联合清宫术治疗,比较两组患者出血量、住院时间、月经复潮时间、术后人绒毛膜促性腺激素(hCG)降至正常时间,并发症情况及术前(T0)、术后第1d(T1)、第3d(T2)神经内分泌激素水平.结果 ①B组患者出血量低于A组,住院时间、月经复潮时间短于A组,比较差异有统计学意义(t出血量=31.85,k院时间=9.36,t月经复t潮时间=16.37,均P<0.05);②B组患者并发症发生率为8.00%,低于A组的15.63%,比较差异有统计学意义(x2=9.35,P<0.05);③B组T1、T2血清COR、β-EP、GLU水平低于A组(CORF交互=17.67,β-EPF交互=132.36,6LUF交互=155.38,均P<0.05).结论 腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠微创优势明显,安全性高,对内分泌影响较轻. 相似文献
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Human leukocyte antigens (HLA) alleles may affect the development of cervical cancer through immunologic control of human papillomavirus (HPV). The association between HLA-DQB1 alleles and risk of cervical cancer has been extensively studied, but the results obtained remain inconsistent. To explore a more extensive role of HLA-DQB1 alleles on cervical cancer risk, we carried out a meta-analysis including 4862 cases and 8988 controls from 22 published studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the strength of the association. The overall results suggested that HLA-DQB1*02 (OR = 0.91, 95% CI = 0.82–0.99), *03 (OR = 0.85, 95% CI = 0.74–0.97) and *0603 (OR = 0.62, 95% CI = 0.53–0.72) had a significantly association with decreased cervical cancer risk. In contrast, DQB1*05 (OR = 1.18, 95% CI = 1.01–1.38), *0301 (OR = 1.14, 95% CI = 1.06–1.23) and *0402 (OR = 1.31, 95% CI = 1.04–1.64) conferred a significantly higher risk to cervical cancer. Moreover, a significantly association with increased or decreased cervical cancer risk was found among Europeans and Asians after stratification of the HLA-DQB1 alleles by ethnicity. These findings supported that the HLA-DQB1 alleles may contribute to genetic susceptibility of cervical cancer. Further studies with a greater number of cases are expected to confirm our results. 相似文献
5.
目的:探讨保妇康凝胶联合诺氟沙星治疗宫颈糜烂的临床效果。方法将100例宫颈糜烂患者根据随机数字表法分为观察组和对照组各50例。观察组给予保妇康凝胶和诺氟沙星联合治疗,对照组单独给予治糜灵栓治疗,比较两组患者临床症状的变化,并对临床疗效进行评价。结果观察组治愈率为86.00%,明显高于对照组的74.00%,临床症状评分改善较对照组明显,且其临床症状消失的时间短于对照组,差异均有统计学意义(P<0.05)。结论保妇康凝胶与诺氟沙星合用比治糜灵栓治疗宫颈糜烂效果更佳,且治愈时间上明显较优,值得临床上推广应用。 相似文献
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M. Iachina P.M. Ljungdalh R.G. Sørensen L. Kaerlev J. Blaakær O. Trosko N. Qvist B.M. Nørgård 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(2):115-123
Aims
To examine the influence of pre-existing psychiatric disorder on the choice of treatment in patients with gynaecological cancer.Materials and methods
The analyses were based on all patients who underwent surgical treatment for endometrial, ovarian or cervical cancer who were registered in the Danish Gynecological Cancer Database in the years 2007–2014 (3059 patients with ovarian cancer, 5100 patients with endometrial cancer and 1150 with cervical cancer). Logistic regression model and Cox regression model, adjusted for relevant confounders, were used to estimate the effect of pre-existing psychiatric disorder on the course of cancer treatment. Our outcomes were (i) presurgical oncological treatment, (ii) macroradical surgery for patients with ovarian cancer, (iii) radiation/chemotherapy within 30 days and 100 days after surgery and (iv) time from surgery to first oncological treatment.Results
In the group of patients with ovarian cancer, more patients with a psychiatric disorder received macroradical surgery versus patients without a psychiatric disorder, corresponding to an adjusted odds ratio of 1.24 (95% confidence interval 0.62–2.41) and the chance for having oncological treatment within 100 days was odds ratio = 1.26 (95% confidence interval 0.77–2.10). As for patients with endometrial cancer, all outcome estimates were close to unity. The adjusted odds ratio for oncological treatment within 30 days after surgery in patients with cervical cancer with a history of psychiatric disorder was 0.20 (95% confidence interval 0.03–1.54).Conclusions
We did not find any significant differences in the treatment of ovarian and endometrial cancer in patients with pre-existing psychiatric diagnoses. When it comes to oncological treatment, we suggest that increased attention should be paid to patients with cervical cancer having a pre-existing psychiatric diagnosis. 相似文献8.
