To describe an open surgical technique for transplanting fresh ovarion tissue to the anterior abdominal wall at the incision site and to determine whether ovarian function would be restored after transplantation. Case...To describe an open surgical technique for transplanting fresh ovarion tissue to the anterior abdominal wall at the incision site and to determine whether ovarian function would be restored after transplantation. Case study. Academic medical center. A 44- year- old patient who underwent an operation for uterine fibroids. Microsurgical reconstruction of ovarian cortex and its transplantation to the anterior abdominal wall at incision site of Pfannenstiel. Follicular development evident by ultrasound examination; restoration of serum FSH and LH levels to nonmenopausal range; and disappearance of menopausal symptoms. Early postoperative FSH, LH, and E2 levels showed that menopause was confirmed. Postoperative hormone levels at months 2, 3, and 6 were as follows: FSH: 77.86, 79.50, and 13.70 mIU/mL; LH: 34.60, 33.92, and 8.78 mIU/mL; E2: 29, 46, and 48 pg/mL. The patient is still followed up for postmenopausal status. Autotransplantation of cortical strips to the anterior abdominal wall at the incision site without further inci sion can be a logical solution for the patients at early climacteric age.展开更多
剖宫产疤痕子宫内膜异位症是一种少见的医源性疾病,本研究旨在探讨其临床特征和预防方法.回顾分析本院2007年1月至2016年12月剖宫产疤痕子宫内膜异位症患者的临床资料,共有169例剖宫产疤痕子宫内膜异位症患者被纳入研究.患者平均年龄(32...剖宫产疤痕子宫内膜异位症是一种少见的医源性疾病,本研究旨在探讨其临床特征和预防方法.回顾分析本院2007年1月至2016年12月剖宫产疤痕子宫内膜异位症患者的临床资料,共有169例剖宫产疤痕子宫内膜异位症患者被纳入研究.患者平均年龄(32.0±3.9)岁,产次1~2次.潜伏期平均为(31.4±23.7)月,与患者年龄、产次等基本特征无明显相关性.80.5%的患者既往剖宫产为Pfannenstiel切口,19.5%的患者为正中纵形切口.统计学分析发现,Pfannenstiel切口发生子宫内膜异位症的潜伏期显著低于正中纵形切口(24.0 vs 36.0,P=0.005),并且多发性子宫内膜腺瘤患者潜伏期显著低于单个腺瘤患者(12.0 vs 24.0,P=0.034).子宫内膜腺瘤在剖宫产疤痕的两端更常见,在Pfannenstiel切口,83.4%的腺瘤位于两端;在正中纵形切口,84.8%的腺瘤位于两端.本研究提示剖宫产Pfannenstiel切口发生子宫内膜异位症的风险可能高于正中纵形切口,但仍需大样本前瞻性研究的验证.在剖宫产结束时彻底冲洗切口,尤其是脂肪层和筋膜层的两端对于预防剖宫产疤痕子宫内膜异位症十分重要.展开更多
目的:比较改良Stoppa入路与Pfannenstiel入路治疗骨盆前环损伤的效果。方法:选取2014年1月至2019年1月收治的52例骨盆前环损伤患者为研究对象,随机分为Stoppa组和Pfannenstiel组两组;Stoppa组患者进行t改良Stoppa入路手术治疗,Pfannenst...目的:比较改良Stoppa入路与Pfannenstiel入路治疗骨盆前环损伤的效果。方法:选取2014年1月至2019年1月收治的52例骨盆前环损伤患者为研究对象,随机分为Stoppa组和Pfannenstiel组两组;Stoppa组患者进行t改良Stoppa入路手术治疗,Pfannenstiel组患者进行Pfannenstiel入路治疗;比较两组患者的临床指标、Majeed评分、Matta骨折复位效果及术后并发症发生率。结果:两组患者的切口长度、手术时间、术中出血量、术后负重时间比较,差异无统计学意义(P>0.05);术后14 d Stoppa组患者的VAS评分(1.20±0.21)分,比Pfannenstiel组患者的(3.61±0.25)分低(P<0.05);Stoppa组和Pfannenstiel组患者的骨盆骨折功能评价(Majeed评分)优良率分别为100.00%和88.46%,组间相比差异无统计学意义(P>0.05);Matta骨折复位效果优良率分别为96.15%、88.46%,组间相比差异无统计学意义(P>0.05);Stoppa组患者术后并发症发生率为0.00%,低于Pfannenstiel组患者的23.08%(P<0.05)。结论:改良Stoppa入路与Pfannenstiel入路治疗骨盆前环损伤疗效相似,且改良Stoppa入路治疗骨盆前环损伤可减轻患者疼痛,减少术后并发症发生,值得在临床推广。展开更多
