目的 分析实时荧光定量PCR检查对宫颈癌早期筛查的临床价值.方法 选取苏州大学附属第二医院486例进行宫颈癌早期筛查的受检者为研究对象,以组织活检结果为金标准,分析实时荧光定量PCR检查的诊断效能.结果 486例受检者中宫颈癌早期筛查阳性82例(16.87％),其中CIN Ⅱ、CIN Ⅲ、宫颈癌分别为7例、40例、35例;阴性404例(83.13％),其中宫颈炎、CIN Ⅰ分别为320例、84例.②以组织活检结果为金标准,实时荧光定量PCR检查的诊断准确率为58.02％、敏感度为84.15％、漏诊率为15.85％、特异度为52.72％、误诊率为47.28％.实时荧光定量PCR检查宫颈病变类型的准确性较低,一致性不理想.结论 实时荧光定量PCR检查对宫颈癌早期筛查有一定临床意义,敏感度较高,但仍存在一定的误诊和漏诊,且宫颈病变类型鉴别效果不理想,因此还需联合其他检查,进一步提升准确率.
目的 了解子痫前期(PE)患者剖宫产术后的睡眠状况并分析其影响因素.方法 选取139例行剖宫产分娩的PE患者,根据患者术后的匹兹堡睡眠质量指数(PSQI)测评有无发生睡眠障碍分为睡眠障碍组和睡眠正常组,对两组资料进行单因素分析,然后通过多因素Logistic回归分析筛选出影响PE患者剖宫产术后睡眠的显著因素.结果 139例PE患者剖宫产术后PSQI评分为(11.06±2.69)分.PSQI总分＞7分为74例(睡眠障碍组)、≤7分为65例(睡眠正常组).睡眠障碍组与睡眠正常组在紧急剖宫产、术后医院焦虑抑郁量表(HAD)评分、术后视觉模拟评分法(VAS)评分、喂养方式指标比较,差异有统计学意义(P＜0.05).多因素Logistic回归分析表明:紧急剖宫产、术后HAD评分高、术后VAS评分高、纯母乳喂养均是PE患者剖宫产术后睡眠的影响因素(P＜0.05).结论 PE患者剖宫产术后睡眠质量差,其中紧急剖宫产、HAD评分高、VAS评分高、婴儿喂养均是其睡眠差的影响因素.
Objective To explore the endocrine characteristics of infertility patients with obese polycystic ovary syndrome(PCOS).Methods 64 obese PCOS patients with infertility were selected as the study objects.According to their body mass index(BMI),they were divided into obese group(BMI＞24 kg/m2)and non-obese group(18.5～24 kg/m2),with 32 cases in each group.Chemiluminescence immunoassay and radioimmunoassay were used to detect the clinical indexes of the two groups.Anthropometric index,sex hormone and blood lipid levels were compared between the two groups.Results The weight,BMI,hip circumference,waist circumference and waist-to-hip ratio in the obese group were higher than those in the non-obese group,with statistical significance(P＜0.05).The levels of total testosterone(TT),total cholesterol(TC),triglyceride(TG)and fasting insulin(FINS)in the obese group were higher than those in the non-obese group,while the levels of sex hormone binding globulin(SHBG),luteinizing hormone(LH),estradiol(E2),progesterone(P)and prolactin(PRL)in the obese group were lower than those in the non-obese group.The difference was statistically significant(P＜0.05).There was no significant difference in the levels of dehydroepiandrosterone sulfate(DHEAS),follicle-stimulating hormone(FSH),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)between the two groups(P＞0.05).Conclusion Obese PCOS patients with infertility have strong high androgen levels and insulin resistance,and obesity factors are associated with endocrine abnormalities.
Medical abortion is a common method to terminate early pregnancy,but in some cases it may lead to abnormal vaginal bleeding.Abnormal vaginal bleeding after drug abortion may be caused by residues in the uterine cavity,poor uterine contraction,uterine infection and other reasons,and will be accompanied by abdominal pain,fever and other symptoms.Abnormal vaginal bleeding can cause physical and psychological discomfort for women.Therefore,it is extremely important to understand the causes,treatment methods and nursing measures of abnormal vaginal bleeding after drug abortion.This paper mainly studies the causes of abnormal vaginal bleeding after drug abortion,abnormal bleeding symptoms and signs,and the corresponding treatment and nursing methods.
