Laparoscopic removal of an intraperitoneal translocated intrauterine contraceptive device

The use of an intrauterine contraceptive device (IUD) is often accompanied by various complications, the perforation of the uterus constituting the most dangerous. Here we report the case of a patient who complained of abdominal pains. She had had an IUD inserted 15 months previously. Three months later, as she could no longer see the IUD strings at the external os of the cervix, she underwent pelvic ultrasonography, which did not show the IUD in the uterine cavity. A diagnosis of expulsion of the IUD was made. A few months later, the patient accidentally became pregnant, and decided to have an abortion. From that time on, she started to complain of the above-mentioned symptoms. She had an abdominal X-ray which revealed the IUD in the abdominal cavity. She then underwent a laparoscopic removal of the translocated IUD.     

宫腔镜子宫内膜切除术治疗功能失调性子宫出血的疗效

【目的】探讨宫腔镜子宫内膜切除术(TCRE)治疗功能失调性子宫出血(dysfunctional uterine bleeding,DUB)的疗效。【方法】选取80例 DUB 患者作为研究对象,根据患者治疗方式分为两组：观察组40例,采用宫腔镜子宫内膜切除手术;对照组40例,采用非手术治疗。比较两组患者的临床疗效,分析观察组预后影响因素。【结果】观察组有效率为92.50%(37/40),显著高于对照组75.00%(30/40),其差异有统计学意义(P <0.05)。观察组患者的年龄、子宫内膜厚度、宫腔深度和子宫腺肌病与患者的预后明显相关(P <0.05)。【结论】TCRE 治疗 DUB 的临床疗效满意,患者预后与患者的年龄、宫腔深度、子宫内膜厚度和子宫腺肌病相关。     

补肾活血中药对无排卵功血患者子宫内膜雌孕激素受体的影响

[目的]探讨中西药物治疗无排卵功能失调性子宫出血(功血)的机理。[方法]采用酶联免疫分析技术和 SP免疫组化半定量检测技术,对37例无排卵功血患者经补肾活血中药宫血饮(主要由补骨脂、川续断、山茱萸、蒲黄、三七、党参、生龙骨、生牡蛎、白花蛇舌草等组成)或西药黄体酮治疗前后进行血清雌、孕激素(E_2、P)及子宫内膜雌、孕激素受体(ER、PR)测定。[结果]无排卵功血患者血清E_2水平和子宫内膜ER、PR水平均较对照组高,且ER、PR含量依子宫内膜的增生程度和类型的不同呈现下降趋势,即单纯增殖症>复杂增生>增生期。经合成孕激素治疗后,血清E_2水平和子宫内膜ER、PR水平均降低。补肾活血中药宫血饮亦能降低ER、PR水平,但对血清E_2影响不大。【结论】中药与合成孕激素治疗无排卵功血的作用机理不同,它并非通过降低血清雌激素的水平而达到治疗目的,推测它可能是通过非甾体激素途径,启动了各方面的因素影响ER、PR的合成而发挥其治疗作用的。     

激光经络穴位疗法治疗功能性子宫出血124例临床观察

笔者于１９８５～１９９４年应用激光经络穴位疗法（ＬＭＰＴ）治疗功能性子宫出血（ＤＵＢ）症１２４例，临床近期治愈１０４例，占８３．９％；有效１８例，占１４．５％；无效２例，占１．６％；总有效率９８．４％。其中７８例经过１～５年随访，痊愈６４例，占８２．０％；有效１３例，占１６．７％；无效１例，占１．３％；总有效率为９８．７％。临床结果表明，ＬＭＰＴ治疗ＤＵＢ症的近期疗效良好，远期效果满意，具有推广应用的意义。     

子宫腺肌病与子宫肌瘤超声鉴别诊断分析

本文回顾性分析了妇科手术切除子宫标本１３２例的超声及病理资料。结果：病理诊断子宫腺肌病３４例．子宫肌瘤９８例，而超声诊断子宫腺肌病只有１９例．子宫肌瘤１１３例。超声诊断子宫腺肌病的漏诊率为４４．１％，所有漏诊的子宫腺肌病均误诊为子宫肌瘤。通过资料分析，探讨了子宫腺肌病的超声诊断及与子宫肌瘤的鉴别诊断，提出了提高该病诊断率应注意的问题。     

助孕3号方对大鼠子宫收缩活动的影响

目的：为进一步探讨助孕3号方（由黄芪、党参、白术、菟丝子、续断、何首乌等组成）防治自然流产的机理。方法：结合现代药理实验方法学和血清药理学建立子宫收缩实验，观察助孕3号方水提液及其含药血清对子宫收缩活动的影响。结果：助孕3号方水提液及其含药血清能降低离体大鼠子宫兴奋性，灌服了助孕3号方水提液的大鼠子宫收缩强度较对照组低（P＜0．05）。结论：提示助孕3号方有抑制子宫收缩的作用，可能是防治自然流产的机理之一。     

