介入再通术联合药物、臭氧灌注治疗输卵管性不孕症

摘要】 目的 探讨输卵管介入再通术联合药物、臭氧灌注治疗输卵管性不孕症的应用价值。方法 回顾整理经子宫输卵管造影诊断的369例共665条输卵管近段阻塞或通而不畅患者资料,将导管置于患侧子宫角部输卵管开口,使用导丝成功再通后跟进导管至输卵管近端,先后经导管注入复方疏通液（庆大霉素8万u、地塞米松5 mg、糜蛋白酶4 000 u和甲硝唑200 mg溶入生理盐水10 ml）及臭氧;造影观察术后开通情况,统计开通率,随访8个月内受孕情况并作数据处理。结果 665条近段阻塞或通而不畅输卵管综合治疗后559条（84.1%）基本通畅,完全阻塞疏通率为81.1%（43/53）。随访8个月:256例患者得以宫内妊娠,其中术后4个月受孕172例,5 ～ 6个月受孕39例,7 ～ 8个月受孕13例;随访者中输卵管妊娠12例。结论 输卵管介入再通术联合药物、臭氧灌注治疗输卵管近段阻塞或通而不畅性不孕症疗效确切,值得临床推广应用。

     

输卵管阻塞的介入治疗进展

子宫输卵管造影（HSG）和选择性输卵管造影（SSG）对输卵管阻塞有较可靠的诊断价值；SSG和经子宫颈输卵管再通术（T-FTR）有较可靠的近、远期疗效和较低的不良反应率。输卵管再通率、妊娠率等结合输卵管灌注压的测定及超声技术，可较客观全面地评价输卵管阻塞的疗效及安全性。今后研究当发展非放射技术、提高诊断准确性，提高妊娠率，减少不良反应，开展随机对照试验，统一评价标准。     

自制同轴导管引导下选择性输卵管造影及再通术的临床应用

目的探讨自制同轴导管引导下选择性输卵管造影及再通术的临床应用价值.方法 116例输卵管梗阻患者,用自制同轴导管行选择性输卵管造影,若输卵管近端仍完全梗阻.则行输卵管再通术.结果随访116例,有55例宫内妊娠和6例宫外孕,宫内妊娠率为47.4%,116例中有28例再次做HSG,25例有好转,有效率为89.3%.结论用自制同轴导管施行选择性输卵管造影及再通术对诊治输卵管梗阻是安全而有效的.     

导管顶端封堵健侧宫角液体加压法联合导丝再通术在单侧输卵管阻塞中的应用

【摘要】 目的 探讨双腔球囊导管顶端封堵健侧宫角液体加压再通法联合导丝再通术在单侧输卵管梗阻中的应用。方法 对不孕症患者行子宫输卵管造影（HSG）,筛选出单侧输卵管梗阻者50例,尝试用导管顶端封堵健侧宫角液体加压法再通输卵管,观察再通与子宫形态间的关系,此法不能再通的患者进一步应用导丝再通术并观察再通率。结果 50例患者中,33例宫角至宫颈内口的距离小于导管进入子宫内的长度,且宫角的宽度小于导管的直径,导管顶端封堵宫角严密,19例输卵管再通,14例因梗阻严重未能再通。17例宫角至宫颈内口的距离大于导管进入子宫内的长度,且宮角的宽度大于导管的直径,导管顶端不能封堵宫角再通失败。未疏通的31例患者联合导丝再通术后22例输卵管复通。结论 导管顶端封堵健侧宮角液体加压法能使部分输卵管再通,其与子宫形态关系密切,联合导丝再通术能明显提高单侧输卵管梗阻的再通率。
     

用自制器械行选择性输卵管造影和再通术

报告用自制器械行子宫输卵管选择性造影及再通术45例,插管成功率95.5%。近端输卵管阻塞再通率80%。随访结果:15例患者正常受孕,受孕率33.3%,其中继发不孕症受孕率50%,原发不孕症受孕率17.4%。近端阻塞再通术后受孕率54.5%,远端积水或阻塞患者受孕率15%。显示选择性输卵管造影及再通术是治疗女性不孕症的有效方法;本手术最佳适应证为继发不孕、近端输卵管阻塞患者;自制器械价廉、安全。     

