目的分析剖宫产术后瘢痕妊娠的临床诊断和治疗方法及效果。方法选取我院2014年5月至2016年5月收治的剖宫产术后瘢痕妊娠患者38例,采用Phicipsiu 22IIPHX,Image Point HX阴道彩色多普勒超声检查仪对所有患者进行妇产科常规超声检查,然后...目的分析剖宫产术后瘢痕妊娠的临床诊断和治疗方法及效果。方法选取我院2014年5月至2016年5月收治的剖宫产术后瘢痕妊娠患者38例,采用Phicipsiu 22IIPHX,Image Point HX阴道彩色多普勒超声检查仪对所有患者进行妇产科常规超声检查,然后依据超声情况及阴道出血情况将有针对性的治疗方案制定出来,最后对38例患者临床诊断和治疗结果进行统计分析。结果 38例患者中,第一步治疗方案中局部化疗28例,UAE10例,分别占总数的73.7%、26.3%,接受UAE治疗的患者的血流信号、HCG值的血流信号和孕囊距离子宫浆膜层的最小距离均显著小于局部化疗(P<0.05);但其的年龄、孕次、剖宫产时年龄、妊娠物直径之间的差异均不显著(P>0.05)。第二步治疗方案中动态观察8例,清宫术22例,子宫修补术8例,分别占总数的21.1%、57.9%、21.1%,接受动态观察、清宫术、子宫修补术治疗的患者的妊娠物直径逐渐增大,组间比较差异具有统计学意义(P<0.05);HCG值的血流信号和孕囊距离子宫浆膜层的最小距离逐渐缩短,组间比较差异具有统计学意义(P<0.05);但其年龄、孕次、剖宫产时年龄、血流信号之间的差异均不显著(P>0.05)。结论剖宫产术后瘢痕妊娠的彩色多普勒超声具有较高的临床诊断价值,其能够对临床治疗进行有效指导,从而有效改善治疗效果,值得推广。展开更多
子宫肌瘤（myoma of uterus）是女性生殖器最常见的良性肿瘤,主要由平滑肌细胞增生而成,其间有少量纤维组织,多见于30～50岁妇女,以40～50岁最多见,20岁以下少见。据尸检报告,35岁以上妇女约20%有子宫肌瘤,其最常见症状为月经改变。传...子宫肌瘤（myoma of uterus）是女性生殖器最常见的良性肿瘤,主要由平滑肌细胞增生而成,其间有少量纤维组织,多见于30～50岁妇女,以40～50岁最多见,20岁以下少见。据尸检报告,35岁以上妇女约20%有子宫肌瘤,其最常见症状为月经改变。传统治疗方法为子宫切除术、子宫肌瘤剔除术及药物治疗，自1995年法国Ravina等首次报道采用UAE治疗症状性子宫肌瘤以来，因其具有与手术切除相当的效果，已在世界范围内越来越多地被使用。本科自2005年6月2007年4月间采用UAE治疗子宫肌瘤30例，现报道如下。展开更多
Objective To compare the analgesic effect of patient-controlled epidural analgesia （PCEA） with multi-model analgesia for interventional uterine artery embolization （UAE）. Methods Five hundreds and forty ASA I-II p...Objective To compare the analgesic effect of patient-controlled epidural analgesia （PCEA） with multi-model analgesia for interventional uterine artery embolization （UAE）. Methods Five hundreds and forty ASA I-II patients receiving UAE were divided into 2 groups, group A: 284 patients received PCEA until 24 h postoperatively;Group B: 256 patients received PCEA for 12 h16 h after UAE procedure, then followed with oral NSAIDs or intramuscular injection of analgesic and so on for pain relief. VAS was recorded. Results In group A, the degree of pain decreased obviously after 12 h, PCA bolus frequency reduced markedly, and the ration of total/actual bolus frequency（D1/D2）was <2. There was no significant difference in VAS between two groups 17 h24 h after UAE procedure （P>0.05）. In group A , the mean time of ambulation and urinary catheters retaining were （25.9±6.9） h and （23.9±2.3） h respectively, however, in group B the mean times were （15.1±4.6） h and （14.6±2.5） h accordingly （P<0.05）. The Bruggman comfort score （BCS） of two groups were （6.1±2.3） and （7.6±1.9） in 24th hour postoperatively （P>0.05）. Conclusion PCEA can provide pain relief effectively during and after UAE procedure, and adjunctive multi-model analgesia may be more benefit to early activity.展开更多
A case of septic expulsion of a leiomyoma is reported 18 weeks after uterine artery embolisation (UAE). The patient underwent UAE for a symptomatic sub- mucous leiomyoma (type 2) of 5 cm. She was feverish and presente...A case of septic expulsion of a leiomyoma is reported 18 weeks after uterine artery embolisation (UAE). The patient underwent UAE for a symptomatic sub- mucous leiomyoma (type 2) of 5 cm. She was feverish and presented pelvic pain and purulent vaginal discharges. Vaginal examination revealed a necrotic mass prolapsed through the cervix that was carefully twisted out. Histopathologic examination showed extensive necrosis of the myomatous tissue. Microbiologic cultures showed heavy growth of Escherichia coli. Such findings challenge the interest and the safety of UAE for submucous fibroids. Our case report stresses that uterine artery embolisation for submucous fibroids does not constitute, because of its risks, an alternative to conventional surgical treatment represented mainly by hysteroscopic resection.展开更多
