Objective To explore the effect of probiotics combined with prebiotics on clinical hypothyroidism during pregnancy combined with small intestinal bacterial overgrowth. Methods (1) In total, 441 pregnant women were included in this study. A total of 231 patients with clinical hypothyroidism during the second trimester of pregnancy and 210 normal pregnant women were enrolled in the lactulose methane-hydrogen breath test. The positive rate of intestinal bacterial overgrowth (SIBO), gastrointestinal symptoms, thyroid function and inflammatory factors were compared between the two groups by chi-square test and two independent sample t-test. (2) SIBO-positive patients in the clinical hypothyroidism group during pregnancy (n=112) were treated with probiotics combined with prebiotics based on conventional levothyroxine sodium tablets treatment. The changes in the methane-hydrogen breath test, gastrointestinal symptoms, thyroid function and inflammatory factors were compared before treatment (G0) and 21 days after treatment (G21) by chi-square test and paired sample t test. Results (1) The positive rates of SIBO in pregnant women in the clinical hypothyroidism group and control group were 48.5% and 24.8%, respectively. (2) The incidence of abdominal distention and constipation in the clinical hypothyroidism group was significantly higher than that in the control group, and the risk of abdominal distention and constipation in SIBO-positive pregnant women was higher than that in SIBO-negative pregnant women. (3) The serum levels of hypersensitive C-reactive protein (hsCRP), IL-10, IL-6, TNF-α, low-density lipoprotein (LDL), total cholesterol (TC), free fatty acids (FFAs) and apolipoprotein B (ApoB) in the hypothyroidism group during pregnancy were higher than those in the control group. (4) After 21 days of probiotics combined with prebiotics, the incidence of pure methane positivity in the methane-hydrogen breath test in the G21 group was significantly reduced, and the average abundance of hydrogen and methane at each time point in the G21 group was lower than that in the G0 group. (5) The incidence of constipation in the G21 group was significantly lower than before treatment. (6) The levels of serum TSH, hsCRP, IL-6, TNF-α, TC and LDL in pregnant women after probiotics combined with prebiotics were lower than those before treatment. Conclusion Probiotics combined with prebiotics are effective in the treatment of pregnant patients with clinical hypothyroidism complicated with SIBO, providing a new idea to treat pregnant patients with clinical hypothyroidism complicated with SIBO.
早发性卵巢功能不全(POI)对女性最大的危害是生殖功能提前衰退和过早出现的低雌激素状态.临床上多数POI患者的生育愿望难以顺利实现,常常需要借助供卵体外受精-胚胎移植(IVF-ET)治疗完成.但是POI患者除生殖以外的卵巢内分泌功能完全可以通过激素补充治疗(HRT)实现,从而有效改善低雌激素状态,预防远期并发症,提高患者生活质量.尤其是对于青春期女性诱发第二性征,维护正常性心理、促进性健康和骨健康等尤为重要.POI患者只要排除了禁忌证,应尽早开始HRT,并坚持长期使用,直至妇女平均绝经年龄(50岁),再按绝经激素治疗(MHT)流程判断是否可以继续采用绝经激素治疗.
腹腔镜下全子宫切除术为妇科良性疾病常见的手术方式.随着腹腔镜技术日益成熟,其适应证不断扩大.在临床实践中,应严格掌握手术适应证,术前精准评估和讨论,加强腹腔镜培训和技术水平提高,熟悉能量器械的使用,掌握腹腔镜手术技巧,规范术后监测,让腹腔镜技术在妇科良性疾病中的优势发挥到最大.
目的 探讨咖啡对妇科恶性肿瘤经腹手术患者术后胃肠功能恢复的影响.方法 选取2020年8月至2021年8月中国医科大学附属盛京医院妇科收治的因恶性肿瘤住院行开腹手术的95例患者,随机分为观察组47例和对照组48例.对照组在术后第1天起8:00am、2:00pm 口服温水150mL,共3d.观察组在术后第1天起分别于8:00am、2:00pm咖啡粉1.8g加温水150mL 口服,共3d.其他治疗及护理与对照组相同.最终共有观察组45例和对照组46例参与分析.比较两组患者一般资料结果与手术变量、术后首次排气时间、首次排便时间、术后24h及术后48h自身疼痛评分;术后腹胀、恶心、呕吐、发生肠梗阻情况;术后住院时间及住院总费用.结果 两组患者的一般资料结果与手术变量无统计学意义(P＞0.05).观察组与对照组相比,术后首次排气时间缩短[(45.2±15.4)hvs.(52.9±13.5)h,P＜0.05)];首次排便时间缩短[(74.4±15.6)hvs.(83.8±13.9)h,P＜0.05];术后24h 自身疼痛评分降低[(5(2～8)分vs.5.5(3～9)分,P＜0.05];术后48h自身疼痛评分降低[2(1～5)分vs.3(2～5)分,P＜0.05].术后腹胀的发生率降低(36.6％vs.58.7％,P＜0.05).而观察组与对照组的术后住院时间、住院费用、术后恶心发生率、术后呕吐发生率、术后肠梗阻发生率比较差异无统计学意义.结论 术后饮用咖啡能缩短妇科恶性肿瘤患者经腹手术后首次排气时间、首次排便时间,促进妇科恶性肿瘤患者经腹手术后胃肠功能的恢复.
子宫颈缩短是指妊娠中期经阴道超声测量的子宫颈长度≤25mm,对于预测自发性早产和指导先兆早产临床决策具有重要意义.近些年,国内外学者开始关注子宫颈缩短的高危因素、筛查方案及治疗手段.文章从妊娠期子宫颈缩短的高危因素谈起,阐述孕酮尤其是阴道用孕酮治疗子宫颈缩短的机制、适应证及临床疗效,为防治早产提供参考依据.
