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find Keyword "剖宫产" 46 results
  • 子宫峡部剖宫产切口部位妊娠的彩色多普勒超声诊断分析

    目的探讨子宫峡部剖宫产切口部位妊娠的彩色多普勒超声声像图特点,为临床诊疗提供有价值的参考依据。 方法选取2011年8月-2013年7月诊断的12 例子宫峡部剖宫产切口部位妊娠的患者作为研究对象,回顾性分析其彩色多普勒超声声像图特点及临床资料。 结果12例患者中5例停经时间短、妊娠囊较小,位置完全位于子宫峡部切口处因声像图典型而确诊;3例因停经时间长、妊娠囊大部分位于宫腔内,少部分位于切口处误诊为宫内孕;2例切口妊娠流产,误诊不全流产;另外2例因院外人工流产术后阴道流血增多就诊,诊断为切口妊娠。 结论彩色多普勒超声对子宫峡部剖宫产切口妊娠的诊断具有准确性、可靠性。

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  • 双胎妊娠临床结局分析

    【摘要】 目的 探讨双胎妊娠剖宫产指征构成比、临床处理与妊娠结局的关系。 方法 对2000年1月-2009年8月321例双胎妊娠的临床资料进行回顾分析。 结果 ①A组第1胎儿为头位,191例双胎妊娠剖宫产指征首位为社会因素,其次为妊娠并发(合并)症、瘢痕子宫;B组第1胎儿为非头位,65例双胎妊娠剖宫产指征首位为单纯臀位因素(包括肩先露),其次为妊娠并发(合并)症、瘢痕子宫。②平均分娩孕周(36±4)周,剖宫产256例占79.75%, 经阴道分娩65例占20.25%。③剖宫产组新生儿体重≥2 500 g者高于阴道分娩组;两组第1胎儿新生儿窒息率比较无差异,第2胎儿经阴道分娩者新生儿窒息率明显高于剖宫产术者。校正孕周影响后,不同分娩方式间新生儿评分无差异。④lt;33孕周的双胎妊娠以阴道分娩为主,占83.33%;≥33孕周的双胎妊娠剖宫产率明显高于阴道产率。不同分娩方式的产后出血率无差异。 结论 双胎妊娠不是剖宫产的手术指征,孕期须加强监护管理,正确选择双胎妊娠的分娩方式,将有助于降低剖宫产率及新生儿窒息率。

    Release date:2016-09-08 09:50 Export PDF Favorites Scan
  • Clinical Analysis of Application of Uterine Cavity Water Sac Compression for Hemorrhea in the Low Cesarean Section

    目的:评估宫腔内水囊压迫治疗剖宫产术中大出血的可行性。方法:选择2005年2月至2009年3月北戴河医院及秦皇岛市妇幼保健院行子宫下段剖宫产,术中发生大出血病例106例,,常规方法处理无效后,应用宫腔内水囊压迫止血。结果:106例患者在12小时后取出水囊,阴道流血量明显减少,均无再次大出血发生。止血效率100%。结论:宫腔内水囊压迫治疗剖宫产术中大出血效果佳、操作简便、止血迅速,留置时间短、可作为治疗剖宫产术中大出血的一种简便、可行、有效的止血方法。

    Release date:2016-09-08 10:04 Export PDF Favorites Scan
  • Clinical Analysis of Abdominal Wall Endometriosis

    ObjectiveTo discuss the clinical characteristics, treatment and prevention of abdominal wall endometriosis (AWE). MethodsA retrospective analysis of 295 cases of AWE from February 2007 to August 2011 in our hospital was performed. ResultsAll of the patients had abdominal operations before and 99% of them had a history of caesarean section. The mean age of the patients was (31.55±4.52) years old. The average size of the mass was (2.66±1.12) cm, significantly larger than the estimation of ultrasonography before operation which was (1.91±0.83) cm (P<0.001). No relapse was discovered five months to three years after the operation. ConclusionIt is easy to diagnose abdominal wall endometriosis through medical history, clinical characteristics, physical signs and ultrasonic assessment. The prevention of AWE is very important. Operation is still the best treatment for AWE.

