随着计划生育政策的变化,二胎放开后大龄妇女生育需求短期内急剧增加,大龄妇女不孕症的比率远高于年轻女性.资料显示,输卵管阻塞是导致女性不孕的重要因素,占女性不孕的30％～40％.采取介入再通术具有较好治疗效果,但大龄妇女再通的成功率及怀孕成功率均低于年轻妇女,且并发症高于年轻妇女.因此如何提高大龄患者的再通和怀孕成功率及降低并发症的发生率是急需解决的问题,笔者认为在治疗基础上配合优质护理措施,具有重要作用.本研究对132例进行输卵管再通术(FTR)患者进行回顾性分析,观察其护理效果,现报道如下.

Objective To analyze the causes of extravasation with high pressure injection of iodine contrast agent,and to find the measures to reduce the leakage. Methods The clinical data of 12825 patients with enhanced CT,CTA and deep venous angiography were retrospectively analyzed,including 15 cases of Iodine contrast agent extravasation. Results Contrast agent injection rate,temperature,situation of vein,nurse injection technique and emotional state of the patients can affect the contrast agent extravasation.15 patients with leakage were treated with wet compress with 50%magnesium sulfate and cold compress with ice packs for 24 hs.After 24-48 hs,Chinese medicine was used to relieve pain and eliminate inflammation and ointment is also used.meanwhile,these patients were heated with hot packs. Conclusion It is necessary to have a comprehensive and reasonable measures to reduce the occurrence of Iodine contrast agent extravasation,and combination of traditional Chinese and Western medicine can make the patients of contrast agent extravasation recover faster.

随着影像医学技术的不断发展, 碘对比次剂的使用越来越多, CT增强扫描已成为不可缺少的重要诊断方法,同时造成了碘对比剂的大量使用,故在检查过程中不可避免地发生碘对比剂不同程度的不良反应, 严重者甚至危及生命, 因此合理应用碘对比剂, 严格掌握适应症, 禁忌症, 检查前与患者或家属进行有效沟通, 检查后严密观察尤为重要, 是有效预防和优质护理的前提.

Objective To assess the effectiveness of uterine arterial embolization for the treatment of hysteromyomas and to discuss the factors related to the clinical results.Methods Super-selective uterine arterial embolization was performed in forty-five patients with hysteromyomas.Of 45 patients,multiple hysteromyomas were seen in 36 and solitary lesion in 9.The lesion was located at the myometrium in 41 cases,among them coexisted endometrioma was found in 5 cases and coexisted submucosal myoma in 2.The lesion was located submucous layer in the remaining 4 cases.The diagnosis was confirmed by imaging study and gynecological examination.After the operation,ultrasonography and laboratory tests were carried out in all patients to observe the tumor size,hormone levels and hemoglobin concentration.Results A total of 91 uterine arteries were found in 45 patients,including double left uterine arteries in one case.Successful catheterization was obtained in 87 arteries(95.6%).All forty-five patients were followed up for 6-36 months.Six months after the procedure the mean reduction of the tumor size was 69.3%,and the lesion completely disappeared in two cases.In the anemic patients the hemoglobin concentration returned to normal level.The main side-effects included low fever and pain at lower abdomen.Conclusion Uterine arterial embolization is a safe and effective treatment for hysteromyomas.