The authors studied retrospectively clinical data of seventy cases with breast cancer during pregnancy and lactation.They were treated and diagnosed by operation and pathology.Primary factors influencing prognosis were analyzed.It was demonstrated that 5year survival rate of the patients were significantly influenced by clinical stage , month of pregnancy and lactation, time of symptoms, type of operation, type of pathology, histological grade of malignancy, recurrence and metastasis, and estrogen receptor status (Ｐ＜0.05).Age and termination of pregnancy had no beneficial effect on survival (Ｐ＞0.05).The prognosis of pregnant and lactating breast cancer was poorer than ordinary breast cancer.Their 5year survival rate were 55.7% and 74.3%, respectively. After they were matched for stage and for age, no difference in survival was found.Early diagnosis and radical operation combined with radiotherapy, chemotherapy and hormonal therapy have better prognosis.The method can shorten time of treatment and improve survival rate.Termination of pregnancy has not been shown to improve survival and shall not be advised routinely.Future pregnancy may be detrimental and shall be discouraged.
目的 了解国内妊娠期抗菌药物的应用现状。 方法 通过检索1994年－2012年国内医学文献，筛选出妊娠期间使用抗菌药物的原始病例报道，对收集的病例按照用药原因、抗菌药物品种、妊娠安全性分级进行统计分析。其中妊娠安全性分级是根据美国药物和食品管理局（FDA）颁布的药物危害等级标准，分为A、B、C、D、X级。 结果 妊娠期使用抗菌药物的常见原因为泌尿系统感染，选用的抗菌药物以头孢菌素和青霉素类为主（B类），但仍有部分病例选用C类、D类药物及超说明书用药。 结论 存在妊娠期抗菌药物不合理应用现象，妊娠合并感染性疾病需用抗菌药物时，医生应权衡抗菌药物对胎儿的可能危害及对母体的治疗作用，最大限度地避免用药对胎儿造成不良影响。
目的探讨妊娠期体外循环手术的围术期处理方法及母婴安全性。 方法回顾性分析2006年1月至2014年3月福建省立医院心外科21例妊娠期行体外循环手术患者的临床资料，年龄（26.2±3.4）岁。 结果母亲19例生存，2例死于多器官功能衰竭。婴儿6例引产，2例死亡，生存13例。随访13例存活新生儿8个月至8年，并对4例年龄大于6岁的儿童进行韦氏儿童智力量表第4版（WISC-IV）测试，得分分别为92分、104分、106分、90分，平均98分，与正常儿童无明显差异[（100±15）分]。 结论体外循环下心脏手术对于妊娠期合并严重心脏病患者是可行的，手术的危险性主要取决于手术方式、手术时间、孕周、体外转流时间、是否深低温等，应采取多学科合作，根据患者具体情况制定个体化方案。
ObjectivesUsing systematic literature review to analyze the effects of levetiracetam (LEV) on neonatal safety during early pregnancy.MethodsThe scope of the literature must be English literature, published from 1997 to 2018. Meta-analysis was performed by random effects models.ResultsSeven literatures were included. A total of 672 cases exposed to LEV in treatment group and 772 234 cases in control groups were selected for meta-analysis. There was no significant difference in neonatal malignancy between treatment group and control group［OR=1.05, 95% CI (0.54, 2.02), P=0.37］. Further, we evaluated the effect of LEV monotherapy and polytherapy on neonatal safety, a total of 464 monotherapy cases and 632 polytherapy cases respectively were selected for meta-analysis. The results showed that there was no significant difference between these two therapies in neonatal malignancy ［OR=0.54, 95% CI(0.31, 0.96), P=0.32］.ConclusionsAs the papers we included, levetiracetam in the treatment of epilepsy during pregnancy is relatively safe for newborn.
目的 探讨不典型胎盘早剥的临床特点。 方法 对2008年5月－2009年5月收治的55例胎盘早剥患者的临床资料进行回顾性分析。其中产前漏诊30例，疑诊15例，确诊10例。胎盘早剥的产前确诊率为18.2%，漏诊率为54.5%。所有患者均经产后证实。 结果 重度子痫前期（25.5%）、胎膜早破（12.7%）是胎盘早剥的主要发病诱因；阴道流血（52.7%）、腰腹痛（47.3%）及胎心异常（36.4%）是其常见的临床表现。胎盘早剥者，剖宫产率、胎儿窘迫及早产率均增加。 结论 不典型胎盘早剥病情隐匿。后壁胎盘、早剥面积小及B型超声检查阴性是漏诊的主要原因。对此患者应提高认识，动态监测，及时处理，以改善母婴结局。
Objective To systematically review the association between periodontal disease during pregnancy and the risk of gestational diabetes mellitus (GDM). Methods PubMed, Web of Science, CBM and CNKI databases were electronically searched to collect studies on periodontal disease and GDM from inception to October 23, 2021. Two researchers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. Results A total of 11 studies were included, involving 2 910 pregnant women. The results of meta-analysis showed that pregnant women with periodontal disease during pregnancy reported more GDM than normal pregnant women (OR=1.81, 95%CI 1.31 to 2.50, P=0.000 3). Conclusion The current evidence suggests that there is a positive association between periodontal disease during pregnancy and the risk of GDM. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective Based on the methodology of evidence-based medicine, we explored the prognosis of a patient with gestational diabetes mellitus (GDM). Methods We searched ACP Journal Club (1991 to October 2006), The Cochrane Library (Issue 4, 2006), MEDLINE (1990 to October 2006) and Chinese Biomedicine database (CBM). Cohort studies, case-control studies and case series studies involving the prognosis of patients with GDM were collected. The available evidence was critically appraised. Results During the period from 6 weeks to 28 years after delivery, the incidence of type 2 diabetes mellitus appeared to vary from 2.6% to 70%. Patients with GDM suffered from an increased incidence of spontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection. Conclusion Patients with GDM appears to be more liable to overt diabetes mellitus, and to suffer fromspontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection than women with normal glucose tolerance during pregnancy. Further studies of the long-term follow-up data from GDM trials are needed.