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  • 影响剖宫产术后母乳喂养的因素分析及干预措施

    目的 讨论提高剖宫产妇母乳喂养率的方法及途径。 方法 2010年2月-2011年2月,将300例拟择期行剖宫产术的单胎初产妇,按随机抽取法分为观察组和对照组,对其进行母乳喂养宣教及干预,并就术后两组母乳喂养状况进行观察对比。 结果 观察组母乳初动时间早于对照组,两组差异有统计学意义(Z=?6.771,P=0.000);观察组母乳量充足时间早于对照组,两组差异有统计学意义(Z=?4.748,P=0.000)。 结论 术前对产妇进行母乳喂养宣教,术后对产妇母乳喂养给予相关协助与指导是提高母乳喂养的关键。

    Release date:2016-09-07 02:38 Export PDF Favorites Scan
  • The effect of continuous phenylephrine infusion and single-dose phenylephrine injection on puerpera undergoing spinal and epidural combined anesthesia and the infant outcomes

    Objective To discuss the effect of continuous phenylephrine infusion and single-dose phenylephrine injection on puerpera undergoing spinal and epidural combined anesthesia and the infant outcomes. Methods A total of 50 patients scheduled for selective cesarean section under combined spinal and epidural anesthesia were selected as the study subjects between July 2015 and June 2016. They were randomly allocated into two groups with 25 in each. Group CII underwent continuous phenylephrine infusion [0.5 μg/(kg·min)] immediately after anesthesia to adjust the blood pressure, while group CON accepted single-dose phenylephrine injection (50 μg) after anesthesia when systolic pressure was lower than 90 mm Hg (1 mm Hg=0.133 kPa) or when the decrease of mean arterial pressure (MAP) was higher than 20% of the base value. The infusion of phenylephrine was stopped after the fetus was taken out. MAP, cardiac output, cardiac index (CI) at the time when the patient went into the delivery room (T1), before anesthesia (T2), 1 minute after anesthesia (T3), 3 minutes after anesthesia (T4), 10 minutes after anesthesia (T5), and delivery (T6) were recorded. Blood gas analysis of fetal umbilical arterial blood was carried out and neonatal Apgar score was recorded. Results Hemodynamics was more stable in group CII compared with group CON. Heart rate at T4 and T5, and cardiac output at T5 and T6 in group CON were significantly lower than those in group CII (P<0.05). The neonatal umbilical arterial blood pH value, base excess and HCO3- were all significantly lower, while partial pressure of carbon dioxide was significantly higher in group CON than group CII (P<0.05). Conclusion Compared with single-dose phenylephrine injection, continuous phenylephrine infusion has more stable hemodynamics, and exert less effect on maternal and infant outcomes for patients undergoing cesarean section under combined spinal and epidural anesthesia.

    Release date:2017-05-18 01:09 Export PDF Favorites Scan
  • 剖宫产术后宫底免盐袋加压对产妇出血量及舒适度的影响

    目的探讨剖宫产术后宫底免盐袋加压对产妇出血量及舒适度的影响。 方法将2012年7月-12月行剖宫产手术的正常初产妇122例随机分为2组,观察组(n=60)术毕不给予盐袋加压,对照组(n=62)常规在宫底部加压1 kg的盐袋,持续6 h,两组其他治疗、护理措施相同。记录两组产妇术后6 h内阴道出血量和呕吐次数,肛门排气时间及产妇主观舒适度。 结果两组产妇术后6 h内阴道出血量[(167.23±31.65)、(178.75±37.42)mL;t=1.833,P=0.069)和呕吐次数(Z=-0.740,P=0.459)比较,差异无统计学意义;观察组主观舒适度明显高于对照组(Z=-4.353,P=0.000);观察组肛门排气时间[(14.45±4.55)d]比对照组[(21.95±6.06)d]明显缩短(t’=-7.747,P=0.000)。 结论剖宫产术后如未发生产后大出血,宫底免盐袋加压治疗可增加产妇舒适度,促进肠功能的恢复。

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  • Effect of Postoperative Patient-Controlled Epidural Analgesia with Different Doses of Sufentanil after Cesarean Section