[Abstrac]Objective To observe the clinical significance of providing dexamethasone treatment for patients with endometrial polyps while also cooperating with hysteroscopic endometrial polyp resection surgery.Methods 74 patients with endometrial polyps were selected and divided into an experimental group and a control group,with 37 patients in each group,according to the computerized numbering method.The former group of patients underwent hysteroscopic endometrial polyp resection combined with dexamethasone treatment,while the latter group of patients underwent hysteroscopic endometrial polyp resection.Different comparisons were made between the two groups of patients.Results The comparison between the experimental group and the control group showed that the difference in surgical time was not statistically significant(P＞0.05),and the difference in bleeding volume was not statistically significant(P＞0.05);Menstrual volume reminder:Intragroup comparison:lower after 3 months of treatment,and also lower after 6 months.Intergroup comparison showed fewer differences in the experimental group,with statistical significance(P＜0.05).The hemoglobin level indicates that the experimental group is higher(P＜0.05).The comparison of endometrial thickness showed that the experimental group was thinner(P＜0.05).The recurrence rate suggests that the experimental group has a lower recurrence rate,and the difference is statistically significant(P＜0.05).Conclusion For patients with endometrial polyps,the use of dexamethasone combined with hysteroscopic endometrial polypectomy can reduce menstrual flow,improve endometrial thickness,increase hemoglobin levels,and control disease recurrence rates.This method is worthy of clinical promotion.
Objective To evaluate the effect of psychological nursing on anxiety and depression during cesarean section.Methods 80 women who received cesarean section were selected and divided into observation group and control group by drawing lots,with 40 cases in each group.The control group received routine nursing,and the observation group received psychological nursing.The scores of anxiety,depression,physiological stress response,postoperative rehabilitation and nursing satisfaction were compared between the two groups.Results Compared with the control group,the scores of anxiety and depression were lower in the observation group after nursing(P＜0.05).Compared with the control group,the mean arterial pressure(MAP)and heart rate(HR)levels in the observation group were decreased(P＜0.05).Postoperative lactation time,anal exhaust time,getting out of bed time and hospitalization time in observation group were shorter than those in control group(P＜0.05).The nursing attitude,nurse-patient communication,service quality and nursing operation scores of the observation group were higher than those of the control group(P＜0.05).Conclusion Psychological nursing has a high quality effect in promoting the relief of anxiety and depression,and can promote the improvement of maternal physiological stress,and contribute to the postoperative rehabilitation of maternal,with high application value.
Objective To analyze the clinical effect of ethinestradiol cyproterone tablets combined with metformin in the treatment of polycystic ovary syndrome.Methods 69 patients with PCOS were divided into control group(34 cases)and experimental group(35 cases)according to random number table method.The control group was treated with ethinestradiol cyproterone tablets,and the experimental group was treated with metformin on the basis of the control group.The clinical efficacy and serum sex hormone levels before and after treatment were compared between the two groups.Results The total effective rate of experimental group was 97.1％higher than that of control group(82.4％),and the difference was statistically significant(P＜0.05).Before treatment,there was no significant difference in serum luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T)and estradiol(E2)levels between 2 groups(P＞0.05).After treatment,E2 level of experimental group was higher than that of control group,LH,FSH,T level was lower than that of control group,the difference was statistically significant(P＜0.05).Conclusion The combination of ethinylestradiol cyproterone and metformin in the treatment of polycystic ovary syndrome is effective and can effectively improve the level of sex hormones in patients,which is worthy of clinical promotion.
