目的:通过建立风险预测模型,探讨腹直肌分离度和盆底肌力级别与压力性尿失禁(stress urinary incontinence,SUI)发生之间的关系.方法:选取2019年5月-2020年8月在南方医科大学附属深圳妇幼保健院规范产检并分娩的初产妇,通过测量盆底肌力级别和腹直肌分离度,并依据SUI诊断标准,获取相关数据建立预测模型.结果:盆底肌力强度指标、腹直肌分离指标和腹直肌分离人数比在SUI组和无SUI组间差异均有统计学意义,腹直肌分离联合盆底肌力级别双因素模型预测效果最优,阳性预测值和阴性预测值受试者工作特征曲线下面积均达到0.85以上.结论:腹直肌分离度联合盆底肌力级别可预测产后SUI的发生.

目的:探讨横纹肌联合平滑肌电刺激进行产后腹直肌分离治疗的疗效.方法:选择2019年1月至2019年12月期间产后42 d于南方医科大学附属深圳市妇幼保健院康复门诊检查的腹直肌分离距离＞2.0 cm的妇女135例作为研究对象,采取随机排列表分成为对照组、观察组A及观察组B,每组45例.对照组予自主锻炼治疗,观察组A予横纹肌联合平滑肌电刺激治疗,观察组B予单一横纹肌电刺激治疗,采取超声测量腹直肌分离距离及视觉模拟评分法(VAS)评估疼痛程度,检查研究对象治疗前和治疗后腹直肌分离的距离及疼痛变化并且进行统计学分析.结果:经过1个月的治疗后,B超测量观察组A、B的腹直肌分离改善情况显著优于对照组,其中,观察组A较观察组B治疗后改善效果更明显,差异均具有统计学意义(P＜0.05).治疗后,三组妇女VAS评分均明显低于治疗前,差异均具有统计学意义(P＜0.05),三组妇女之间的VAS评分比较,差异均无统计学意义(P＞0.05).结论:横纹肌电刺激治疗产后腹直肌分离临床效果良好,采用横纹肌联合平滑肌电刺激治疗则效果更为显著.

目的 探讨电刺激联合生物反馈治疗用于产妇产后盆底康复的临床效果.方法 选取2015年10月-2016年10月于我院治疗的盆底功能障碍性疾病产妇300例,采用随机数字表法将所有患者分为对照组和观察组,每组150例.对照组行Kegel法盆底肌功能锻炼方案,观察组在对照组的基础上行电刺激联合生物反馈治疗方案.比较2组患者盆底肌力、盆腔器官脱垂分期以及尿失禁程度.结果 治疗后,观察组盆底肌Ⅰ类及Ⅱ类肌纤维肌力均优于对照组(t=10.732,P=0.029;t=12.061,P=0.026),盆腔器官脱垂分期轻于对照组(Z=-2.737,P=0.006),尿失禁程度轻于对照组(Z=-2.931,P=0.003).结论 电刺激联合生物反馈治疗用于产妇产后盆底康复,能够促进患者盆底肌功能恢复,改善患者盆腔器官脱垂以及尿失禁,具有重要的临床意义.

Purpose To investigate the awareness status of knowledge about cervical cancer prevention and screening participation among low-income women in Shenzhen city,to provide basis for cervical cancer prevention and control strategies. Methods An epidemiological questionnaires survey was conducted among 1 892 low-income women aged 30 ~59 years old recruited by the stratified cluster sampling in 8 districts,Shenzhen city. Results The awareness rate with HPV infection was the necessary cause of cervical cancer was 32.05%,sexual behavior disorder increased risk of cervical cancer occuring,49.63% ;good Sexual health habits can prevent cervical cancer,66.84% ;and having early detection methods of cervical cancer and precancerous lesions,51.76%. The difference of cervical cancer screening rate was statistically significant among various education levels groups (χ 2 =68.616,P0.001). Expensive screening cost or economic difficulty was the main cause of no-participating in cervical cancer screening for low-income women. Conclusion The low-income women knew little knowledge about cervical cancer prevention.Health education diversity and the government-funds help could increase the screening rate of cervical cancer.

