健康教育对异位妊娠患者保守治疗的临床意义

目的探讨健康教育对异位妊娠保守治疗患者的治疗意义。方法300例异位妊娠保守治疗患者随机分为观察组和对照组,对照组进行常规治疗和护理,观察组进行常规治疗和护理外,还进行心理护理、个体化指导及出院指导等健康教育。结果观察组患者在心理焦虑发生率、并发症发生率及保守治疗失败率与对照组比较,有非常显著性差异(P<0.01)。结论对异位妊娠保守治疗患者开展健康教育可改善治疗效果。     

甲氨蝶呤联合米非司酮治疗异位妊娠的疗效观察

目的探讨甲氨蝶呤联合米非司酮治疗异位妊娠患者的方法及疗效。方法将2008年7月至2010年7月我院保守治疗的异位妊娠患者45例中随机分为采用甲氨蝶呤联合米非司酮治疗观察组23例和采用米非司酮治疗的对照组22例,对2组的治疗效果进行比较。结果 2组治疗后的包块缩小、症状消失、尿HCG转阴、血HCG见下降、治愈率相比差异均有显著性差异(P<0.01或P<0.05)。结论甲氨蝶呤联合米非司酮治疗异位妊娠患者疗效明显,值得临床推广运用。     

56例异位妊娠患者的临床诊断与治疗

目的探讨异位妊娠患者的临床诊断与治疗方法及其治疗效果。方法采用米非司酮联合甲氨蝶呤(MTX)及甲氨蝶呤单药注射治疗异位妊娠。结果两组患者经过积极的治疗,观察组的治愈率达92.86%,对照组的治愈率为85.71%,两组治愈率比较,差异无统计学意义(P>0.05)。结论甲氨喋呤联合米非司酮治疗异位妊娠能起效加快,而且不良反应减少,其在临床上的应用具有良好的前景。     

甲氨蝶呤联用米非司酮治疗异位妊娠的临床观察

目的观察甲氨蝶呤联用米非司酮治疗异位妊娠患者的临床效果。方法将我院2003年1月至2009年10月行保守治疗的68例未破裂型异位妊娠患者随机分为观察组34例(甲氨蝶呤+米非司酮)和对照组34例(米非司酮)。对2组的治疗效果及各项指标进行对比;结果2组的治愈率相比差异性显著(P<0.05)。2组治疗后的包块缩小、症状消失、尿HCG转阴相比差异有非常显著性(P<0.01),血HCG见下降、达治愈标准相比差异有显著性(P<0.05)。结论甲氨蝶呤联用米非司酮是治疗未破裂型异位妊娠患者的有效方案。     

米非司酮治疗异位妊娠临床观察及护理

目的探讨米非司酮治疗异位妊娠的观察及护理方法。方法对异位妊娠患者给予口服米非司酮,进行用药前准备、用药后护理、心理护理及出院指导。结果15例服米非司酮患者13例治疗成功。结论米非司酮终止早孕是一种安全、可靠、简便和有效的非手术方法,减少了手术带来的损伤,减轻了患者的痛苦。     

腹腔镜下治疗异位妊娠的临床分析

目的探讨腹腔镜在治疗异位妊娠中的临床应用价值。方法回顾分析腹腔镜手术治疗异位妊娠125例的临床资料。结果125例患者均成功实施腹腔镜手术治疗,治愈120例,失败5例,手术治愈率96.0%。手术时间35～90min,平均(46.2±5.20)min,无明显并发症。结论腹腔镜手术创伤小、恢复快、住院时间短,是治疗异位妊娠首选的手术方式。     

未破裂异位妊娠保守治疗56例临床分析

目的探讨异位妊娠中西医结合保守治疗的疗效。方法将2005年1月至2009年1月于铁西中西医结合医院就诊的符合保守治疗条件的异位妊娠患者56例,采用甲氨喋呤联合中药治疗。结果56例中成功41例,占73.2%,15例失败改手术治疗,占26.8%。结论异位妊娠采用中西医结合治疗能保守杀胚,促进包块吸收,保留生育功能,开辟了非手术治疗途径。     

腹腔镜诊治异位妊娠的临床分析

目的探讨电视腹腔镜手术治疗异位妊娠的临床价值。方法回顾分析2003年6月至2006年6月间,共收治120例异位妊娠,对两组术式异位妊娠的临床资料进行分析。结果62例患者手术在腹腔镜下进行,无中转开腹,58例为开腹手术,比较两组患者,住院时间、术中出血量、术后病率,经统计学检验差异有显著性(P<0.01)。结论腹腔镜手术为治疗异位妊娠的一种理想的手术方式,异位妊娠大出血不是腹腔镜手术的禁忌症,虽腹腔镜内大量积血给手术增加了难度,但只要术中处理得当,均能成功完成手术。     