Objective This study aimed to analyze the clinical effects of vaginal insertion and sublingual administration of misoprostol during outpatient painless abortion surgery for pregnancy termination.Methods 94 patients who underwent painless abortion surgery were selected as the research subjects and divided into control group and observation group in a 1∶1 ratio using random sampling method,47 cases in each group.Both groups received misoprostol before the surgery,while the control group received vaginal administration and the observation group received sublingual administration.The surgical time,intraoperative blood loss,and incidence of adverse events were compared between the two groups.Results The operative time of observation group was significantly shorter than that of control group,and the amount of intraoperative blood loss was significantly less than that of control group,with statistical significance(P＜0.05).The incidence of adverse events in observation group(2.13％)was significantly lower than that in control group(14.89％),and the difference was statistically significant(P＜0.05).Conclusion Sublingual administration of misoprostol during outpatient painless abortion surgery can effectively shorten the surgical time.By taking specific measures,the intraoperative blood loss can be significantly reduced and the incidence of adverse events can be reduced.
Objective To investigate the effect of Cross-linked sodium hyaluronate gel on preventing intrauterine adhesion after intrauterine operation.Methods 78 patients undergoing intrauterine operation were divided into control group and observation group according to random number sampling method,with 39 cases in each group.The control group was treated with conventional antibiotics and uterine stimulating therapy after uterine operation,and the observation group was treated with uterine Cross-linked sodium hyaluronate gel after uterine operation,while conventional antibiotics and uterine stimulating therapy were administered.The indexes of postoperative rehabilitation and the incidence of intrauterine adhesions were compared between the two groups.Results The duration of postoperative abdominal pain and vaginal bleeding in the observation group were significantly shorter than those in the control group,and the amount of postoperative vaginal bleeding was significantly lower than that in the control group,with statistical significance(P＜0.05).Follow-up showed that the period of menstrual rehydration in the observation group was significantly shorter than that in the control group,and the endometrial thickness was thicker 3 months after surgery,with statistical significance(P＜0.05).The IUA score of intrauterine adhesions in the observation group(1.92±0.78)points was significantly lower than that in the control group(3.65±1.42)points three months after surgery,and the incidence of intrauterine adhesions in the observation group 5.13％(2/39)was significantly lower than that in the control group 20.51％(8/39),with statistical significance(P＜0.05).Conclusion Cross-linked sodium hyaluronate gel can effectively reduce the risk of intrauterine adhesions after intrauterine operation,and accelerate the recovery process of patients,and the clinical application effect is reliable.
Objective To observe the value of human papillomavirus DNA(HPV-DNA)typing combined with liquid based thin layer cytology(TCT)in cervical cancer screening.Methods 3000 women undergoing cervical cancer screening were selected as the study objects,and HPV-DNA typing test and TCT examination were all adopted.Colposcopic biopsy histopathology examination was performed on those with HPV-DNA typing high risk type(+),TCT(+)or two kinds of detection double(+),and the test results were compared.Results The positive rates of TCT detection and HPV-DNA detection in 3000 subjects were 4.50％(135/3000)and 21.67％(650/3000),respectively.The positive rate of HPV-DNA in patients with inflammatory or normal atypical squamous epithelial cells(ASC-US),low-grade squamous intraepithelial lesions(LSIL),high-grade squamous epithelial lesions(HSIL)and squamous cell carcinoma(SCC)was gradually increased by TCT.Taking colposcopic biopsy histopathology as the gold standard,the positive detection rate of the two methods in the cervical intraepithelial neoplasia(CIN)grade 1,CIN2 and CIN3 groups was significantly higher than that of the single method,with statistical significance(P＜0.05).The synergistic positive detection rate of CIN3 and SCC groups was higher than that of CIN1 and CIN2 groups,but the difference was not statistically significant(P＞0.05).Conclusion HPV-DNA typing test,TCT test and colposcopic biopsy histopathology have their advantages and disadvantages,and reasonable combined screening can make up for each other's shortcomings.