文摘目的分析剖宫产术后瘢痕妊娠的临床诊断和治疗方法及效果。方法选取我院2014年5月至2016年5月收治的剖宫产术后瘢痕妊娠患者38例,采用Phicipsiu 22IIPHX,Image Point HX阴道彩色多普勒超声检查仪对所有患者进行妇产科常规超声检查,然后依据超声情况及阴道出血情况将有针对性的治疗方案制定出来,最后对38例患者临床诊断和治疗结果进行统计分析。结果 38例患者中,第一步治疗方案中局部化疗28例,UAE10例,分别占总数的73.7%、26.3%,接受UAE治疗的患者的血流信号、HCG值的血流信号和孕囊距离子宫浆膜层的最小距离均显著小于局部化疗(P<0.05);但其的年龄、孕次、剖宫产时年龄、妊娠物直径之间的差异均不显著(P>0.05)。第二步治疗方案中动态观察8例,清宫术22例,子宫修补术8例,分别占总数的21.1%、57.9%、21.1%,接受动态观察、清宫术、子宫修补术治疗的患者的妊娠物直径逐渐增大,组间比较差异具有统计学意义(P<0.05);HCG值的血流信号和孕囊距离子宫浆膜层的最小距离逐渐缩短,组间比较差异具有统计学意义(P<0.05);但其年龄、孕次、剖宫产时年龄、血流信号之间的差异均不显著(P>0.05)。结论剖宫产术后瘢痕妊娠的彩色多普勒超声具有较高的临床诊断价值,其能够对临床治疗进行有效指导,从而有效改善治疗效果,值得推广。
文摘子宫肌瘤（myoma of uterus）是女性生殖器最常见的良性肿瘤,主要由平滑肌细胞增生而成,其间有少量纤维组织,多见于30～50岁妇女,以40～50岁最多见,20岁以下少见。据尸检报告,35岁以上妇女约20%有子宫肌瘤,其最常见症状为月经改变。传统治疗方法为子宫切除术、子宫肌瘤剔除术及药物治疗，自1995年法国Ravina等首次报道采用UAE治疗症状性子宫肌瘤以来，因其具有与手术切除相当的效果，已在世界范围内越来越多地被使用。本科自2005年6月2007年4月间采用UAE治疗子宫肌瘤30例，现报道如下。
文摘Objective To compare the analgesic effect of patient-controlled epidural analgesia （PCEA） with multi-model analgesia for interventional uterine artery embolization （UAE）. Methods Five hundreds and forty ASA I-II patients receiving UAE were divided into 2 groups, group A: 284 patients received PCEA until 24 h postoperatively;Group B: 256 patients received PCEA for 12 h16 h after UAE procedure, then followed with oral NSAIDs or intramuscular injection of analgesic and so on for pain relief. VAS was recorded. Results In group A, the degree of pain decreased obviously after 12 h, PCA bolus frequency reduced markedly, and the ration of total/actual bolus frequency（D1/D2）was <2. There was no significant difference in VAS between two groups 17 h24 h after UAE procedure （P>0.05）. In group A , the mean time of ambulation and urinary catheters retaining were （25.9±6.9） h and （23.9±2.3） h respectively, however, in group B the mean times were （15.1±4.6） h and （14.6±2.5） h accordingly （P<0.05）. The Bruggman comfort score （BCS） of two groups were （6.1±2.3） and （7.6±1.9） in 24th hour postoperatively （P>0.05）. Conclusion PCEA can provide pain relief effectively during and after UAE procedure, and adjunctive multi-model analgesia may be more benefit to early activity.
文摘A case of septic expulsion of a leiomyoma is reported 18 weeks after uterine artery embolisation (UAE). The patient underwent UAE for a symptomatic sub- mucous leiomyoma (type 2) of 5 cm. She was feverish and presented pelvic pain and purulent vaginal discharges. Vaginal examination revealed a necrotic mass prolapsed through the cervix that was carefully twisted out. Histopathologic examination showed extensive necrosis of the myomatous tissue. Microbiologic cultures showed heavy growth of Escherichia coli. Such findings challenge the interest and the safety of UAE for submucous fibroids. Our case report stresses that uterine artery embolisation for submucous fibroids does not constitute, because of its risks, an alternative to conventional surgical treatment represented mainly by hysteroscopic resection.
