目的:探究分娩镇痛对单胎子痫前期产妇平均动脉压(MAP)、外周血管阻力(SVR)、产程及不良妊娠结局的影响.方法:将本院2017年2月一2019年10月收治的107例单胎子痫前期患者纳为观察对象,根据患者意愿分为镇痛组(硬膜外自控镇痛,n=67)与非镇痛组(不使用镇痛药物,n=40),分别监测两组临产时(T0)、潜伏期(宫口>1cm,T1)、活跃期(宫口>3cm,T2)、活跃期lh(T3)、宫口全开(T4)时产妇平均动脉压(MAP)、外周血管阻力(SVR)、心输出量(CO)水平,并记录两组产程及不良妊娠结局.结果:非镇痛组T0、T1、T2、T3、T4过程中MAP、SVR及CO水平均维持较高水平,无显著性波动(P>0.05),镇痛组T2、T3、T4时MAP、SVR及CO均较T0时降低(P<0.05),且低于同期非镇痛组(均P<0.05);第一产程镇痛组(144.15±35.59mm)短于非镇痛组(198.15±41.15mm),第二产程镇痛组(46.15±6.47mm)长于非镇痛组(37.15±7.44mm)(P<0.05);镇痛组产妇平产率(80.6％)高于非镇痛组(60.0％),产钳助产率(16.4％)低于非镇痛组(35.0％)(均P<0.05),两组中转剖宫产率无差异(P>0.05);镇痛组宫缩素使用率(74.6％)高于非镇痛组(32.5％),降压药使用率(29.9％)低于非镇痛组(65.0％), VAS评分(2.37±0.68分)低于非镇痛组(7.45±1.24分)(均P<0.05);两组产后出血、新生儿窒息、胎儿窘迫发生率,以及新生儿1min及5min Apgar评分均无差异(均P>0.05).结论:分娩镇痛能有效改善子痫前期产妇血流动力学状态,降低阴道试产危险性,提高平产率,更好保障母婴安全.

To explore the efficacy of hemoglobin A 1c(HbA1c) screening in the diagnosis and detec-tion of 6-month-postpartum recurrence of gestational diabetes mellitus (GDM ) and the influence of interventional ther-apy on body weight and blood glucose of newborns .[Methods] Totally 231 GDM patients and 240 healthy pregnant women were enrolled in the study .Body weight ,fasting blood glucose(FBG) ,oral glucose tolerance test(OGTT) and HbA1 level of newborns at 6 weeks after delivery were measured and compared .The recurrence rate of diabetes mellitus was calculated .[Results] The recurrent case number of GDM patients detected by FBG ,OGTT and HbA1c at 6 weeks after delivery were 7(3% ) ,8(3 .5% ) and 14(6 .1% ) ,respectively .The sensitivity and specificity of HbA1c≥43mmol/mol for the detection of diabetes mellitus were 100% and 92 .6% ,respectively .The sensitivity and specificity of HbA1c≥48mmol/mol for the detection of diabetes mellitus were 73 .6% and 98 .5% ,respectively . There was no significant difference in blood glucose and body weight between newborns of GDM patients and normal newborns( P>0 .05) .[Conclusion] HbA1c≥48mmol/mol is more suitable for the early diagnosis of GDM postpar-tum diabetes mellitus .

Objective To investigate effect of bile acid and liver enzyme index on prognosis of neonates in intrahepatic cholestasis of pregnancy (ICP).Methods 35 pregnant patients with in-trahepatic cholestasis were as the observation group,and the relationship between ICP pregnant women,total bile acid (TBA),alanine aminotransferase (ALT),aspartate aminotransferase (AST),gestational age,newborn meconium-staining amniotic fluid and bile acid,the birth of ges-tational age,birth weight,meconium stained amniotic fluid and neonatal asphyxia were analyzed. 60 normal pregnant women during the same period were selected as control group,and the data of the two groups were comparative analyzed.Results In the observation group,TBA,ALT and AST in pregnant women were significantly higher than that in the control group,the difference was significant (P <0.05);Gestational age and body weight in the observation group was significantly lower than that in the control group,which showed statistically significant (P <0.05);Meconium stained amniotic fluid rate,the rate of neonatal asphyxia,fetal distress in the observation group was significantly higher than that in control group ,so the difference was statistically significant (P <0.05).Conclusion The increased bile acid and liver enzymes in ICP pregnancy women may be the main cause of fetal hypoxia and bad prognosis of neonates,so it should be actively controlled.