甲氨蝶呤和米非司酮辅以中药治疗异位妊娠

目的观察异位妊娠中西医结合保守治疗疗效。方法对168例符合异位妊娠保守治疗条件者,临床检验无用药禁忌症,给予甲氨蝶呤肌肉注射,米非司酮口服并联合中药宫外孕方水煎服。结果145例治愈,治愈率为86.3%。结论此法对符合异位妊娠保守治疗条件者,用药简单,不良反应小,可避免手术创伤,患者易于接受,可以推广应用。     

经腹超声对异位妊娠的诊断分析

目的通过经腹超声对异位妊娠图像的特征性分析,为临床提供可靠的依据。方法取我院2007年以来应用超声诊断的53例异位妊娠,将术前超声诊断与术后病理诊断对比分析评估诊断效果。结果53例超声诊断异位妊娠患者经手术后确诊48例,符合率为90.6%,误诊5例误诊率为9.4%。结论经腹超声对异位妊娠的检查,具有特征性,简便、直观、敏感性高、无损伤等优点,是诊断异位妊娠的理想方法,具有重要的临床应用价值。     

宫外孕临床诊治的探讨

目的探讨宫外孕的超声图像特点,及其在指导临床治疗措施中的应用。方法对36例宫外孕患者的阴道超声图像特点进行分析,根据超声图像特点治疗措施分为手术治疗和药物保守治疗。结果36例经阴道超声诊断为宫外孕患者,其中检出胚芽搏动者15例,以及检出最大径线<3.0cm不均质包块患者5例,临床采取手术治疗;余16例采取保守治疗。结论阴道超声检查在宫外孕早期的定位诊断中起着重要的作用,并对临床医生根据超声图像特点结合临床表现采取相应治疗措施,具有重要意义。     

经阴道彩超诊断早期异位妊娠84例的临床分析

目的探讨经阴道超声对早期异位妊娠的诊断价值。方法选取我院2010年1月至2010年12月收治的经临床诊断为异位妊娠的患者为研究对象,对该组患者进行经腹超声和经阴道超声检查,比较其诊断率,总结异位妊娠的声像学特点。结果经阴道超声的确诊率为84.5%(71/84)显著高于经腹超声的67.9%(57/84),P<0.05。异位妊娠典型的声像特点为在附件区探及异常回声团块,部分可见胎囊、胎芽及心管搏动。结论经阴道彩超的分辨率较高,具有无创性和可重复性强的特点,对早期异位妊娠的诊断具有较高的价值。     

超声诊断不同类型异位妊娠120例的临床应用

目的分析超声诊断不同类型异位妊娠的临床价值。方法选择我院2007年6月至2010年6月收治的120例经超声确诊的异位妊娠患者作为研究对象,采用美国GE-LOGIQ-400、Acuson128XP/10c彩色多普勒超声诊断仪。彩色多普勒超声诊断仪进行检查,总结分析不同类型异位妊娠的超声声像图表现。结果超声诊断的120例异位妊娠患者,经手术及病理证实者112例,诊断符合率93.3%。120例超声诊断的异位妊娠患者中,未破型、破裂型、流产型、陈旧型异位妊娠患者的超声声像图表现均有其自身的特点。结论超声对异位妊娠的诊断符合率较高,不同类型的异位妊娠超声声像图具有不同的特点,因此,临床诊断异位妊娠时同时结合HCG及患者自身的因素而确诊。     

Variation in stability of endogenous reference genes in fallopian tubes and endometrium from healthy and ectopic pregnant women

RT-qPCR is commonly employed in gene expression studies in ectopic pregnancy. Most use RN18S1, β-actin or GAPDH as internal controls without validation of their suitability as reference genes. A systematic study of the suitability of endogenous reference genes for gene expression studies in ectopic pregnancy is lacking. The aims of this study were therefore to evaluate the stability of 12 reference genes and suggest those that are stable for use as internal control genes in fallopian tubes and endometrium from ectopic pregnancy and healthy non-pregnant controls. Analysis of the results showed that the genes consistently ranked in the top six by geNorm and NormFinder algorithms, were UBC, GAPDH, CYC1 and EIF4A2 (fallopian tubes) and UBC and ATP5B (endometrium). mRNA expression of NAPE-PLD as a test gene of interest varied between the groups depending on which of the 12 reference genes was used as internal controls. This study demonstrates that arbitrary selection of reference genes for normalisation in RT-qPCR studies in ectopic pregnancy without validation, risk producing inaccurate data and should therefore be discouraged.     

