目的 探讨腹腔镜下电凝术联合孕三烯酮治疗子宫内膜异位症的效果.方法 选取2014年9月至2016年9月洛阳东方医院收治的102例子宫内膜异位症患者,按随机数表法分组,各51例.对照组接受腹腔镜下电凝术治疗,观察组接受腹腔镜下电凝术联合孕三烯酮治疗,统计对比两组临床疗效,并对比两组手术情况.结果 观察组治疗总有效率[94.12％(48/51)]高于对照组[78.43％(40/51)],差异有统计学意义(P<0.05);观察组康复时间、肛门排气时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率[5.88％(3/51)]低于对照组[29.41％(15/51)],差异有统计学意义(P<0.05).结论 腹腔镜下电凝术联合孕三烯酮治疗子宫内膜异位症效果显著,可减少术中出血量,促进患者康复,降低不良反应发生率,值得推广.

产科出血是围产期孕妇死亡的主要原因.完全性前置胎盘是足月后胎盘附着于子宫的下段 ,覆盖在孕妇的子宫颈内口 ,其位置低于胎先露部 ,是妊娠晚期孕妇发生产后出血的最常见原因[1 ] .近年来 ,完全性前置胎盘的植入概率有不断增加的趋势 ,而临床上对有完全性前置胎盘的产妇均需用剖宫产方式分娩 ,但术中大出血仍是难以完全避免的问题.因此 ,如何减少术中产妇的出血量,降低产妇死亡率 ,是临床产科研究的重要课题.本研究对介入性治疗方法处置完全性前置胎盘患者的效果进行了分析 ,现报道如下.

目的 探讨腹腔镜与开腹手术治疗异位妊娠的效果.方法 纳入2013年2月至2016年1月异位妊娠患者64例,随机分组方法:随机数字表法,分为2组,第Ⅱ组和第Ⅰ组,每组例数一致(32例).第Ⅰ组行异位妊娠开腹术;第Ⅱ组行异位妊娠腹腔镜术.对比两组患者手术耗时、术中失血、术后排气、尿管留置、下床、抗生素使用时间、住院日和发热率、感染率.结果 第Ⅱ组发热率、感染率低于第Ⅰ组,经χ2检验差异显著(P<0.05).第Ⅱ组患者手术耗时、术中失血、术后排气、尿管留置、下床、抗生素使用时间、住院日均少于第Ⅰ组,经t检验差异显著(P<0.05).结论 腹腔镜与开腹手术治疗异位妊娠均有一定价值,但腹腔镜手术创伤更小,术后恢复更快,可减少感染和发热等并发症发生率,患者预后佳,值得推广.

目的:分析米索前列醇促宫颈成熟的应用效果.方法:随机选取所在医院2014年3月~2016年9月216例妊娠晚期引产产妇,随机分组,观察组采用米索前列醇促宫颈成熟.对照组采用缩宫素进行处理,比较两组临床总体治疗情况.结果:观察组产妇宫颈Bishop、新生儿Apgar评分优于对照组(P<0.05);观察组引产不良反应发生率(6.48%)低于对照组(20.37%),两组引产效果差异明显(P<0.05).结论:米索前列醇临床效果明显,促宫颈成熟具有临床价值.

目的 对三联法治疗难治性宫缩乏力性产后出血的疗效进行探讨.方法 2013年5月-2015年5月在我院接受治疗的196例难治性宫缩乏力性产后出血患者,按照随机数字法将其分为2组,每组98例,对对照组患者进行宫腔纱布填塞,对研究组患者给予三联法,观察2组患者的治疗效果.结果 研究组患者的治疗总有效率(94.90％)明显高于对照组(73.47％),组间差异明显(P＜0.05);研究组患者术后24h出血量、并发症例数分别为(206.82±12.02)mL、0例,均明显低于对照组患者的(346.32±23.73)mL、18例(P＜0.05).结论 对难治性宫缩乏力性产后出血患者实施三联法治疗效果较好.

Objective To evaluate the clinical treatment of ectopic pregnancy.Methods The methods and characteristics of clinical treatment of 342 cases of ectopic pregnancy in our hospital nearly five years were retrospectively analyzed.Results 38 cases of ectopic pregnancy were treated by conservative drugMTX,the success rate was 92.11%;the defeated factors had the medicine side effect to cause the treatment termination and acute abdomen,the failure rate was 7.89%.Surgical treatment had open operation and laparoscopic operation,laparoscopic operation had a small scar,shorter operative time,less bleeding,rapid postoperative recovery,shorter hospital stay,and the difference was statistically significant(P 0.05) compared with open operation.Tubal pregnancy surgery treatment had Salpingectomy and retain tubal conservative surgery,blood β-HCG returned to normal after 14 days using Salpingectomy,but the conservative surgery returned to normal after 21 days,both compared to postoperative day 1 was no significant difference(P 0.05);After 4,7 and 14 days the difference was statistically significant(P 0.05);the mesosalpinx of pregnancy site was injected with MTX 20 mg after conservative surgery to prevent persistent ectopic pregnancy,and the difference was statistically significant(P 0.05) compared with no injection of MTX.Conclusion The success rate of MTX treated conservatively ectopic pregnancy is high,which become the first choice to patients who retain uterine tube and fear the surgery.The laparoscopic operation can be taken as the priority method of treatment to patients and doctors.Injecting MTX into mesosalpinx of pregnancy site after conservative surgery can effectively prevent the occurrence of persistent ectopic pregnancy.