Objective:To investigate the correlation of pregnant women's calcium content and gestational hypertension.Methods:235 cases gestational hypertension pregnant women were chosen as the observation group,maternity serum samples were extracted to detect calcium content in serum,a kind of trace elements.200 cases normal pregnant women were chosen as the control group,and the calcium content in serum were also detected.The calcium contents of two groups were compared,and after treating hypertension pregnant women with calcium supplements,to detect the trend of their blood pressure,the correlation of pregnant women calcium content and gestational hypertension were investigated.Results:The average concentration of calcium ions in mild gestational hypertension pregnant women of the observation group was(2.11±0.24) mmol/L,In moderate gestational hypertension pregnant women of the observation group the average concentration of calcium ions was(2.03±0.21)mmol/L,and in severe gestational hypertension pregnant women of the observation group it was(1.98±0.25)mmol/L.The average concentration of calcium ions in the observation group was(2.05±0.22) mmol/L while the value in the control group was(2.40±0.28) mmol/L.The average concentration of calcium ions in the control group was higher than that in the observation group(P0.05).And in the observation group,the average concentration of calcium ions was on the decline with the rising blood pressure value(P0.05).After calcium treatment,the average blood pressure of mild gestational hypertension pregnant was lower than the value before the treatment(P0.05).And in the moderate and severe gestational hypertension pregnant women,the value of average blood pressure after the treatment were both obviously lower than the value before the treatment(P0.01).Conclusions:The occurrence of gestational hypertension should be correlated with serum calcium content in pregnant women.So enhancing the uptake of trace elements calcium in pregnancy,can provide a new idea for controlling the occurrence and development of gestational hypertension.

Objective: To study the scar uterus women after pregnancy again the clinical effect of using different delivery way,provide reliable experience and guidance for the future of scar uterus puerpera childbirth.Methods: 120 cases of uterine scar pregnancy again pregnant women from May 2011 to October 2012 in our hospital were selected and divided into two groups,cesarean section group and vaginal delivery group respectively,compared two groups' pregnant women postpartum and neonatal asphyxia,postpartum hemorrhage and puerperal fever,etc.Results: Through statistical after cesarean delivery group is found that on average postpartum blood loss,neonatal asphyxia,maternal labor time and the vaginal delivery group difference is not much,but the gap between more and first-time mothers cesarean delivery.Conclusion: Scar uterus women after pregnancy childbirth vaginal delivery mode,can be used again in before and after childbirth to prepare work and the maternal psychological counseling,is worthy of clinical use.

目的:探讨盐酸利托君对妊娠合并重度贫血先兆早产、先兆临产患者中抑制宫缩、延长孕龄、赢得输血时间、改善妊娠结局的临床效果。方法:60例妊娠合并重度贫血患者,30例使用盐酸利托君,30例使用硫酸镁治疗,对比分析用药后抑制宫缩显效时间、作用强度、延长孕龄、输血量、不良反应及妊娠结局。结果:盐酸利托君组抑制宫缩显效快、作用强、延长孕期时间均显著高于硫酸镁组。盐酸利托君组孕妇贫血状况明显改善,不良反应率下降。结论:盐酸利托君抑制宫缩作用强、显效快、成功率较高,安全有效,用于重度贫血先兆早产、先兆临产的患者,能赢得输血时间、改善妊娠结局。