    【摘要】 目的 观察不同剂量的舒芬太尼用于剖宫产术后硬膜外自控镇痛的效果比较。 方法 将2009年4-11月60例硬膜外麻醉下行剖宫产手术术后的患者随机分为三组,术后镇痛液A组采用0.125%罗哌卡因复合0.3 μg/mL舒芬太尼;B组为0.125%罗哌卡因复合0.4 μg/mL舒芬太尼;C组0.125%罗哌卡因复合0.5 μg/mL舒芬太尼,观察三组患者的术后镇痛效果(视觉模拟法评分,即VAS评分)及不良反应。 结果 A组VAS评分高于B组和C组,B组VAS评分高于C组(Plt;0.05)。三组患者术后恶心呕吐、运动阻滞、嗜睡及肠蠕动抑制等并发症无统计学差异(Pgt;0.05)。 结论 0.125%罗哌卡因复合0.5 μg/mL舒芬太尼以4 mL/h持续输注用于剖宫产术后患者自控硬膜外镇痛术后疼痛VAS评分最小,患者镇痛满意度最高。【Abstract】 Objective To observe the effect of postoperative patient-controlled epidural analgesia (PCEA) with three different doses of sufentanil combined with 0.125% ropivacaine after cesarean section. Methods Data was collected from April 2009 to November 2009. Sixty patients after cesarean section under continuous epidural anesthesia were randomly divided into three different groups.Group A was given sufentanil 0.3 μg/mL and 0.125% ropivacaine for PCEA, group B was given sufentanil 0.4 μg/mL and 0.125% ropivacaine, group C was given sufentanil 0.5 μg/mL and 0.125% ropivacaine. The analgesia effects were evaluated by the visual analogue scales (VAS). Side effects were also recorded. Results The VAS scores were significantly the highest in group A than that in group B and group C, the VAS scores in group B were higher than that in group C (Plt;0.05). The incidence of side effects, such as postoperative nausea and vomiting, lethargy, and pruritus, was not significant among the three groups (Pgt;0.05). Conclusion 0.5 μg/ mL sufentanil and 0.125% ropivacaine recommended for PCEA with background 4 mL/h is safe and effective for patients after cesarean section.

    Release date:2016-09-08 09:50 Export PDF Favorites Scan
  • Influence of Remifentanil on Newborns During Cesarean Section under General Anesthesia: A Meta Analysis

    目的 系统评价瑞芬太尼用于全身麻醉下剖宫产时对新生儿的影响。 方法 检索Cochrane Library、PubMed、OVID、EMbase、CNKI、万方等中外数据库,收集1990年-2012年关于瑞芬太尼用于全身麻醉下剖宫产的临床随机对照研究。按Cochrane系统评价方法评估文献质量,用Revman 5.1软件对提取的数据进行Meta分析。 结果 共纳入10项研究,包括342例产妇。与空白对照组相比,瑞芬太尼降低新生儿1 min Apgar评分[WMD=?0.46,95%CI(?0.65,?0.27),P<0.000 01],提高出生时脐动脉pH值[WMD=0.01,95%CI(0.00,0.02),P=0.004],增加出生时窒息发生率[RR=1.76,95%CI(1.06,2.95),P=0.03];当诱导剂量为1.0~1.5 μg/kg时,对5 min Apgar评分无影响[WMD=?0.14,95%CI(?0.32,0.04),P=0.13]。 结论 瑞芬太尼用于全身麻醉剖宫产可减轻新生儿酸中毒,但是会对新生儿产生一过性的呼吸抑制。

    Release date:2016-09-08 09:18 Export PDF Favorites Scan
  • The prospective clinical controlled study of high intensity focused ultrasound and uterine artery embolization in the treatment of cesarean scar pregnancy

    Objective To investigate the clinical effect of high intensity focused ultrasound (HIFU) and uterine artery embolization (UAE) in the treatment of cesarean scar pregnancy (CSP). Methods A total of 152 patients with CSP diagnosed by B-type ultrasonography were enrolled prospectively in this study from June 2014 to May 2016 in Chengdu Women and Children’s Central Hospital and Suining Central Hospital. Six patients from Chengdu Women and Children’s Central Hospital and 84 from Suining Central Hospital for Volunteered HIFU treatment were regarded as observation group. The other 62 patients from Chengdu Women and Children’s Central Hospital were selected to accept UAE treatment voluntarily were designated as control group. The clinical efficacy and therapeutic safety of the two groups were compared after the treatment. Results Eighty-two patients (91.1%) in the observation group and 32 (51.6%) in the control group had a bleeding volume equal to 100 mL or lower during complete curettage of uterine cavity (P<0.05). The hospitalization expenses of the above two groups were respectively (25 126.51±1 473.49) and (32 928.42 ±1 579.35) yuan (P<0.05). The hospitalization time was (11.03±1.52) and (10.65±1.87) days respectively, and the difference was not statistically significant (P>0.05). There was no significant difference in the normal rate of human chorionic gonadotropin recovery between the observation group and the control group at 14 days after treatment (P>0.05). Eighty-seven patients (96.7%) in the observation group and 51 (82.3%) in the control group had their menstrual recovery to normal level at 2 months after treatment, and the difference was statistically significant (P<0.05). The incidence of postoperative complications was 1.1% and 6.4% in the observation group and the control group, respectively, and the difference was not statistically significant (P>0.05). Conclusions HIFU in the treatment of CSP is safe and effective. Compared with UAE, HIFU requires less cost with fewer complications, which is worth promoting.

    Release date:2017-05-18 01:09 Export PDF Favorites Scan
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