阴道内放置PGE_2用于足月妊娠引产351例疗效观察

目的　比较 PGE2 阴道栓剂及催产素静滴引产的效果。方法　将 5 85例同样条件孕妇 ,随机分两组 ,分别给PGE2 阴道栓剂和催产素静脉滴注引产。结果　前列腺素组及催产素组引产成功率分别为 96 .3%和 79.92 % ;临产发动时间及总产程分别为 (2 .70± 0 .6 3) h,(3.0 1± 3.41) h和 (3.91± 0 .71) h,(6 .0 3± 3.5 0 ) h;剖宫产率分别为6 .8%和 18.18% (P<0 .0 1) ,有显著差异。结论　 PGE2 栓剂用于足月妊娠引产效果显著、安全、方便 ,对促宫颈成熟意义重要 ,可缩短住院天数 ,减少住院费用。     

阴道内放置PGE2用于足月妊娠引产351例疗效观察

目的比较PGE\-2阴道栓剂及催产素静滴引产的效果。方法将585例同样条件孕妇，随机分两组，分别给PGE\-2阴道栓剂和催产素静脉滴注引产。结果前列腺素组及催产素组引产成功率分别为96.3%和79.92%；临产发动时间及总产程分别为(2.70±0.63)h,(3.01±3.41)h和(3.91±0.71)h,(6.03±3.50)h；剖宫产率分别为6.8%和18.18%(P<0.01)，有显著差异。结论PGE\-2栓剂用于足月妊娠引产效果显著、安全、方便，对促宫颈成熟意义重要，可缩短住院天数，减少住院费用。     

米非司酮用于足月妊娠引产的价值探讨

目的：探讨米非司酮用于足月妊娠引产的临床效果、药物副反应以及药物对胎儿的安全性。方法：将66例有引产指征的孕足月单胎头位的初产妇，随机分为两组，研究组（33例）用米非司酮50mg口服，每12小时一次，共4次；对照组（33例）静脉点滴催产素引产。结果：研究组用48小时后宫颈评分增加与对照组差异显著（P＜0．01），研究组引产总有效率高于对照（P＜0．05），用药后临产发动时间显著短于对照组（P＜0．01）；而两组剖宫产率、产后出血率、胎儿窘迫及新生儿窒息率、药物副反应率均无显著差异（P＞0．05）。结论：米非司酮具有良好的促宫颈成熟作用，可配伍米索前列醇或催产素用于足月妊娠引产。     

Induction of Labour for Prevention of Stillbirth from Rh Hemolytic Disease

The fate of 80 infants delivered after induction of labour in 72 Rh-sensitized mothers was studied to determine whether the stillbirth rate could be reduced. Labour was induced at 32 to 39 weeks of gestation; the criteria for induction were based on the history of previously affected infants, and a maternal Rh-antibody titre of 1/40 or greater, using an indirect antiglobulin technique. Nine mothers were delivered by Cesarean section. It was estimated that 26 infants were so severely affected as to be unlikely to have survived to term. However, only seven died, and one was stillborn. Two of these would normally have survived, one being Rh-negative. These two cases demonstrated the main danger in this method of management. There was a probable saving of 18 infants. In 22 mothers there was no history of previous delivery of an affected infant; in all 22 the infants survived, though six probably would not have survived to term. In 15 pregnancies in which the mothers had had a previous stillbirth, 12 infants survived. Sixty-seven infants required a total of 116 exchange transfusions. Despite the hazards it is concluded that early induction has an important place in management of Rh hemolytic disease.     

Elective Induction of Labour: A Controlled Study

The objective of this paper is to assess the safety of elective induction, particularly with regard to fetal hazards. Emphasis is placed on the necessity of using a control group in order to obtain a meaningful comparison with patients whose labour commenced spontaneously. Two hundred and thirteen consecutive cases of electively induced labour are compared with 213 consecutive controls. The two groups are scrutinized with regard to their similarity in all respects save that of induction. Their performance in labour is documented. The perinatal and maternal complications are presented and discussed. No evidence of added risk for induced patients is found in this series.     