目的 探讨分隔膜无针密闭输液接头在妊娠滋养细胞肿瘤患者PICC化疗中的应用效果.方法 选择65例经确诊后需要静脉化疗的妊娠滋养细胞肿瘤住院患者作为研究对象,经知情同意后随机分为观察组32例和对照组各33例.观察组用分隔膜无针密闭输液接头,对照组用传统式的肝素帽,对比两组导管留置时间、静脉炎和感染的发生率、针刺伤等情况.结果 分隔膜无针密闭输液接头组发生静脉炎、针刺伤和感染率明显低于肝素帽组(P＜0.05);导管留置时间上明显高于肝素帽.结论 妊娠滋养细胞肿瘤患者在PICC化疗中使用分隔膜无针密闭输液接头能有效的降低置管的感染率,减少局部静脉炎的发生,延长导管留置时间等方面有优势,同时也减少了护士针刺伤的危险,提高了患者对护理工作的满意度,使用安全、方便,值得临床推广应用.

目的:探讨加温二氧化碳气腹对妇科腹腔镜手术患者术中体温变化、寒战发生及血气、血液流变学的影响,并提出相关对策.方法:将268例妇科腹腔镜手术病人随机分为两组,加温二氧化碳气腹机组和不加温气腹机组,记录两组患者围手术期体温变化和寒战发生情况及手术前后的血气和血液流变学变化.结果:两组低体温及寒战的发生率比较差异有统计学意义(P＜0.05),两组血气和血液流变学变化比较差异无统计学意义(P＜0.05).结论:加温二氧化碳气腹可使术野清晰,减少术后低体温及寒战的发生,不加重术后血气及血液流变学的改变.

目的 10％肥皂液用于妇科腹腔镜手术术前脐部清洁效果的比较.方法 将入住妇科需行腹腔镜手术患者300例随机分为对照组和观察组各150例,手术前1d备皮,对照组用消毒棉签蘸取松节油擦拭脐孔,再用75％酒精消毒,观察组先将少量10％肥皂液倒入脐孔浸泡,备皮后用消毒棉签擦拭浸泡后的脐孔,再用75％酒精消毒.观察两组患者脐孔局部不良反应及不良反应的消退时间.结果 观察组发生不良反应,如红肿、疼痛、破溃明显低于对照组(P＜0.05)；不良反应消退时间比对照组快,差异有统计学意(P＜0.05).结论 应用10％肥皂液-清水-75％酒精的备皮方法用于妇科腹腔镜手术术前脐部清洁能明显降低脐孔不良反应的发生率。

Objective: To explore the effect of pneumoperitoneum with heated carbon dioxide on the change of intraoperative body temperature,the occurrence of shiver,and the changes of blood gas and hemarheology of the patients undergoing gynecological laparoscopic surgery,put forward related countermeasures. Methods: Two hundred and sixty-eight patients undergoing gynecological laparoscopic surgery were randomly divided into pneumoperitoneum with heated carbon dioxide group and pneumoperitoneum with unheated carbon dioxide group;the changes of body temperature during perioperative period,the incidences of shiver,the changes of blood gas and hemarheology before and after operation in the two groups were recorded. Results: There was statistically significant difference in the incidence of low body temperature and shiver between the two groups(P<0.05),there was no statistically significant difference in the changes of blood gas and hemarheology between the two groups(P>0.05). Conclusion: Pneumoperitoneum with heated carbon dioxide can make clear the surgical field and reduce the incidences of postoperative low body temperature and shiver,which doesn't aggravate the changes of postoperative blood gas and hemarheology.

