目的:对耳穴贴压联合推拿及刮痧对肝郁气滞型产后缺乳患者的影响进行研究与探讨.方法:选取在2018年2月～2020年2月期间于我院进行治疗的部分肝郁气滞型产后缺乳患者作为本次研究的研究对象,共计76例,随机分为对比组与观察组,各38例.对对比组患者以耳穴贴压进行治疗,对观察组患者在对比组患者的基础上加入推拿与刮痧措施进行联合治疗.治疗完成后,对两组患者的临床疗效分别进行评估,并进行组间对比分析.结果:对比两组患者的临床研究数据发现,观察组患者的治疗总有效率为92.11％,显著高于对比组患者的71.05％,差异具有统计学意义(P<0.05).结论:对肝郁气滞型产后缺乳患者以耳穴贴压联合推拿及刮痧措施进行治疗临床疗效显著,能够有效缓解患者的缺乳情况,对于改善患者泌乳,促进患者乳汁分泌具有重要意义,临床应用价值较高.

Objective To observe the effect of Weici combined with electric acupuncture on E 2 /P,prolactin(PRL), testosterone(T),ER expression and mammary gland tissue morphous in rats with mammary gland hyperplasia in order to explore its action mechanism .Methods The 40 Wistar rats were randomly divided into 4 groups:normal control group ,model group,acupuncture group and tamoxifen ( TAM) group.The animal models with breast hyperplasia were established by intramuscular injection with diethylstilbestrol +progesteroner .The rats in acupuncture group were fixed and acupunctured (Weici) in the second pair of breasts,and connected with the electric acupuncture instrument for 30 min,moreover, Danzhong acupuncture point was acupunctured for 30min;the rats in TAM group were given tamoxifen 1.8mg/kg by gavage,once a day for 30 days,after last treatment,the serum levels of E2,P,PRL,T were detected,and the ratio of E2/P was calculated,the second pair of breasts were taken to be HE stained , then the changes of breast tissue morphous were observed under light microscope,and the expression levels of ER in breast tissue were detected by immunohistochemisty .Results After treatment, the ratio of E2/P in acupuncture group and TAM group was significantly lower than that in model group ( P <0.05 );the serum levels of PRL in acupuncture group and TAM group were obviously lower than those in model group ( P <0.05), moreover,there were significant differences between acupuncture group and TAM group ( P <0.05).The serum levels of T in acupuncture group and TAM group were significantly lower than those in model group ( P <0.05).The pathological changes of breast tissue in acupuncture group were similar to those in TAM group , however , which were obviously improved , as compared with those in model group .The expression levels of ER of breast tissue in TAM group were significantly decreased , furthermore,the AOD value was obviously lower than that of normal control group ( P <0.05).Conclusion Weici combined with electric acupuncture can decrease nipple height and nipple diameter , improve disorder state of E2/P, PRL, T and pathological morphous of breast tissue ,and reduce ER expression levels in breast tissue of rats with breast hyperplasia .

目的 分析彩色多普勒超声检查在胎儿骶尾部畸胎瘤产前诊断中的意义.方法 对11例产前经多普勒诊断而术后经病理确诊的骶尾部畸胎瘤的胎儿产前超声诊断资料进行回顾性分析.结果 11例胎儿骶尾部畸胎瘤均可通过产前超声检查明确诊断.11例骶尾部畸胎瘤的肿瘤声像图显示囊性3例、囊实性8例.按解剖学分型,Ⅰ型6例、Ⅱ型4例、Ⅲ型1例.病理诊断良性畸胎瘤10例,恶性畸胎瘤1例.结论 彩色多普勒超声检查是诊断胎儿骶尾部畸胎瘤的主要方法.早期发现早期诊断,对于胎儿预后判断及优生优育具有十分重要的临床意义.

1病例资料 患者史××,女性,31岁,汉族,已婚,河北省邢台人,末次月经2000年9月2日,孕3产2,于2001年5月18日9:30因孕8月余、第3胎、双胎、贫血入院.此孕妇于孕6月时发现贫血,于当地予抗贫血药物门诊治疗2个月,5月18日复查血色素64g/L,加之B超示双胎,门诊以贫血收入院.既往于1994年10月足月顺产一活女婴,现健在,1999年5月足月产1次,早期新生儿死亡(死因不详).否认月经不调、贫血病史,家族中无双胎史.查体二生命体征平稳,贫血貌,宫高34cm,腹围94cm,耻上只触及一胎头,另一胎头触诊不满意,腹部两侧听胎心144/142次/min,B超报告:双胎儿,双顶径8.7/8.8cm,胎位LOP/ROA,羊水深8.0cm.据此初诊:①宫内孕36+5周,第3胎;②双胎;③妊娠合并贫血.