目的:探讨尿脂联素、内皮素-1和一氧化氮与妊娠期高血压疾病发病的关系。方法:分别采用酶联免疫吸附法、硝酸还原法测定457例妊娠期高血压疾病患者及148例正常晚期妊娠孕妇尿脂联素、内皮素-1和NO水平。结果:与对照组相比,GH组、MP组、SP组、子痫组尿脂联素、NO逐渐降低,ET-1逐渐升高且各组之间差异有统计学意义（P＜0.05）。GH组、MP组、SP组、子痫组尿脂联素水平与ET-1、收缩压、舒张压成负相关（r=-0.42,P＜0.05;r=-0.571,P＜0.05;r=-0.64,P＜0.05）,而与NO成正相关（r=0.413,P＜0.01）。尿脂联素与HDCP的发病成负相关（r=0.37,P＜0.05;β=0.127,P＜0.05）。校正年龄、孕次、BMI这些混淆因素后,尿脂联素水平仍与HDCP的发生显著负相关（r=0.33,P＜0.05;β=0.129,P＜0.05）结论:尿脂联素可预测妊娠期高血压疾病的发生。

Objective To reduce complications of pregnancy and childbirth and tto improve maternal and newborn health by screening for gestational diabetes mellitus.Method From 2010-01-2012-01,1470 of 24~28 week pregnant women access to voluntary screening for gestational diabetes mellitus were grouped according to with or without risk factors of diabetes;no risk factors are divided into group A,a total of 930,rick factors into group B,a total of 540 people.Screening include gestational diabetes millitus FPG+75g OGTT.In necessary,check the glyyosylated hemoglobin.Results the group of A,460 persons lost to follow-up,by routine antenatal checks no exceptions for FPG+75gOGTT,Detected in patients with gestational diabetes mellitus 3 people,detection rate of 0.3 per cent,loss to follow-up of 49.4 per cent.The group of B,4 persons lost to follow-up,people who have diabetes risk factors,through positive for urine routine inspection identified people,112 people confirmed patients,detection rate of 20.7 per cent,loss to follow-up of 0.7 per cent.The compliance of patients with good,compared to both have sighificant differences,P<0.05.Conclusion screening for GDM in Yan,an area,regular antenatal urine positive and risk factors in patients with FPG +75g OGTT in necessary check the glycosylated hemoglobin methods,simple,economic,high detection rate,patients with affordable,reducing maternal mortality and neonatal morbidity,so as to improve the health of women and children,so it,s worth promoting.

Objective:To investigate whether or not urine adiponectin of progestation can predict gestational diabetes mellitus(GDM).Methods:From December 2009 to June 2010,blood and urine samples were obtained from 260 progestation women,134 normal pregnant women served as control group and 126 GDM pregnant women served as test group.The enzyme-linked immunosorbent assay was used to examine the levels of adiponectin,at the same time the fasting blood glucose,insulin concentration were detected.Results:The urine levels of adiponectin in GDM group was lower than in control group,there was significant difference between the two groups(P<0.05).The serum levels of insulin in GDM group was higher than in control group,there was significant difference between the two groups(P<0.05).The level of urine adiponectin was no correlation with the level of FBG in GDM group and control group,but was negative correlation with the insulin(r=﹣0.41,P<0.05;r=﹣0.56,P<0.05).Among pregnant women,urine adiponectin of progestation was negative associated with GDM(r=0.34,P<0.05) and was still negative associated with GDM after correcting some obscure factors(r=0.32,P<0.05;β=0.121,P<0.05).Conclusion:Urine adiponectin of progestation can predict gestational diabetes.

