目的：采用网织红细胞血红蛋白含量（CHr）和红细胞平均体积（MCV）鉴别诊断产后贫血中的缺铁性贫血，以减少不必要的铁剂补充。方法将216例产妇分成101例对照组（Hb≥10.5g/dl）和115例贫血组（6.0<Hb<10.5g/dl）。产后贫血组给予4周的补铁治疗，利用Hb、MCV、CHr在基线（T0）和4周后（T4）间水平变化来观察补铁治疗反应。使用MCV、CHr诊断缺铁性贫血的参考值（80fl、28pg）再将产后贫血组分别分成各两小组：MCV低值组和正常值组、CHr低值组和正常值组。结果在贫血组中，MCV和CHr各低值组和正常值组的Hb均相同增加，在MCV和CHr的低值组中相对应的MCV和CHr都显著增加，而MCV和CHr的正常值组中相对应的MCV和CHr未显著变化，推测MCV和CHr的低值组对补铁有治疗反应，存在缺铁现象，反之无。结论产后贫血并非一定是缺铁性贫血，Hb、MCV、CHr的联合检测可有效地鉴别诊断真正的产后缺铁性贫血，减少不必要的铁剂补充。

目的 观察克霉唑栓与伊曲康唑联合治疗复发性外阴阴道假丝酵母菌病(RVVC)的临床疗效.方法 收集135例RVVC患者,按照治疗方法不同分为A、B及C3组,每组45例.A、B两组均于第1个月给予克霉唑栓与伊曲康唑联合治疗,但A组次月起单用克霉唑栓,B组继续使用联合治疗,C组仅给予克霉唑栓治疗,6个月后对比观察3组治疗的临床疗效、不良反应及复发率情况.结果 随访6个月后,A、B两组的镜检假丝酵母菌转阴率及有效率均显著性高于C组;A、B两组的复发率显著低于C组;但两组假丝酵母菌转阴率、有效率及复发率差异均无统计学意义(均P＞ 0.05).结论 采用首月克霉唑栓阴道用药配合口服伊曲康唑,次月单用克霉唑栓阴道用药方案,治疗效果好.

Objective To investigate the clinical value of umbilical cord blood flow S/D ratio and?fetal heart rate monitoring in evaluation of high-risk pregnancy women with fetal distress.Methods A total of 300 high-risk pregnancy women were detected by fetal heart rate monitoring and umbilical artery flow velocimetry from January 2010 to December 2011.The pollution rate of amniotic fluid,the rate of fetal distress and Apgar score of newborn were compared and analyzed.Results The incidence of oligohydramnios(66.7%),fetal distress(43.3%)and Apgar score(48.3%)increased significantly in Ⅳ group than those in normal group(Ⅰgroup)(47.2%、27.3%、27.3%).The umbilical cord entangle neck of Caesarean section with fetal distress was significantly higher than that in Ⅰgroup(35.0% vs18.2%、66.7%vs44.9%).The umbilical cord entangle neck in Ⅱ group was lower than that in Ⅰgroup(4.0%vs18.2%)with significant difference,and the incidence of caesarean section in Ⅱ group was higher than that in Ⅲ group(60.0%vs51.3%),but there was no significant different.The umbilical cord blood flow S/D ratio combined with fetal heart rate monitoring in sensitivity,specificity,positive rate,negative rate was better than that of which was single used.Conclusion Detection of S/D ratio of umbilical cord blood flow combined with Fetal heart rate monitoring can obviously increase the judgment and improve the fetal prognosis with fetal distress.

发生于特殊部位如间质部、宫角、宫颈、残角子宫等部位的异位妊娠比较少见,因其早期诊断困难,易致误诊、误治造成不良后果.平湖市第一人民医院2000年2月～2008年2月收治32例特殊部位异位妊娠患者,报道如下.

盆腔包裹性积液亦称盆腔炎性包裹性囊肿或盆腔腹膜囊肿,可由盆腔炎症、盆腹部手术造成,具有难治性和易复发的特点.笔者对我院2004年7月-2007年7月收治的42例包裹性积液患者进行分析,报道如下.