目的 探讨体位指导对产程的影响。 方法 选择2007年1月-2008年1月产科住院的经特殊体位管理分娩的260例产妇,作为观察组;同期未予以体位指导的经阴道分娩的260例产妇作为对照组,产程中未作体位指导,一般以平卧为主。观察两组产程进展情况、胎儿宫内窘迫、剖宫产率等。 结果 观察组与对照组相比,第1产程及第2产程明显缩短,胎儿宫内窘迫、剖宫产率明显降低,有统计学意义(P<0.05)。 结论 对孕妇实行体位管理能加快产程,避免各种产科并发症的发生,增加了阴道分娩率,减少了剖宫产率。
Objective To summarize the latest developments in neurosurgical treatments for neurofibromatosis type 1 (NF1) and explore therapeutic strategies to provide comprehensive treatment guidelines for clinicians. Methods The recent domestic and international literature and clinical cases in the field of NF1 were reviewed. The main types of neurological complications associated with NF1 and their treatments were thorough summarized and the future research directions in neurosurgery was analyzed. Results NF1 frequently results in complex and diverse lesions in the central and peripheral nervous systems, particularly low-grade gliomas in the brain and spinal canal and paraspinal neurofibromas. Treatment decisions should be made by a multidisciplinary team. Symptomatic plexiform neurofibromas and tumors with malignant imaging evidence require neurosurgical intervention. The goals of surgery include reducing tumor size, alleviating pain, and improving appearance. Postoperative functional rehabilitation exercises, long-term multidisciplinary follow-up, and psychosocial interventions are crucial for improving the quality of life for patients. Advanced imaging guidance systems and artificial intelligence technologies can help increase tumor resection rates and reduce recurrence. Conclusion Neurosurgical intervention is the primary treatment for symptomatic plexiform neurofibromas and malignant peripheral nerve sheath tumors when medical treatment is ineffective and the lesions progress rapidly. Preoperative multidisciplinary assessment, intraoperative electrophysiological monitoring, and advanced surgical assistance devices significantly enhance surgical efficacy and safety. Future research should continue to explore new surgical techniques and improve postoperative management strategies to achieve more precise and personalized treatment for NF1 patients.