觀察受體鼠妊娠和胚胎著床情況,并檢測胚胎移植時小鼠子宮內膜中白血病抑制因子(Lif)表達水平,探討超排卵對小鼠胚胎著床潛能的影響。方法:建立超排周期胚胎和自然周期胚胎移植小鼠模型,比較妊娠率、胚胎著床率的差異及其與Lif蛋白的表達水平之間的關系。結果:超排卵周期受體組的妊娠率(20.00%)和胚胎著床率(8.33%)顯著低于自然周期組的妊娠率(55.00%)和胚胎著床率(35.00%)(P＜0.05)。自然周期胚胎和超排周期胚胎受體組內膜中Lif蛋白的表達水平相似(P＞0.05),妊娠受體組Lif蛋白的表達水平顯著高于未孕受體組(P＜0.05),但單胎妊娠和多胎妊娠受體組內膜中Lif蛋白的表達水平相似(P＞0.05)。結論:超排卵可能降低胚胎的著床潛能,Lif蛋白的表達水平與胚胎著床有關,但與著床胚胎的數目無比例關系。
目的:探討妊娠合并哮喘的臨床表現及治療方法。方法:對32 例妊娠合并支氣管哮喘患者的臨床資料進行回顧性分析。結果:經過適當的治療,32例支氣管哮喘合并妊娠患者癥狀緩解,隨訪至產后1 個月,嬰兒和母親均正常。結論:支氣管哮喘合并妊娠時,妊娠早期可選用對胎兒無影響的藥物如頭孢菌素類抗生素、β2 受體激動劑、糖皮質激素(吸入布地奈德,強的松口服,短期甲強龍靜滴),妊娠中晚期還可選用茶堿類藥物及全身使用糖皮質激素等藥物。
Abstract: There is a 1% - 4% incidence of cardiac disease in pregnancy, and rheumatic heart disease is the most common diagnosis. On the condition that medical treatment is inefficacious, an open heart surgery should be performed. Because of the changes in physiological functions, there is a major difference between pregnant patients and the general population in perioperative management of valve replacement. Now , the pregnancy is not an absolute contraindication for cardiopulmonary bypass, though the incidence of mortality and birth defects remains high. It is helpful in decreasing complications and increasing survival rate by improving themethods of cardiopulmonary bypass, postoperative monitoring, anticoagulation etc. In this article, the progress in t reatments of perioperative period of cardiac valve replacement during pregnancy is reviewed.
目的 探討急診行子宮動脈灌注藥物栓塞術治療剖宮產后切口妊娠的可行性和臨床價值。 方法 2009年10月－2011年12月，對17例臨床證實切口瘢痕妊娠并陰道出血患者，急診行雙側子宮動脈灌注甲氨蝶呤并超選擇栓塞術，術后通過觀察人絨毛膜促性腺激素（HCG）水平、陰道出血及術后清宮術來評價療效。 結果 17例患者急診行子宮動脈灌注栓塞術成功，術后陰道出血均停止或減少，HCG水平均明顯下降，3例因孕囊自行排除而未行清宮，14例術后2～4 d行胚胎鉗刮術，術中出血量較少。所有患者1周后均治愈出院。 結論 子宮動脈灌注栓塞術是治療剖宮產術后切口瘢痕妊娠的一種有效方法，可及時治療陰道大出血，促進殺胚，并為術后清宮提供安全保障。
Objective To guide blood glucose management during pregnancy and reduce the incidence of long-term complications of the fetus by exploring the long-term growth condition of offspring of pregnant women with gestational diabetes mellitus. Methods A total of 180 cases full-term newborns of pregnant women with gestational diabetes mellitus from December 25th, 2011 to December 25th, 2012 were selected as the diabetes group. Another 200 newborns of pregnant women without any complications were randomly collected as the control group. Birth weight, gestational age, sex, blood glucose, and 24-, 48-, 72- and 120-hour transcutaneous bilirubin value after the birth of the newborns were recorded; weight, height, body mass index (BMI), triglycerides, total cholesterol, high density lipoprotein (HDL), low density lipoprotein, blood pressure and fasting plasma glucose quota between the two groups were contrasted when the children were three years old. Results There were no significant difference in the birth weight, gestational age and sex between the diabetic and the control group. The blood glucose levels of the newborns in the diabetic group was significantly lower than that in the control group (P<0.05). The 24-, 48-, 72- and 120-hour transcutaneous bilirubin values of the newborns in the diabetic group were significantly higher than those of the control group (P<0.05). The weight, height and BMI of the three years old offspring in the diabetic group were significantly higher than those in the control group (P<0.05). There were no significant difference in triglycerides, total cholesterol, HDL, Low density lipoprotein, fasting plasma glucose quota, and systolic blood pressure between the diabetic group and the control group (P>0.05), but the diastolic blood pressure in the diabetic group was much higher than that in the control group (P<0.05). Conclusion The impact of gestational diabetes mellitus on offspring of pregnant women was not only in the fetus and newborn period, but also in the future, which should be timely intervened.
【摘要】 目的 探討子宮部位異位妊娠的臨床特征和處理對策。 方法 回顧分析2002年9月-2009年9月間收治的31例子宮部位異位妊娠患者的臨床資料。 結果 31例患者中，初診確診僅8例，誤診率74.2%。除5例因難以控制的大出血行經腹病灶清除術加子宮修補術或全子宮切除術外，其余26例患者均經氨甲喋呤（MTX）治療加清宮術或宮腔鏡下病灶清除術保守治療成功。 結論 子宮部位異位妊娠容易誤診，超聲檢查是診斷的主要方法。保守治療安全、有效，可保留生育能力。氨甲喋呤治療加清宮術可作為治療子宮部位異位妊娠的主要方法。【Abstract】 Objective To investigate the clinical characteristics and treatment of ectopic pregnancy in the uterus. Methods The clinical data of 31 patients diagnosed as ectopic pregnancy from September 2002 to September 2009 were analyzed retrospectively. Results During preliminary diagnosis, only eight patients were accurately diagnosed.The error rate of first diagnosis was 74.2%. Five patients suffered focal cleaning and uterus neoplasty or total hysterectomy due to uncontrollable bleeding.The other 26 patients were successfully cured by conservation treatment of methotrexate (MTX) combined with dilatation and curettage or clearance of focal lesion under hysteroscopy. Conclusion Misdiagnosis of ectopic pregnancy in the uterus is easy to make.The ultrasonography is the main method for the diagnosis of ectopic pregnancy in the uterus.Conservative treatment is proved to be safe and effective and can preserve the patients’ fertility. Administration of MTX combined with dilatation and curettage is an main therapeutic method in handling ectopic pregnancy in the uterus.