Objective To explore the application value of ultrasound diagnosis of velamentous placenta in obstetrics in the third trimester of pregnancy.Methods According to the presence or absence of velar placenta,70 parturients were divided into the patient group(velamentous placenta parturients)and the healthy group(non-velamentous placenta parturients),with 35 cases each.The patient group was given late ultrasound examination,based on the postpartum diagnosis results,and the postpartum diagnosis and ultrasonic placental disease detection in the third trimester of pregnancy were compared in the patient group,and the clinical indicators of the two groups were compared,and the ultrasonic imaging characteristics of the velamentous placenta were analyzed.Results The ultrasound detection rate in the third trimester of pregnancy(91.43％)was significantly consistent with the postpartum diagnosis result(100％),with no statistical significance(x2=3.1343,P=0.0767＞0.05).The incidence of prenatal vaginal bleeding,abnormal fetal heart monitoring,cesarean section and poor neonatal prognosis in the patient group was higher than that in the healthy group,and the average blood loss was higher than that in the healthy group,the difference was statistically significant(P＜0.05).Conclusion If pregnant women with velar placenta symptoms are not paid attention to,they may have a poor prognosis for newborns.Ultrasonography in the third trimester can effectively detect and screen the velamentous placenta,and the umbilical cord is located at the placenta insertion position,providing a reliable reference for clinical practice.
Objective To analyze the implementation value of integrating emotional regulation self-efficacy in nursing teaching of obstetrics and gynecology.Methods 71 students of obstetrics and gynecology nursing from 2 classes in 2021 were selected,and class 1 was included in the control group(35 students),and the traditional teaching method was adopted.Class 2 was included in the observation group(36 students),and self-efficacy of emotion regulation was taught.The test results,teaching effect and teaching satisfaction of the two groups were compared.Results The scores of prenatal examination,perineal cleaning,cervical medicine and breastfeeding in the observation group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The scores of emotion regulation ability,mastery of emotion regulation methods,learning interest and knowledge self-summary ability of the observation group were higher than those of the control group,and the differences were statistically significant(P＜0.05).The teaching satisfaction of the observation group was 94.44％higher than that of the control group(77.14％),the difference was statistically significant(P＜0.05).Conclusion Integrating emotional self-efficacy into nursing teaching of obstetrics and gynecology can improve teaching effect,enhance students'mastery of professional knowledge and improve teaching satisfaction,which is worth popularizing.
Objective To brief analysis of the treatment experience of critical patients with hemorrhagic shock in obstetrics.Methods 32 critically ill patients with obstetric hemorrhagic shock were selected(the actual number of patients after excluding the survivors),and the patients were given real-time monitoring,rescue treatment,anti-shock treatment,prevention and treatment of organ failure,etc.The treatment results of the patients,the satisfaction degree of the rescue effect of the patients'families,and the anxiety scores of the patients before and after treatment were analyzed.Results All 32 patients were out of danger after active treatment,and the success rate of treatment was 100％.Perinatal outcome:29 cases were good,3 cases were mild asphyxia,and no severe asphyxia or stillbirth.Maternal outcome:Total hysterectomy in 3 cases,no death cases.The total satisfaction of 32 patients'family members was 96.88％.After treatment,the anxiety score of patients[(43.29±3.10)points]was lower than that before treatment[(56.34±2.91)points],and the difference was statistically significant(P＜0.05).Conclusion The positive treatment of critical patients with hemorrhagic shock in obstetrics can reduce the death rate,promote the improvement of the condition,improve the satisfaction of the family members of the patients on the rescue results,and improve the anxiety of the patients.
Objective To analyze the effect of standardized graded transport scheme on the transport of critical patients in emergency obstetrics and gynecology.Methods 70 critically ill patients were selected and divided into control group and observation group according to different transport schedules,with 35 cases each.The control group carried out the work according to the hospital operation process,and the observation group implemented the standardized graded transport scheme.The transport time,adverse transport events and nursing satisfaction were compared between the two groups.Results The transport time from observation group to intervention room,intensive care unit,operating room and general ward was shorter than that of control group,and the difference was statistically significant(P＜0.05).The incidence of bed fall,vaginal bleeding,disease deterioration and abnormal fetal movement during transport in observation group was lower than that in control group,and the difference was statistically significant(P＜0.05).The total nursing satisfaction of the observation group(97.14％)was higher than that of the control group(77.14％),and the difference was statistically significant(P＜0.05).Conclusion The implementation of standardized graded transport scheme for critical patients in emergency obstetrics and gynecology can effectively shorten the transport time,ensure the safety of the patient's transport process,and improve their nursing satisfaction,which has high clinical promotion value.