选择性输卵管造影及输卵管阻塞的介入治疗

目的为明确输卵管阻塞部位,提供一种安全、可靠、成功率高的诊断和治疗方法.方法 对50例23～38岁女性不孕症患者,确诊为两侧或单侧输卵管狭窄、粘连或闭塞,采用同轴导管系统,利用微导丝的机械作用和再通液的消炎、抗粘连等作用,疏通和治疗输卵管狭窄、阻塞或粘连病变.术后抗炎及定期输卵管通液治疗.结果插管成功率为92%,再通成功率为86.7%,无严重并发症.术后1年随访怀孕23例,达46%.结论选择性输卵管造影及再通术是诊治输卵管性不孕的一种微创有效的介入治疗技术.     

输卵管积水不同处理方式对体外受精-胚胎移植结局的影响

【摘要】 目的 探讨输卵管积水不同的处理方式对体外受精-胚胎移植（IVF- ET）结局的影响。方法对2013年8月至2017年6月因输卵管积水性不孕于2院辅助生殖中心行IVF- ET 260例临床资料进行回顾性分析。按移植前输卵管积水的处理方式分为3组。栓塞组:行介入性输卵管栓塞术（85例）；手术组:行输卵管积水腹腔镜造口术或切除术（90例）；对照组:移植前未对输卵管积水做任何处理（85例），比较3组患者控制性超排卵（COH）指标及IVF- ET的相关指标，分析输卵管积水不同处理方式对IVF- ET的影响。结果 栓塞组85例患者中，单侧输卵管积水46例，双侧输卵管积水39例，共124条输卵管，栓塞成功124条，总成功率100%。显著有效112条（90.3%）；3组患者受精率比较无明显差异（P>0.05），栓塞组和手术组临床妊娠率较对照组明显提高（P<0.05），流产率及异位妊娠率较对照组明显降低（P<0.05）。结论 输卵管积水患者行IVF- ET前，栓塞组和手术组处理方法均可以提高IVF- ET临床妊娠率，降低流产及异位妊娠发生率。但介入性输卵管栓塞术更简便、安全、有效，且不影响卵巢的功能，值得临床首选推广应用。
     

输卵管介入再通术后受孕时机的研究

【摘要】 目的 探讨输卵管介入再通术后最佳受孕时机。方法 选择山东淄博市妇婴保健院收治输卵管不通的不孕患者６３５例９５０条输卵管行介入再通，对术后不同受孕时机进行比较。结果 成功介入再通后受孕率１　～　４个月组与５　～　８个月组、９　～　１２个月组有明显差异（χ２　＝　８２．６２９， Ｐ　＜　０．０５、 χ２　＝　１７０．０８， Ｐ　＜　０．０５），以后逐渐递减，５　～　８个月组与９　～　１２个月组则无明显差异（χ２ ＝ ２４．２９７， Ｐ﹥０．０５）。前６个月受孕率明显高于后６个月（χ２ ＝ １５４．５１， Ｐ﹤０．０５）。前４个月输卵管妊娠率较高，以后逐渐递减，半年后明显降低。结论 成功介入再通后４个月内为最佳受孕时机，我们主张前半年积极采取受孕措施创造受孕机会。
     

选择性输卵管造影及再通术在不孕症中的应用价值

目的评价选择性输卵管造影（ＳＳＧ）及再通术（ＦＴＲ）在输卵管不孕症中的疗效。方法经子宫输卵管造影证实４５９例患者共８９５条输卵管近端阻塞或通畅度不佳,将导管置于输卵管口,使用导丝疏通后造影,对比分析其手术前后输卵管通畅程度并随访１８个月内妊娠率。结果８９５条近端阻塞或不通畅输卵管疏通后５７２条（６３．９％）基本通畅。完全性阻塞输卵管ＳＳＧ及ＦＴＲ术后疏通率为８０．３％（５３／６６）;不完全性阻塞患者疏通率为９６．７％（８０２／８２９）。随访１８个月,２１２例患者中妊娠９３例（４３．９％）,异位妊娠２例（２．１％）。中位妊娠期为８．２个月。双侧输卵管基本通畅者妊娠率为５１．３％（５８／１１３）,双侧输卵管不完全通畅者妊娠率为３５．４％（３５／９９）。结论ＳＳＧ及ＦＴＲ安全有效,是治疗因输卵管近端阻塞或不通畅导致不孕的有效方法。     

