Objective To explore the clinical characteristics and management of ovarian tumor complicated by pregnancy and its influence on the pregnancy outcome, so as to provide diagnostic and therapeutic experiences. Methods A total of 248 cases were surgically and pathologically diagnosed as ovarian tumor complicated by pregnancy in The 202 Military Hospital from January, 2003 to December, 2009, and their clinical data were analyzed retrospectively. Results The incidence rate of ovarian tumor complicated by pregnancy was 0.49%. Among total 248 cases, 131 (52.82%) were benign tumors, of which 22.18% were ovarian mature teratomas; 113 (45.57%) were tumourlike lesions, of which most were ovarian chocolatecyst and lutealcyst, and 4 (1.61%) were malignant tumors. There were 212 cases treated by tumorectomy or salpingo-oophorectomy, and 3 of 4 cases with malignant tumors took postoperative chemotherapy. A total of 192 cases were diagnosed by regular antenatal care and ultrasound examination, accounting for 77.42% of the total sample size found during pregnancy. Among 14 cases receiving emergency operations, 9 were complicated by torsion, and the other 5 were by rupture. There were 67 cases receiving operation from the 14th to 18th gestational week, and 57 cases had full-time pregnancy. Conclusion Ultrasonography and pelvioscopy are of principal importance in the diagnosis and detection of ovarian tumor complicated by pregnancy which should be treated by tumorectomy, and suitable surgery intervention during second trimester is safe.
Objective To assess different anticoagulant regimens in pregnant women with mechanical heart valves: taking oral warfarin throughout the pregnancy, or heparin in the 1st trimester and oral warfarin for the other trimesters. The main outcome measures were major maternal complications and perinatal outcomes. Methods The MEDLINE, EMbase, CBM and CNKI were searched. The quality of the included studies was evaluated and data were extracted by two reviewers independently. Meta-analyses were performed on the results of homogeneous studies. Result Seven studies involving 629 pregnancies in 469 patients met the inclusion criteria for this review, all of which were retrospective surveys. The comparison between the administration of heparin in the 1st trimester plus oral warfarin for the other trimesters and warfarin throughout the pregnancy showed that, there are not significant different in the incidence of major maternal complications and the incidence of adverse perinatal outcomes. Conclusion Compared with the administration of warfarin throughout the pregnancy, the administration of heparin in the 1st trimester and oral warfarin for the other trimesters might increase the incidence of major maternal complications, but with a similar incidence of adverse perinatal outcomes.
目的 分析死胎死亡原因及可能的相关因素，为降低死胎发生的措施提供依据。 方法 对2007年1月－2011年12月住院分娩的609例死胎（≥28周） 的病例资料进行回顾性分析,包括对产检次数差异、死胎性别、死胎孕周分布、母亲年龄差别、母亲文化程度等进行统计分析。 结果 ① 死胎的原因依次为：胎儿因素（41.2%），母体因素（24.1%），胎盘因素（21.7%）及不明原因（13.0%）；其中胎儿畸形、重度子痫前期及胎盘早剥为主要原因；② 母亲的文化程度低、未建卡或未正规产检者死胎发生的几率高于正规产检者，差异有统计学意义（P＜0.05）。 结论 加强围产保健，早期筛查胎儿畸形、防治妊娠期并发症及合并症等都有助于降低死胎的发生率。
【摘要】 目的 探讨甲氨蝶呤(MTX)联合米非司酮治疗早期异位妊娠(EP)的临床效果。 方法 收集2006年2月-2010年2月收治的早期未破裂型EP患者126例，随机分为MTX联合米非司酮组62例，单独应用MTX组64例， MTX治疗采用小剂量分次肌肉注射给药进行。 结果 126例患者中，MTX联合米非司酮组和单独应用MTX治疗组的成功率为分别为88%和65%，两组差异有统计学意义(Plt;0.05)。 结论 MTX小剂量分次给药联合米非司酮治疗早期未破裂型EP效果优于MTX的单独使用。【Abstract】 Objective To observe the therapeutic effect of methotrexate (MTX) combined with mifepristone on early ectopic pregnancy. Methods A total of 126 patients with early ectopic pregnancy diagnosed from February 2006 to Febrary 2010 were randomly divided into two groups. In 126 patients, 62 treated with MTX combined with mifepristone were in the treatment group,and 64 treated independently with MTX were in the control group. MTX was administrated at a low dose in several times. Results In 126 patients,the success ratio of the treatment was 88% in treatment group groups and 65% in the control group; the difference between the two groups was significant (Plt;0.05). Conclusion Low-dose MTX in separate times combined with mifepriston is effective on the early ectopic pregnancy, and the therapeutic effect of the combined administration of MTX and mifepriston is better than that of the single administration with MTX.