目的观察分析宫腔镜在子宫肌瘤治疗中的疗效及护理配合意义。方法回顾性分析2009年2月~2011年2月,在我院诊断为粘膜下子宫肌瘤的患者168例,全部行宫腔镜电切术治疗,并给予合理化护理配合。结果所有患者在护理配合下均顺利完成手术,其中142例0~Ⅰ型粘膜下肌瘤一次性切除;16例Ⅱ型粘膜下肌瘤一次性切除,10例大部分切除。所有患者均无子宫穿孔、感染发生,术中出血少,手术时间短,术后2例出现一过性发热,但白细胞计数及分类均在正常范围。术后病理检查示平滑肌瘤138例,腺肌瘤30例。所有患者术后5~7 d内阴道有粉红色分泌物排出。随访6~12个月,临床症状均有改善。术后满意率0~Ⅰ型肌瘤者为100%,Ⅱ型者为96.7%。结论在合理的护理配合下进行宫腔镜电切术治疗子宫粘膜下肌瘤,手术时间短、成功率高、并发症少,是一种安全、可靠的治疗方法。

目的探讨经外周静脉穿刺中心静脉置管(PICC)与浅静脉头皮针在妊娠滋养细胞肿瘤化疗中的应用效果。方法 64例患者分为两组,A组35例为接受PICC途径输注者。B组29例为接受浅静脉头皮针途径输注者,对比两组留置时间、并发症及满意度。结果留置时间A组(2313.12±227.04)h,B组(12.21±6.14)h;静脉炎发生率A组2.8%,B组51%;疼痛率A组为5.6%,B组为34%;A组无1例外渗,B组发生外渗4例;差异有显著意义。两组患者和护士的满意度调查结果比较A组明显高于B组,差异有显著意义。结论 PICC置管在妊娠滋养细胞肿瘤患者的化疗中置管简单安全,留置时间长,并发症少,患者痛苦少,值得临床推广。

Objective To explore the value of color doppler ultrasonography combined with pelvic angiography in diagnosis and therapy of uterine arterivenous fistula.Methods Patients with irregular vaginal bleeding or abrupt vaginal hemorrhea that bled after induced abortion or curettage were selected from January 2001 to December 2009.The color doppler ultrasonography were undertaken in these patients,which would demonstrate whether need to undertake the pelvic angiography or not.The patients with uterine arterivenous fistula confirmed by pelvic angiography were treated with uterine artery embolization.Results Total 45 patients were demonstrated with formation of uterine arteriovenous fistula by color doppler ultrasonagraphy,39 cases among them were undertaken pelvic angiography.Finally,28 cases were confirmedwith uterine arteriovenous fistula and treated with uterine artery embolization.Conclusion Color doppler ultrasonography combined with pelvic angiography would be valuable for diagnosis of uterine arterivenous fistula,uterine artery enbolisation could be an effective treatment method.

Objective To evaluate the safety and efficacy of scrubbing autologous blood transfusion for the treatment of intraperitoneal bleeding in ectopic pregnancy.Methods Fifty-one cases of intraperitoneal bleeding patients with ectopic pregnancy were given autologous blood transfusion by using American blood cell saver 5 recycling machine,the components of blood silting in abdominal cavitywere compared before and after treatment of recycling machine.The hematocrit,erythrocyte count,hemoglobin content,blood platelet and coagulation changes in patients were observed before and after transfusion,the adverse reaction was recorded.Results The platelet,fibrinogen,free hemoglobin of blood silting in abdominal cavity were basically eliminated after treating with recycling machine,the hematocrit was obviously increased;the result of bacterial culture was negative.The change of hemoglobin content,blood platelet and coagulation changes in patients had no significant difference before and after transfusion,the hematocrit was decreased after transfusion,no obvious adverse reaction was observed.Conclusion Scrubbing autologous blood transfusion was safety and efficient for the treatment of intraperitoneal bleeding in ectopic pregnancy.