目的分析讨论盐酸利托君治疗先兆早产的临床效果。方法对40例使用盐酸利托君和40例使用硫酸镁的先兆早产患者进行回顾性分析,对患者用药后的保胎效果、起效时间、不良反应及治疗时间与住院时间进行比较。结果盐酸利托君组保胎成功率、起效时间、延长孕期时间均显著高于硫酸镁组。盐酸利托君组新生儿状况改善,不良反应率下降,患者治疗时间与住院时间明显缩短。结论盐酸利托君抑制宫缩作用强,显效快,成功率较高,安全有效,可作为目前治疗先兆早产的首选药物。

目的:探讨胎头高直后位的诊断及处理。方法:对68例胎头高直后位病例资料进行回顾性分析。结果:68例中有64例临产后发生胎头不入盆,占94.1%。宫缩乏力49例,占72.0%。潜伏期延长58例,占85.3%,胎膜早破17例,占25%。65例行剖宫产,占95.6%。无1例发生子宫破裂和产后出血。结论:胎头高直后位是分娩难度很大、剖宫产率高的异常胎位.应早期诊断。

<正> 资料与方法2004年4月～2006年4月收住输卵管妊娠69例,年龄20～45岁,平均28.5岁,其中21～30岁49例(71.01%)。经产妇40例,未产妇29例;已孕育者60例(86.96%),其中21例为经产妇。发病因素:69例中曾有盆腔炎性疾病史及手术史45例,其中有流产史18例,盆腔炎性疾病史8例,异位妊娠史7

<正> 资料与方法2005年4月～2007年4月收治绝经后妇女取宫内节育器31例,年龄49～65岁,平均53.23岁;常规应用尼尔雌醇配伍米索前列醇软化宫颈。宫内置宫内节育器(IUD)时间18～29年,均为金属单环;孕次2～9次,绝经时间3～15年,平

目的探讨微波治疗慢性宫颈炎的效果,治疗时遇到的问题及对策。方法对接受门诊治疗的慢性宫颈炎121例进行回顾性分析。结果其中96例宫颈糜烂一次性治愈率为93.75(、17例宫颈腺体囊肿治愈率为100%、8例宫颈息肉治愈率为100%。结论微波治疗慢性宫颈炎效果满意,治疗间隔时间应大于3个月,注意术中与术后出血的防治。

目的:探讨羊水过少对围产儿的影响及相关因素,采取正确的处理方法,降低围产儿的死亡率,提高围产儿生活质量。方法:回顾性分析59例羊水过少对围产儿预后的影响及相关资料。结果:羊水过少高发于孕40周以后,B超诊断羊水过少的临床符合率84.74%,羊水过少最多的并发症为妊娠期高血压疾病,胎儿生长发育迟缓(IUGR)及过期妊娠,羊水量越少,胎儿窘迫发生率越高。结论:B超诊断是及时发现羊水过少的可靠方法,胎盘功能不全是羊水过少的主要原因,与胎儿宫内缺氧有密切关系,一经确诊,及早行剖宫产终止妊娠。

中期妊娠引产方法很多,为了寻找一种更为安全、有效、经济、简便的引产方法,本文对单用雷夫诺尔羊膜腔注射引产、米非司酮配伍米索前列腺醇引产以及米非司酮作为雷夫诺尔羊膜腔注射引产前的准备终止中期妊娠的效果及其副反应,现将结果报道如下.

我院1999年8月-2001年9月对腹部切口裂开25例病人采用KS光热治疗仪(北京科龙生物医学技术总公司KS-5A型)照射治疗,取得良好效果,现报道如下.

妊娠期孕妇对无机盐和微量元素的需要增加,而一般膳食中较易缺乏的主要是钙、铁、锌、碘.本课题在西安市微量元素检测所共同参与下进行,调查了在我科分娩的新生儿脐血中钙、铁、锌的含量,对加强孕期保健,进行高危管理.

会阴Ⅲ°裂伤是经阴道分娩较少见的并发症,如不及时进行正确修补和术后护理,可导致大便失禁和粪漏,本文对48例会阴Ⅲ°裂伤分析报道如下.