生育是人类基本的权利,而不孕是全世界育龄期妇女都有可能面对的问题.我国不孕的患病率从20世纪70年代的1％～2％上升至今天的10％～15％,且仍在继续升高[1].体外受精-胚胎移植(In-vitro fertilizationand embryo transfer,IVF-ET)技术是治疗不孕的重要手段,成为许多不孕患者的最终希望,但现阶段IVF-ET妊娠率并不能达到100％,不孕患者生育的基本权利及社会繁衍功能不能得到充分的保证.近期研究[2]显示,大部分不孕患者家属出现连带病耻感,不仅影响IVF-ET成功率、患者婚姻质量,增加IVF-ET治疗中断率,同时影响患者接受治疗的依从性,导致患者社会关系紧张、生活质量下降等一系列的社会功能紊乱.笔者就不孕症家庭病耻感在IVF-ET中的结局研究展开综述.
Objective:To assess the effectiveness of intravenous hydroxyethyl starch(HES) administration for the prevention of ovarian hyperstimulation syndrome(OHSS).Methods:All randomized controlled trials (RCTs) on HES for the prevention of OHSS were retrieved from databases including Cochrane Library,MEDLINE,Embase,CBMdisc,CNKI,VIP and Wanfang databases update to Sep.2012.Information was collected by two researchers independently.The quality of included RCTs was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions,and the Cochrane Collaboration′s software RevMan 5.0 was used for meta-analysis.Results:4 RCTs involving 666 patients were included.The incidence of OHSS and severe OHSS in the HES group (OR=0.18,95%CI 0.10 to 0.32,P=0.000, OR=0.15,95%CI 0.05 to 0.48,P=0.001,respectively) was significantly reducted compared to the control group.The differences of the pregnancy rate between the two groups has no statiscal significance (OR=1.02,95%CI 0.60 to 1.73,P=0.94).Conclusions:Current evidence shows that HES markedly decreases the incidence of OHSS,especially the severe OHSS,and do not affect the pregnancy rate.However,considering the limitation of the methodological quality and sample size of the included studies,more high-quality,large-scale RCTs are still needed to confirm this conclusion.
不孕不育人群是一个特殊的群体,不孕症虽然不是致命性的疾病,但可造成患者身心痛苦和婚姻不美满,为社会和家庭带来诸多不稳定因素。医学科学研究在治疗不孕症方面已取得了巨大进展,但对患者心理的影响和干预却很少。而良好的心理护理及恰当的心理干预可使患者改善心理状态,增强治疗信心,对提高疗效有一定积极作用。
目的:探讨碧兰麻在宫颈局部注射麻醉止痛效果。方法:2008年9月—2009年7月对200例不孕症妇女月经期子宫内膜活检时宫颈局部注射碧兰麻止痛,进行效果观察。结果:月经期子宫内膜活检时宫颈局部注射碧兰麻止痛效果明显。结论:宫颈局部注射碧兰麻能减轻疼痛,缩短麻醉时间,镇痛效果好。
整体护理的特色是护士不仅要估计病人需要,按其功能水平及个体差异给以适当的护理治疗,更重要的是教给病人相应的健康知识,即如何正确认识自己的疾病,如何防止疾病复发与自我保健。手术对外科病人而言都会带来心理、机体的损伤,从而影响病人的预后、在手术病人中实施健康教育应根据不同病种以及病人住院期间不同阶段的心理特点对病人实施合理、分期的教育,使病人减轻心理负担,了解与疾病有关的健康知识,主动配合治疗和护理,减少并发症、促进康复。
随着辅助生殖技术的开展,异位妊娠的发病率亦明显增高.现将本院生殖所2004至2005两年来实施体外受精-胚胎移植(IVF-ET)后宫外孕的发生情况作一总结分析供临床参考.