Second-trimester uterine artery Doppler screening in unselected populations: a review

Objective: Doppler ultrasound provides a non-invasive method for the study of the uteroplacental circulation. In normal pregnancy, impedance to flow in the uterine arteries decreases with gestation, which may be the consequence of trophoblastic invasion of the spiral arteries and their conversion into low-resistance vessels. Pre-eclampsia and fetal growth restriction are associated with failure of trophoblastic invasion of spiral arteries, and Doppler studies, in these conditions, have shown that impedance to flow in the uterine arteries is increased. A series of screening studies involving assessment of impedance to flow in the uterine arteries have examined the potential value of Doppler in identifying pregnancies at risk of the complications of impaired placentation. This review examines the findings of Doppler studies in unselected populations. Methods: Searches of a computerized medical database were performed to identify relevant studies. Only those studies that provided sufficient data to allow calculation of the performance of the test were included in the analysis. Likelihood ratios were calculated for each study and are reported for pre-eclampsia, fetal growth restriction and perinatal death as well as for more severe forms of pre-eclampsia and fetal growth restriction. Results: The literature search identified 19 relevant studies, four of which were excluded from the further analysis. The main characteristics and results of the 15 remaining studies provided discrepant results, which may be the consequence of differences in Doppler technique for sampling, the definition of abnormal flow velocity waveform, differences in the populations examined, the gestational age at which women were studied and different criteria for the diagnosis of pre-eclampsia and fetal growth restriction. Nevertheless, the studies provided evidence that increased impedance to flow in the uterine arteries is associated with increased risk for subsequent development of pre-eclampsia, fetal growth restriction and perinatal death. In addition, women with normal impedance to flow in the uterine arteries constituted a group that have a low risk of developing obstetric complications related to uteroplacental insufficiency. Conclusions: The review suggests that increased impedance to flow in the uterine arteries in pregnancies attending for routine antenatal care identifies about 40% of those who subsequently develop pre-eclampsia and about 20% of those who develop fetal growth restriction. Following a positive test, the likelihood of these complications is increased by about 6 and 3.5 times, respectively.     

宫血停合剂对血瘀型崩漏的止血疗效及止血机理探讨

目的：观察宫血停合剂（由丹参、赤芍、桃仁、三棱、莪术、蒲黄、益毒草、五爪龙、枳壳组成,以下简称宫停）治疗血瘀型崩漏的止血疗效及探讨其止血机理。方法：通过观察３７例血瘀型崩漏病人治疗前后的出血时间、出血量的改变来判断宫血停的止血疗效;通过对８例病人治疗前后血分析、血液流变学、凝血三项、前列腺素等指标的测量,推断其止血机理。结果：宫血停对血瘀型崩漏病人在经期的缩短和维持正常经量方面有较显著的疗效（止血     

Non-invasive transabdominal uterine electromyography correlates with the strength of intrauterine pressure and is predictive of labor and delivery

Objective: The study was conducted to investigate whether the strength of uterine contractions monitored invasively by intrauterine pressure catheter could be determined from transabdominal electromyography (EMG) and to estimate whether EMG is a better predictor of true labor compared to tocodynamometry (TOCO).

Study design: Uterine EMG was recorded from the abdominal surface in laboring patients simultaneously monitored with an intrauterine pressure catheter (n?=?13) or TOCO (n?=?24). Three to five contractions per patient and corresponding electrical bursts were randomly selected and analyzed (integral of intrauterine pressure; integral, frequency, amplitude of contraction curve on TOCO; burst energy for EMG). The Mann–Whitney test, Spearman correlation and receiver operator characteristics (ROC) analysis were used as appropriate (significance was assumed at a value of p <?0.05).

Results: EMG correlated strongly with intrauterine pressure (r?=?0.764; p?=?0.002). EMG burst energy levels were significantly higher in patients who delivered within 48?h compared to those who delivered later (median [25%/75%]: 96?640 [26?520–322?240] vs. 2960 [1560–10?240]; p <?0.001), whereas none of the TOCO parameters were different. In addition, burst energy levels were highly predictive of delivery within 48?h (AUC?=?0.9531; p <?0.0001).

Conclusion: EMG measurements correlated strongly with the strength of contractions and therefore may be a valuable alternative to invasive measurement of intrauterine pressure. Unlike TOCO, transabdominal uterine EMG can be used reliably to predict labor and delivery.     

桃红二丹四物汤治疗血瘀型功血的临床观察

[目的]观察桃红二丹四物汤治疗血瘀型功能失调性子宫出血(简称功血)的l临床疗效.[方法]采用桃红二丹四物汤治疗血瘀型功血30例,观察患者的止血疗效、中医症候改善情况以及病程、病情轻重程度和年龄与疗效的关系.[结果]桃红二丹四物汤治疗血瘀型功血的止血总有效率为90.00%;中医症候改善显著,愈显率为73.33%,总有效率...