非急性期颅内椎-基底动脉闭塞支架再通术围手术期并发症分析

【摘要】 目的 分析非急性期颅内椎-基底动脉闭塞腔内支架再通术围手术期并发症的发生情况及预防策略。方法 2010年2月至2011年12月收治21例非急性期椎-基底动脉闭塞患者，行腔内支架再通治疗。其中12例为单纯椎动脉闭塞（闭塞未累及基底动脉），9例为基底动脉闭塞（闭塞累及基底动脉）。记录和分析围手术期并发症。结果 21例患者中，20例（95.2%）成功开通， 发生围手术期并发症3例，发生率14.3%:1例术中导丝通过时出现动脉夹层，手术终止，未成功再通；1例再通术后急性闭塞，尽管成功再通，但病情无缓解，术后3个月死于系统性并发症；1例术中急性血栓形成，及时球囊扩张再通，无新发症状。围手术期并发症3例中，椎动脉组1例（1/12，8.3%），基底动脉组2例（2/9），两组间差异无统计学意义（P = 0.553）。结论 腔内支架再通术治疗非急性期颅内椎-基底动脉闭塞病变技术上可行，但较高的围手术并发症发生率及复杂的手术操作应引起足够重视。     

管束排列方式及管间距对水平管外液体成膜情况的影响分析

针对水平管降膜蒸发器管外液体的成膜情况,采用数值模拟方法,分析了管束排列方式及管间距等结构参数对水平管外液体成膜情况的影响.结果表明:管束布置方式、管间距对顶排管的影响不大,对于顶排管以下的管排来说,叉排方式时的液膜厚度要明显小于顺排方式的液膜厚度;随着管间距的增大,第二根管壁上的液膜厚度逐渐减小.     

带排挤管的真空管太阳能热水器实验研究

用排挤管装入真空管的内管内 ,使真空管内的储水大大地减少 ,减少了能量损失 (实际是提高了水箱内的水温 ) ,经多次实验和计算证明 ,改装后的真空管太阳能热水器的热效率有较大提高 ,经济效益明显     

Comparison of heat transfer conditions in tube bundle cross-flow for different tube shapes

Detailed transient numerical simulations of fluid and heat flow were performed for a number of heat exchanger segments with cylindrical, ellipsoidal and wing-shaped tubes in a staggered arrangement. The purpose of the analysis was to get an insight of local heat transfer and fluid flow conditions in a heat exchanger and to establish widely applicable drag coefficient and Stanton number correlations for the heat exchanger integral model, based on average flow variables. The simulation results revealed much more complex flow behavior than reported in current literature. For each of the almost 100 analyzed cases, the time distributions of the Reynolds number, the drag coefficient and the Stanton number were recorded, and their average values calculated. Based on these average values, the drag coefficient and the Stanton number correlations were constructed as polynomial functions of the Reynolds number and the hydraulic diameter. The comparison of the collected results also allows more general conclusions on efficiency and stability of the heat transfer process in tube bundles.     

Parametric studies of tube in tube heat exchanger coupled to a panel of collectors

This paper deals with the transient analysis of a one pass, tube in tube heat exchanger coupled to a panel of flat plate collectors under both cocurrent and counter-current modes of flow. Explicit expressions for the temperatures of the cold and hot fluid streams have been developed as a function of the time and space coordinates for both modes of flow. To make a quantitative assessment of the analytical results, numerical calculations have been carried out for a typical winter day, i.e., 13 February 1985 at Delhi. The effects of several parameters, viz. length of the heat exchanger, mass flow rate, radii of heat exchanger tube, etc., have been studied in detail.     