Sabrina Ronco 《Nursing for Women's Health》2021,25(3):207-211
A review of the literature was performed to explore the association between prenatal education and rates of primary cesarean birth for women at low risk for cesarean birth. Most women who are nulliparous with a singleton fetus of term gestational age and in the vertex position are considered to be at low risk and favorable for a vaginal birth, yet the cesarean birth rate for women at low risk was 25.6% in 2019. It has been suggested that the rise in the cesarean birth rate among low-risk women may not be due to medical indications but, rather, to nonmedical factors, such as a provider’s or woman’s preference or lack of prenatal education. Evidence from this literature review supports the premise that prenatal education classes should be routinely incorporated into maternity care in an effort to reduce cesarean birth rates for the low-risk population. 相似文献
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目的 评价逐瘀止血汤加减对慢性子宫内膜炎(CE)气虚血瘀证患者妊娠结局的影响及对免疫炎症因子的调节作用。方法 将144例患者随机按数字表法分为观察组和对照组各72例。观察组脱落、失访4例,剔除2例,完成66例;对照组脱落、失访3例,剔除5例,完成65例。两组均给予抗感染治疗14 d。对照组口服妇科千金片,6片/次,3次/d。观察组内服逐瘀止血汤加减,1剂/d。两组疗程均为3个月,并随访6个月。记录治疗前后月经经量、经期和周期变化情况;进行治疗前后宫腔镜和阴道彩色多普勒超声检查,评价子宫内膜形态、子宫内膜容受性(CP)[子宫内膜厚度、阻力指数(RI),搏动指数(PI)和血流指数(FI)]等,并进行子宫内膜病理检查;进行治疗前后气虚血瘀证评分;检测治疗前后月经血白细胞介素-1β(IL-1β),IL-6和肿瘤坏死因子-α(TNF-α)水平和外周血测T淋巴亚群(CD3+,CD4+,CD8+)水平;随访记录妊娠情况和流产情况。进行安全性评价。结果 治疗后观察组经量、经期、周期和月经完全正常率均高于对照组(P<0.05);观察组子宫内膜厚度和FI均高于对照组(P<0.01),RI和PI均低于对照组(P<0.01);观察组月经血IL-1β,IL-6和TNF-α水平均低于对照组(P<0.01);观察组CD3+,CD4+水平和CD4+/ CD8+均高于对照组(P<0.01),CD8+水平低于对照组(P<0.01);在6个月随访期间,观察组妊娠率46.97%(31/66),高于对照组的27.69%(18/65)(χ2=5.197,P<0.05);观察组子宫内膜形态疗效总有效率为96.97%(64/66),高于对照组的86.15%(56/65)(χ2=4.981,P<0.05);观察组子宫内膜病理组织疗效总有效率为95.45%(63/66),高于对照组的84.62%(55/65)(χ2=4.304,P<0.05);观察组综合临床疗效总有效率为93.94%(62/66),高于对照组的81.54%(55/65)(χ2=4.696,P<0.05);两组治疗期间均未发现与中药相关不良反应。结论 逐瘀止血汤加减治疗CE气虚血瘀证患者,可调经月经、减轻临床症状,改善宫腔镜下内膜形态,调节全身和局部的免疫炎症反应,提高了CP,从而改善了妊娠结局,有着较好的综合疗效,且安全。 相似文献