文摘To describe an open surgical technique for transplanting fresh ovarion tissue to the anterior abdominal wall at the incision site and to determine whether ovarian function would be restored after transplantation. Case study. Academic medical center. A 44- year- old patient who underwent an operation for uterine fibroids. Microsurgical reconstruction of ovarian cortex and its transplantation to the anterior abdominal wall at incision site of Pfannenstiel. Follicular development evident by ultrasound examination; restoration of serum FSH and LH levels to nonmenopausal range; and disappearance of menopausal symptoms. Early postoperative FSH, LH, and E2 levels showed that menopause was confirmed. Postoperative hormone levels at months 2, 3, and 6 were as follows: FSH: 77.86, 79.50, and 13.70 mIU/mL; LH: 34.60, 33.92, and 8.78 mIU/mL; E2: 29, 46, and 48 pg/mL. The patient is still followed up for postmenopausal status. Autotransplantation of cortical strips to the anterior abdominal wall at the incision site without further inci sion can be a logical solution for the patients at early climacteric age.
文摘剖宫产疤痕子宫内膜异位症是一种少见的医源性疾病,本研究旨在探讨其临床特征和预防方法.回顾分析本院2007年1月至2016年12月剖宫产疤痕子宫内膜异位症患者的临床资料,共有169例剖宫产疤痕子宫内膜异位症患者被纳入研究.患者平均年龄(32.0±3.9)岁,产次1~2次.潜伏期平均为(31.4±23.7)月,与患者年龄、产次等基本特征无明显相关性.80.5%的患者既往剖宫产为Pfannenstiel切口,19.5%的患者为正中纵形切口.统计学分析发现,Pfannenstiel切口发生子宫内膜异位症的潜伏期显著低于正中纵形切口(24.0 vs 36.0,P=0.005),并且多发性子宫内膜腺瘤患者潜伏期显著低于单个腺瘤患者(12.0 vs 24.0,P=0.034).子宫内膜腺瘤在剖宫产疤痕的两端更常见,在Pfannenstiel切口,83.4%的腺瘤位于两端;在正中纵形切口,84.8%的腺瘤位于两端.本研究提示剖宫产Pfannenstiel切口发生子宫内膜异位症的风险可能高于正中纵形切口,但仍需大样本前瞻性研究的验证.在剖宫产结束时彻底冲洗切口,尤其是脂肪层和筋膜层的两端对于预防剖宫产疤痕子宫内膜异位症十分重要.
文摘目的:比较改良Stoppa入路与Pfannenstiel入路治疗骨盆前环损伤的效果。方法:选取2014年1月至2019年1月收治的52例骨盆前环损伤患者为研究对象,随机分为Stoppa组和Pfannenstiel组两组;Stoppa组患者进行t改良Stoppa入路手术治疗,Pfannenstiel组患者进行Pfannenstiel入路治疗;比较两组患者的临床指标、Majeed评分、Matta骨折复位效果及术后并发症发生率。结果:两组患者的切口长度、手术时间、术中出血量、术后负重时间比较,差异无统计学意义(P>0.05);术后14 d Stoppa组患者的VAS评分(1.20±0.21)分,比Pfannenstiel组患者的(3.61±0.25)分低(P<0.05);Stoppa组和Pfannenstiel组患者的骨盆骨折功能评价(Majeed评分)优良率分别为100.00%和88.46%,组间相比差异无统计学意义(P>0.05);Matta骨折复位效果优良率分别为96.15%、88.46%,组间相比差异无统计学意义(P>0.05);Stoppa组患者术后并发症发生率为0.00%,低于Pfannenstiel组患者的23.08%(P<0.05)。结论:改良Stoppa入路与Pfannenstiel入路治疗骨盆前环损伤疗效相似,且改良Stoppa入路治疗骨盆前环损伤可减轻患者疼痛,减少术后并发症发生,值得在临床推广。