Objective To analyze the significance of TORCH(Toxoplasma gondii,rubella virus and cytomegalo virus)detection in pre-pregnancy health examination.Methods A total of 265 women who underwent pre-pregnancy health examination were selected as the study objects.All of them were tested with TORCH antibody and the test results were observed.Results The positive rates of TOX-IgG(Toxoplasma gondii),CMV-IgG(Cytomegalo virus)and RUV-IgG(rubella virus)were 1.13％,43.02％and 38.49％respectively.The positive rate of TOX-IgM(Toxoplasma gondii)was 0.75％and that of CMV-IgM(Cytomegalo virus)was 0.38％.Conclusion TORCH test has a very important significance in the pre-pregnancy health examination,and it is worthy of screening application in the female Dre-Dregnancy health examination.
Objective To study the effect of low dose oral contraceptives on blood clotting in women.Methods 100 women were selected and divided into small dose oral contraceptive group(oral contraceptive group)and intrauterine device group(50 cases each)according to different contraceptive methods.The blood coagulation index level and abnormal coagulation index were compared between the two groups.Results Comparison of plasma partial thromboplastin time(APTT),thrombin time(TT),prothrombin time-fibrinogen[PT-FIB(A),PT-FIB(B)],Factor Ⅱ,Factor Ⅴ,Factor Ⅶ and Factor Ⅷ of the two groups of women There was no statistically significant difference(P＞0.05).Factor Ⅹ of 18-a and No.1 tablets in the oral contraceptive group was higher than that in the intrauterine device group(P＜0.05),but there was no statistically significant difference in Factor Ⅹ of 18-A and No.1 tablets in the oral contraceptive group(P＞0.05).The abnormal rates of 18-A and No.1 tablets in the oral contraceptive group were 36.00％and 48.00％,respectively,compared with 40.00％in the intrauterine device group,there was no significant difference(P＞0.05).Conclusion Women taking small doses of oral contraceptives have a certain degree of negative impact on blood clotting.Different oral contraceptives also have different effects on blood clotting,but the level of coagulation index fluctuates within the normal range.
Objective To observe the effect of nutrition support comprehensive nursing in elderly patients with gynecological tumors.Methods 110 elderly patients with gynecological tumors were selected and divided into control group and observation group according to random drawing method,with 55 cases in each group.The control group received conventional nutrition nursing,and the observation group received comprehensive nutrition support nursing.Serum albumin(ALB),prealbumin(PA),body mass index(BMI)and psychological status scores were compared between the two groups at admission and discharge.Results Before admission,there was no significant difference in ALB,PA and BMI between the two groups(P＞0.05).At discharge,the indexes of ALB,PA and BMI in observation group were higher than those in control group,and the difference was statistically significant(P＜0.05).Before nursing,there was no significant difference in hamilton anxiety scale(HAMA)and hamilton depression scale(HAMD)scores between the two groups(P＞0.05).After nursing,HAMD and HAMA scores in the observation group were(12.34±1.64)points and(7.24±1.66)points,respectively,which were lower than those in the control group(17.41±2.36)points and(12.67±2.44)points,and the differences were statistically significant(P＜0.05).Conclusion The application of comprehensive nursing of nutrition support to elderly patients with gynecological tumors can get better nutrition support and physical function recovery,improve psychological state,and is worthy of clinical promotion.