目的探讨施行以腹膜替代行阴道延长术在宫颈鳞状上皮细胞癌治疗中的作用。方法50例宫颈鳞状上皮细胞癌患者中,研究组24例在常规宫颈癌根治术后以腹膜替代行阴道延长术,对照组26例采用常规宫颈癌根治术,比较两组术中及术后情况。结果50例手术均顺利完成。两组在手术时间、术中出血量和术后恢复时间等方面差异均无统计学意义(P>0.05);而术后6个月测定阴道长度,研究组阴道深7.5～11cm,平均8.1cm,对照组阴道深4～5.5cm,平均4.7cm,两组差异有统计学意义(P<0.05)。术后6～12个月研究组对性生活的满意度均高于对照组(P<0.05)。结论宫颈鳞状上皮细胞癌根治术中施行以腹膜替代行阴道延长手术能使患者术后阴道有足够的长度,有效地改善患者术后性生活质量,并且简便、易行,具有较好的临床应用价值。

Objective:To discuss the clinical feasibility and safety about the treatment of oviduct interstinial portion pregnancy by doing cornua uteri resection under laparoscope. Methods:By reviewing the collected cases of oviduct interstitial portion pregnancy from July , 2000 to June, 2004 in our hospital, in which 43 cases were treated with laparoscopic surgery and 48 cases were treated with laparotomy , we took the the group of laparoscopy as study group and the group of laparotomy as contrast group to analyse the situation of the two different groups during and after operations. Results: There were no obvious differences in ordinary conditions between the study group and the contrast group. The broken rates of oviduct interstitial portion were 2. 33% and 20. 83% , respectively in 2 groups. The contrast group has higher broken rate (P0. 01). The measurements of celiac bleeding were 186. 35±57. 20 and 433. 15±116. 56 ml, respectively(P0. 01); The measurements of bleeding in operations were 61. 31±11. 98 and 176. 15±68. 37 ml, respectively(P0. 01). The operations last 51. 28±6. 91 and 42. 06±9. 87 minutes respectively (P0. 01), The leaving-bed time after operation was 10. 45±2. 09 and 24. 42±3. 57 hours, respectively (P0. 01), The time of first time fart after operarion was 18. 95±1. 61 and 42. 36±8. 96 hours (P0. 01) ;The time of the concrescence was 3. 18±0. 47and 5. 82±0. 63 days, respectively (P (l. 01).Conclusion:Using celioscope for the early diagnose of the oviduct interstitial portion pregnancy and laparoscopic cornua uteri resection and suture have great clinical effect and feasibility.

Objective:To discuss the clinical feasibility and effect about the conservative treatment of tubal pregnancy under ce lioscope with the help of methotrexate injection in mesosalpinx,find a better treatment method of preventing the patient fromp ersistent ectopic pregnancy.Methods:65 tubal pregnancy patients who were treated conservatively under celioscope are separa- ted to 2 groups.31 patients in Group A had simply the tubal pregnancy product eliminating operation under celioscope;34 pa- tients in Group B had both the tubal pregnancy product eliminating operation under celioscope and the injection of MTX 30mg in mesosalpinx simultaneously.The decreasing level(titer)of serumβ-HCG- was monitored and measured after operation.Re- sults:Before the operaion,the differences of the general data,the serumβ-HCG levels and tubal diameters at the focus of the 2 groups(P＞0.05)did not have any obvious meaning.The cure rate and the time for the serumβ-HCG decreased to normal level of the 2 groups were as followings:Group A 87.10% and 13.5±1.86 days;Group B 100% and 9.0±1.01 days.Group B had the better effect than Group A.This difference had very obvious and important meaning(P＜0.05).Conclusion:The conservative treatment of tubal pregnancy under celioscope with the help of injection of methotrexate(MTX)in mesosalpinx has great clinical feasibility and effect.This is a better solution,when we do the tubal pregnancy product eliminating operation plus the injection of MTX 30mg in mesosalpinx under celioscope.It can prevent the patient from happening of persistent ectop- ic pregnancy effectively.