目的:探讨妊娠相关性宫颈癌的早期诊断、治疗和预后。方法:结合文献回顾分析我院2000年至2007年收治的13例妊娠相关性宫颈癌的诊治经过和预后。结果:妊娠相关性宫颈癌分化程度低，癌灶体积大，早期盆腔淋巴结转移率高，产褥期宫颈癌预后差。结论:宫颈细胞学检查应列为首次产检常规项目；妊娠期宫颈原位癌在密切随诊前提下可暂不予处理，待分娩后6~8周活检确认病变性质后，再采取相应治疗措施；新辅助化疗同样可为晚期别的妊娠相关性宫颈癌争取手术时机。
目的：讨论剖宫产瘢痕妊娠的早期正确诊断方法和适当的治疗措施。方法：回顾性分析我院35例剖宫产瘢痕妊娠病例的临床表现、超声影像和治疗方法。结果：33例病例经血βhCG测定、B超或彩超确诊，2例行清宫术或诊刮术时发生大出血，后经彩超修正诊断。31例接受药物、清宫等保守性治疗，4例接受介入治疗，所有病例均好转或痊愈。结论：广大临床医师对剖宫产瘢痕妊娠认识的提高，以及超声检查技术的发展，使早期明确诊断和成功保守治疗该病成为可能。
目的：分析我院近10年来异位妊娠发生率、发病年龄、诊断和治疗。方法：以5年为一个时间段回顾分析我院1997年1月至2006年12月异位妊娠发生率、发病年龄、诊断和治疗。结果：我院1997年1月至2006年12月共收治异位妊娠740例。异位妊娠数与同期宫内妊娠数之比，由1997年1月至2001年12月的1∶23.99上升为2002年1月至2006年12月的1∶11.60（P＜0.01）。≤25岁异位妊娠的发病率由1997年至2001年的14.7%上升到2002年至2006年的289%，其中≤20岁妇女及合并不孕者有增多趋势。异位妊娠的早期诊断率增高，发生异位妊娠破裂者由1997年至2001年的120例（45.3%）下降至2002年至2006年的85例（17.9%）（P＜0.01）。经腹行输卵管切除仍为主要治疗手段，但腹腔镜手术及保守性手术逐渐增多，非手术治疗明显增多。结论：异位妊娠发生率呈上升趋势，发病年龄年轻化，近年早期诊断率增高，减少误诊及异位妊娠破裂发生，经腹手术仍为主要治疗手段，但腹腔镜和保守治疗上升。
目的 探讨妊娠期乳腺癌的诊断、治疗及预后。方法 回顾性分析1986年1月至2007年12月期间笔者所在医院收治的12例妊娠期乳腺癌患者的临床资料和随访资料。结果 12例妊娠期乳腺癌患者中，有8例患者于术前行B超检查，3例患者行钼靶检查，均有阳性发现。12例患者均行手术治疗，其中10例行乳腺癌改良根治术，2例行乳腺癌根治术；7例在妊娠期间确诊的患者中，仅1例行人流术，另外6例行剖宫产；所有患者乳腺癌术后并妊娠结束后均行化疗，5例化疗后再行放疗，1例在妊娠结束后行内分泌治疗。随访期间（平均随访时间35.8个月），1例患者出现胸壁结节，2例盆腔多发转移并死亡，余9例均未出现复发和转移。结论 妊娠期乳腺癌可行乳腺切除加腋窝淋巴结清扫术； 妊娠结束后可行化疗，妊娠期间不应行放疗及内分泌治疗。
目的 探讨妊娠期并发急性胰腺炎(APIP)的病因、发病机理、临床特点及防治措施. 方法 对四川省宜宾市第二人民医院和四川大学华西医院1995年1月至2006年12月期间收治的72例APIP患者的临床资料进行回顾性分析. 结果 本组72例中,属轻型急性胰腺炎(MAP)者49例(68.06%),重症急性胰腺炎(SAP)者23例(31.94%); 有胆囊炎合并胆囊结石病史者43例(59.72%),伴高脂血症者21例(29.17%).采用非手术治疗56例,手术治疗16例,孕妇治愈66例(91.67%),死亡6例(8.33%),死因为多器官功能障碍综合征、急性呼吸窘迫综合征及严重复腔感染; 终止妊娠16例(均为32～38周妊娠),56例继续妊娠; 72例中双胎2例,胎儿死亡共15例(20.27%); 漏诊、误诊6例.结论 APIP的发生与胆结石和高脂血症有关,并于妊娠中晚期发病率高; 其临床表现复杂,易误诊,对孕妇及胎儿威胁极大; 把握该疾病的特点,提高对APIP的认识和警惕性,及时准确的诊断与"个体化"的治疗原则,适时终止妊娠,可以提高其治愈率,降低母婴死亡率.