阴道产钳助产用于分娩困难产妇的临床价值

目的探讨阴道产钳助产术用于分娩困难产妇的临床价值。方法选择绵阳市人民医院产科2011年1月至2013年2月收治的分娩困难产妇210例作为研究对象,按照随机数字表法分为两组:产钳助产术组(105例)行低位产钳助产术,吸引器助产术组(105例)予以胎头吸引器助产术。比较两组产妇转为剖宫产手术的情况以及术后母体并发症及新生儿并发症发生情况。结果产钳助产组产妇有9例(8.6%)转为剖宫产手术,吸引器助产组有25例(23.8%),剖宫产手术率比较,差异有统计学意义(P<0.05);两组产妇宫颈裂伤、阴道壁裂伤、产后出血发生情况以及新生儿头皮血肿及面部损伤情况比较,差异均无统计学意义(P>0.05),但产钳助产组产后尿潴留的发生情况及新生儿窒息率均显著少于吸引器助产组(P<0.05)。结论在严格掌握操作要点及适应证的情况下,对分娩困难产妇应用阴道产钳助产术能有效缩短产程,减少母婴所受损伤,降低剖宫产率。     

米索前列醇两种不同给药法用于足月妊娠引产的安全性及有效性

米索前列醇（ｍｉｓｏｐｒｏｓｔｏｌ,ＭＰ）是８０年代人工合成的前列腺素Ｅ１（ＰＧＥ１）衍生物。在国内外均有应用于足月妊娠引产成功的报道［１～３］。本文旨在探讨米索前列醇两种不同给药法用于足月妊娠引产的安全性及有效性。对象和方法对象　收集我科１９９７年...     

聚氨酯海绵塞条引产时宫颈管厌氧菌培养

30例晚期妊娠产妇应用聚氨酯海棉塞条(以下简称塞条)引产。为了解塞条引产的安全性,在放置塞条前后取宫颈管粘液作厌氧菌培养。实验结果:8例于放置塞条前后均未检出厌氧菌;检出厌氧菌的22例中,18例放置塞条前后检出的菌种一致,没有因放置塞条引起新的厌氧菌感染,余4例在放置塞条后虽出现了菌种不一致,然而。新菌种均为低毒力或条件性致病菌,无一例检出产气荚膜梭菌。临床上本组无一例发生产时或产后感染。作者认为在严格无菌条件下应用聚氨酯海棉塞条引产是安全的。     

Simplified Induction of Labour for the Patient with a Dead Baby in Utero

The problem posed by the presence of a dead fetus in utero after the first trimester is important because of the psychological attitude of the patient and the danger of hypofibrinogenemia. In the past, induction of labour in these patients has often been difficult, and surgery has had to be undertaken to empty the uterus.

In these patients, labour was induced by inserting a needle with a trocar through the abdominal wall under local anesthesia into the amniotic sac. Approximately 200 ml. of amniotic fluid is withdrawn and replaced with a slightly larger amount of 20% saline solution. Labour began within 24 hours and delivery occurred within the next 14 hours. There have been no complications or failures with this technique in the cases reported in the literature.

     

甲巯咪唑大鼠经皮给药的药代动力学

目的:研究甲巯咪唑在大鼠体内经皮吸收的药代动力学,并与口服吸收动力学进行比较。方法:采用HPLC法测定大鼠口服(2 mg/kg)或经皮(1,2,4 mg/kg)给药后血清和甲状腺组织中的甲巯咪唑浓度。色谱柱为Lichrospher C18柱,流动相为甲醇-水(10∶90),流速1.0 min,柱温30℃,检测波长UV 254 nm。结果:口服或经皮(2 mg/kg)给药后,甲巯咪唑的tmax分别为1.5 h和2.5 h,cmax分别为1 716.6和817.2 ng/mL,AUC分别为4 606.2和3 739.6 ng.h/mL,t1/2分别为2.64 h和2.70 h,甲状腺组织中的药物浓度分别于给药后2 h和1 h达到峰值,其峰浓度分别为307.7和320.9 ng/50 mg。经皮给予高、中和低3个剂量甲巯咪唑后,其AUC与剂量呈现线性相关性。结论:甲巯咪唑口服给药的血药浓度明显高于经皮给药的血药浓度,但甲状腺组织中的药物浓度无显著性差异,提示经皮给药的全身不良反应小于口服给药。     