Objective To investigate the effect of ultrasound-guided block of lower back quadrate muscle in patients undergoing laparoscopic myomectomy,and to evaluate its effect on hemodynamics and quality of recovery.Methods 100 patients undergoing laparoscopic myomectomy were selected and divided into control group(general anesthesia with visual laryngeal mask)and experimental group(general anesthesia with visual laryngeal mask+ultrasound guided quadrate muscle block)according to different anesthesia methods,with 50 cases each.The hemodynamic indexes and recovery quality of the two groups were compared.Results Before anesthesia,there was no significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two groups(P＞0.05).MAP and HR levels in experimental group were lower than those in control group(P＜0.05)after myomectomy.The eye opening time,extubation time and recovery time of experimental groups were(6.12±0.53)min,(8.43±1.23)min and(25.54±2.35)min,respectively.The eye opening time,extubation time and recovery time of the control group were(8.43±0.41)min,(9.55±1.34)min and(28.34±2.09)min,respectively.Compared with control group,the eye opening time,extubation time and recovery time of experimental group were shorter(P＜0.05).Conclusion Ultrasound-guided block of low back quadrate muscle in patients undergoing laparoscopic myomectomy can keep the hemodynamic indexes of patients stable and shorten the time of extubation and recovery of patients,which is worthy of clinical promotion.
Objective To study the clinical characteristics of adult female patients with chronic pelvic pain(CPP)in Wuhai City,and analyze its influencing factors,so as to provide clinical basis for prevention and treatment of CPP.Methods 1672 gynecological outpatient patients were selected,and the modified pelvic pain assessment table was used to evaluate the clinical characteristics of CPP,and the influencing factors of CPP were analyzed by univariate analysis and multivariate Logistic regression.Results A total of 1672 questionnaires were distributed and 1659 valid questionnaires were collected,with an effective rate of 99.22％.Among the 1659 patients,1020(61.48％)were CPP patients and 639(38.52％)were non-CPP patients.The main causes of CPP postpartum(37.35％)and were menarche(36.67％).Most of the causes of pain attack were single factors(72.06％).The pain was concentrated in the lower abdomen(53.82％)and perineum(36.76％).The main ways to relieve pain were keeping warm(38.33％),rest(31.37％),and medication(31.47％).In the course of onset,most of the pain sites were fixed(66.86％).Pain associated with urination was more than half(56.76％).Most of them had anorectal symptoms(59.71％).There were significant differences between CPP group and non-CPP group in body mass index(BMI),pregnancy time,delivery time,educational background,anorectal symptoms and urine leakage(P＜0.05).Multivariate Logistic regression analysis showed that anorectal symptoms,urine leakage and educational background were the influencing factors for the onset of CPP(P＜0.05).Conclusion CPP is easy to be associated with anxiety,when patients appear anorectum,urine leakage related symptoms,attention should be paid,timely treatment can prevent and improve CPP.
Objective To investigate the effect of hormone replacement therapy(HRT)on the level and safety of bone metabolism markers in perimenopausal women with osteoporosis.Methods 60 cases of perimenopausal female osteoporosis patients were selected and divided into control group and observation group according to random number table method.The control group was treated with alendronate sodium,and the observation group was treated with HRT.The bone mineral density(BMD),estradio(E2),follicle-stimulating hormone(FSH)and bone-specific alkaline phosphatase(BAP)type Ⅰ procollagen N-terminal propeptide(PINP),type Ⅰ collagen cross-linked C-terminal peptide(S-CTX)before and after treatment,the complication occurrence were compared between the two groups.Results Before treatment,there were no significant differences in BMD,E2,FSH and BAP levels between 2 groups(P＞0.05).After treatment,BMD,E2,FSH and BAP levels in observation group were significantly better than those in control group,with statistical significance(P＜0.05).Before treatment,there was no significant difference in PINP and S-CTX between 2 groups(P＞0.05).After treatment,PINP and S-CTX in observation group were significantly lower than those in control group,with statistical significance(P＜0.05).The incidence of adverse reactions in observation group(3.3％)was significantly lower than that in control group(20.0％),and the difference was statistically significant(P＜0.05).Conclusion HRT therapy can improve the level of bone metabolism markers and improve treatment safety in perimenopausal women with osteoporosis,which is worthy of promotion.