Shock tube pyrolysis of thiophene

The kinetics of the thermal decomposition of thiophene diluted in argon have been studied behind reflected shock waves in a single pulse shock tube over the temperature range 1598–2022 K and pressures between 2.5 and 3.44 bar. Product yields and composition were determined using capillary column gas chromatography with flame ionization detection and flame photometric sulphur selective detection. The principal hydrocarbon product at all temperatures was ethyne. Ethanethiol was found to be the major sulphur product together with H₂S formed in significant concentrations at lower temperatures. Carbon disulphide was also formed at higher temperatures. Additional reaction products were CH₄, C₂H₄, C₃H₄, C₄H₃, C₄H₆, C₄H₄, C6H6 and C₄H₂ with some traces were found of C₅ and C₆H₅ species. It was concluded that pyrolysis of thiophene is initiated by C–S bond fission to form the C₄H₄S radical which reacts to give C₄H₃ + SH together with the reaction giving C₃H₄ + CS. The rate expression obtained for the pyrolysis reaction was k _(C4H4S)=2.2×1011 exp (270 kJ mol⁻¹) s⁻¹. Copyright © 2002 John Wiley & Sons, Ltd.     

Theoretical and experimental investigation of the filled-type evacuated tube solar collector with U tube

The filled-type evacuated tube with U-tube, in which the filled layer is used to transfer energy absorbed by the working fluid flowing in the U-tube, is proposed to eliminate the influence of thermal resistance between the absorber tube and the copper fin of the conventional evacuated solar collector. In this paper, the thermal performance of the filled-type evacuated tube with U-tube was researched by means of theoretical analysis and experimental study. The temperature of the working fluid in the flow direction was obtained, and the efficiency of the evacuated tube was also calculated, based on the energy balance equations for the working fluid in the U-tube. The effects of the heat loss coefficient and the thermal conductivity of the filled layer on the thermal performance of the evacuated tube were studied. In addition, the test setup of the thermal performance of the filled-type evacuated tube with U-tube was established. The evacuated tube considered in this study was a two-layered glass evacuated tube, and the absorber film was deposited in the outer surface of the absorber tube. The results show that the filled-type evacuated tube with U-tube has a favourable thermal performance. When the thermal conductivity of the heat transmission component is λ_c = 100, the efficiency of the filled-type evacuated tube with U-tube is 12% higher than that of the U-tube evacuated tube with a copper fin. The modelling predictions were validated using experimental data which show that there is a good concurrence between the measured and predicted results.     

陶瓷管式锻造加热炉

本文综述了两种型式管式加热炉的优缺点,并运用(火用)分析方法分析了管式炉结构设计与提高能质的关系,以及扩大管式炉应用需进一步解决的四个主要问题。     

Thermal performances comparisons of the glass evacuated tube solar collectors with shapes of absorber tube

The thermal performance of a glass evacuated tube solar collector is numerically and experimentally investigated. The solar collector considered in this paper consists of a two-layered glass tube and an absorber tube. Air is used as the working fluid. The length and diameter of this glass tube are 1200 and 37 mm, respectively. Four different shapes of absorber tubes are considered, and the performances of the solar collectors are studied to find the best shape of the absorber tube for the solar collector. Beam irradiation, diffuse irradiation, and shade due to adjacent tubes are taken into account for a collector model to obtain a realistic estimation. In addition, a single collector tube with only beam irradiation is studied as a simplified model, and the results of the simplified model are compared to those of the collector model to identify the difference between these two models. The performance of a solar collector is affected by the shape of the absorber, incidence angle of solar irradiation, and arrangement of collector tubes. The results obtained from the simplified model are very different from those from the collector model, which considered not only beam and diffuse irradiation but also shade due to adjacent tubes.     

Vortex tube optimization theory

The Ranque–Hilsch vortex tube splits a single high pressure stream of gas into cold and warm streams. Simple models for the vortex tube combined with regenerative precooling are given from which an optimization can be undertaken. Two such optimizations are needed: the first shows that at any given cut or fraction of the cold stream, the best refrigerative load, allowing for the temperature lift, is nearly half the maximum loading that would result in no lift. The second optimization shows that the optimum cut is an equal division of the vortex streams between hot and cold. Bounds are obtainable within this theory for the performance of the system for a given gas and pressure ratio.     

Review of analysis of tube sheets

Various design methods have been proposed by a number of researchers for analyzing stresses and deflections in multiperforated plates, popularly known as tube sheets. The purpose of this paper is to show the different techniques developed by various researchers in the analysis of tube sheets. A thorough literature review is undertaken and the different techniques such as analytical, experimental and numerical are dealt with separately. Finally the results obtained by various research workers are compared and the authors' work is also mentioned. The future scope in this field as proposed by the authors is also discussed.