米非司酮促中孕水囊引产60例临床分析

选择６０例终止中孕者给口服米非司酮（Ｒｕ４８６）后再行双囊水引产术，民对的６０例对照组进行比较。结果发现：实验组的宫颈成熟度分值平均提高２．５±０．８，以产时间平均为１１８７ｍｉｎ比对照组的１７７９ｍｉｎ明显缩短，差别有高度显著性；实验组使用催产素平均药量和宫腔残留组织量均比对照组明显减少（Ｐ〈０．０１）；出血量则两组无差别，结果表明，米非司酮可用作中期妊娠引产的辅助药。     

糖尿病型牙周病患者龈沟液前列腺素E2及糖化血红蛋白的检测

:【目的】研究胰岛素依赖型糖尿病 (IDDM)型牙周病患者龈沟液前列腺素E2 水平及其与糖代谢状况的关系。【方法】以 2 8例IDDM型牙周病患者及 5 4例全身健康的牙周病人为研究对象 ,利用放射免疫法测龈沟液前列腺素E2 水平 ,同时测IDDM病人糖化血红蛋白浓度。【结果】当牙周病严重度相同时 ,IDDM患者龈沟液前列腺素E2 水平 (μg/L)明显高于全身健康者 (186± 5 3vs46± 7,346± 2 8vs48± 10 ,P <0 0 1)。糖尿病人中 ,中重度牙周炎值几乎为轻度牙周病的两倍。龈沟液前列腺素E2 水平与糖化血红蛋白浓度无相关性。【结论】IDDM病人龈沟液前列腺素E2 增高可能因全身反应异常所致 ,这一介质水平的上升 ,反过来会进一步促进牙周病变发展     

米索前列醇用于足月妊娠引产的剂量探讨

目的：探讨米索前列醇（ＭＰ）在足月妊娠引产中的最适剂量。方法：将９２例妊娠３８～４１＋周的正常孕妇有引产指征者，随机分为３组：Ａ组在阴道后穹窿放ＭＰ５０μｇ，每４ｈ加１次至临产；Ｂ组在阴道后穹窿放ＭＰ５０μｇ，４ｈ后放２５μｇ，如未临产，每２ｈ放２５μｇ１次至临产；Ｃ组在阴道后穹窿放ＭＰ２５μｇ，每２ｈ放１次至临产。结果：３组总有效率无明显差异，Ａ组引产成功率９０．６３％，Ｂ组成功率９０．００％，Ｃ组成功率９０．００％。３组宫缩异常发生率分别为Ａ组１８．７５％，Ｂ组与Ｃ组均为６．６７％。结论：阴道放置米索前列醇用于足月妊娠引产是安全、有效的引产方法，但Ｂ组的方案更适合于临床应用。     

阴式子宫切除术中巴曲亭局部应用止血效果观察

目的 比较巴曲亭(国产注射甩血凝酶)不同给药途径对阴式子宫切除术中出血的止血效果.方法 选取接受阴式子宫切除术的患者50例,随机分为两组,在手术开始前2 min将溶有2 u巴曲亭的生理盐水液40 mL注射至膀胱阴道间隙、膀胱宫颈间隙、宫颈直肠间隙及宫旁间隙(局部给药组);在手术开始前5 min将1 u/mL的巴曲亭生理盐水溶液2 mL于静脉输液管滴壶中加入(静脉给药组),比较术中两组术毕出血量及术前术毕凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原定量(FIB).结果 两组术毕出血量:局部给药组为(130±21) mL,静脉给药组为(150±19) mL,两组比较差异有统计学意义(P＜0.05):不同给药方式均对凝血状态无影响.结论 局部应用巴曲亭可以显著减少阴式子宫切除术中出血量.