Aberrant Sphingolipid Metabolism in the Human Fallopian Tube with Ectopic Pregnancy

Sphingosine 1-phosphate (S1P), a product of sphingomyelin metabolism, is generated via phosphorylation of sphingosine by sphingosine kinases (SphK). It acts via a family of G protein-coupled receptors or as an intracellular second messenger for agonists acting through the S1P receptors (S1P1–5). In our study, the expression of SphK1 and S1P1 was identified by immunohistochemistry and immunoblot. The concentration of S1P was measured using ELISA. The spontaneous contraction of isolated fallopian tube strips was determined by tension recording. Our results showed that SphK1 and S1P1 were localized in the fallopian tube epithelial cells. In addition, smooth muscle cells also contained S1P1. Compared with the intrauterine pregnancy group, SPHK1 and S1P1 were overexpressed in ectopic pregnancy. However, the S1P concentration within the human oviduct from ectopic pregnancy subjects was largely reduced than that from normal pregnancy subject. The results from tension recording indicated that exogenous and intracellularly generated S1P can regulate the spontaneous contraction of oviduct isolated from rats and human. In conclusion, the sphingolipid metabolism signal pathway functionally existed in the human fallopian tube. Aberrant sphingolipid metabolism in the human fallopian tube may be involved in ectopic pregnancy.     

The Regulation of Nitric Oxide Synthase Isoform Expression in Mouse and Human Fallopian Tubes: Potential Insights for Ectopic Pregnancy

Nitric oxide (NO) is highly unstable and has a half-life of seconds in buffer solutions. It is synthesized by NO-synthase (NOS), which has been found to exist in the following three isoforms: neuro nitric oxide synthase (nNOS), inducible nitric oxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS). NOS activity is localized in the reproductive tracts of many species, although direct evidence for NOS isoforms in the Fallopian tubes of mice is still lacking. In the present study, we investigated the expression and regulation of NOS isoforms in the mouse and human Fallopian tubes during the estrous and menstrual cycles, respectively. We also measured isoform expression in humans with ectopic pregnancy and in mice treated with lipopolysaccharide (LPS). Our results confirmed the presence of different NOS isoforms in the mouse and human Fallopian tubes during different stages of the estrous and menstrual cycles and showed that iNOS expression increased in the Fallopian tubes of women with ectopic pregnancy and in LPS-treated mice. Elevated iNOS activity might influence ovulation, cilia beats, contractility, and embryo transportation in such a manner as to increase the risk of ectopic pregnancy. This study has provided morphological and molecular evidence that NOS isoforms are present and active in the human and mouse Fallopian tubes and suggests that iNOS might play an important role in both the reproductive cycle and infection-induced ectopic pregnancies.     

妇科腹腔内出血108例分析

目的明确妇科腹腔内出血的临床特征,以提高早期诊断率,减少误诊、误治。方法异位妊娠的有82例,占了75.9%;卵巢巧克力囊肿破裂的有6例,占了5.6%;卵巢黄体破裂的有16例,占到14.8%;不明原因的有1例,占到0.9%;附件扭转卵巢破裂有1例,占到0.9%;还有出血性输卵管炎占到2例,占了1.8%。结论提高妇科腹腔内出血疾病的早期诊断,尤其是异位妊娠和卵巢黄体破裂。     

Prioritization of Susceptibility Genes for Ectopic Pregnancy by Gene Network Analysis

Ectopic pregnancy is a very dangerous complication of pregnancy, affecting 1%–2% of all reported pregnancies. Due to ethical constraints on human biopsies and the lack of suitable animal models, there has been little success in identifying functionally important genes in the pathogenesis of ectopic pregnancy. In the present study, we developed a random walk–based computational method named TM-rank to prioritize ectopic pregnancy–related genes based on text mining data and gene network information. Using a defined threshold value, we identified five top-ranked genes: VEGFA (vascular endothelial growth factor A), IL8 (interleukin 8), IL6 (interleukin 6), ESR1 (estrogen receptor 1) and EGFR (epidermal growth factor receptor). These genes are promising candidate genes that can serve as useful diagnostic biomarkers and therapeutic targets. Our approach represents a novel strategy for prioritizing disease susceptibility genes.