小柴胡汤是《伤寒杂病论》中的一首经典方剂，是和解法的基础方，后世将其广泛用于治疗妇科疾病。本研究旨在通过文献检索，探讨小柴胡汤在治疗妇科疾病方面的有效性及其应用的最新进展。文章综述了小柴胡汤在治疗妇科痛证、血证、带下证、块证等相关疾病方面的临床研究和实践经验。小柴胡汤通过其疏肝利胆、健运脾胃、和解枢机的作用，有效改善了女性痛经、盆腔炎性疾病、月经不调、妇科肿瘤、围绝经期综合征等妇科疾病症状。作为临床常用的妇科学方剂，小柴胡汤亟需进一步的发扬与创新，以期更有效地应用于未来的临床实践。
Xiaochaihu Decoction，as a classic prescription in the Treatise on Cold Pathogenic and Miscellaneous Diseases，laid the foundation for reconciliation．It has a wide range of applications in the treatment of gynecological diseases．Through a literature search，this study aimed to explore the effectiveness of Xiaochaihu Decoction in the treatment of gynecological diseases and the latest progress of its application．This article reviews the clinical research and practical experience of Xiaochaihu Decoction in the treatment of gynecological pain，bleeding，leucorrhea disease，tumors and other related diseases．Xiaochaihu Decoction has effectively improved the symptoms of gynecological diseases such as dysmenorrhea，pelvic inflammatory disease，menstrual irregularities，gynecological tumors，and perimenopausal syndrome through its role of soothing the liver and promoting bile flow，strengthening the spleen and stomach，and harmonizing and releasing the pivot．As a commonly used gynecological prescription in clinical practice，Xiaochaihu Decoction urgently needs to be further developed and innovated to be more effectively applied to clinical practice in the future．
探讨改良拔尿管方法在妇科腹腔镜术后留置尿管患者临床的影响。方法 选取2025年2月7日—2025年10 月10日我院妇科腹腔镜手术术后留置尿管患者60例为研究对象。本研究采用随机数字表法将研究对象分为对照组与观察组，两组各纳入30例。比较两组首次拔管尿路疼痛评价、首次排尿时间、患者尿潴留例数。结果 观察组首次拔尿管尿路疼痛程度显著低于对照组，两组差异有统计学意义（P<0.05）。观察组首次排尿时间显著少于对照组，两组差异有统计学意义（P<0.05）。观察两组尿潴留发生率差异无统计学意义（P>0.05）。结论 本次研究采用改良后的尿管拔除方法，虽未明显降低妇科腹腔镜术后患者的尿潴留发生率，但能有效降低拔尿管时患者的不适感 ，减少尿道损伤，缓解疼痛，加快患者自主排尿，具有积极临床实践意义。
探讨改良拔尿管方法在妇科腹腔镜术后留置尿管患者临床的影响。方法 选取2025年2月7日—2025年10 月10日我院妇科腹腔镜手术术后留置尿管患者60例为研究对象。本研究采用随机数字表法将研究对象分为对照组与观察组，两组各纳入30例。比较两组首次拔管尿路疼痛评价、首次排尿时间、患者尿潴留例数。结果 观察组首次拔尿管尿路疼痛程度显著低于对照组，两组差异有统计学意义（P<0.05）。观察组首次排尿时间显著少于对照组，两组差异有统计学意义（P<0.05）。观察两组尿潴留发生率差异无统计学意义（P>0.05）。结论 本次研究采用改良后的尿管拔除方法，虽未明显降低妇科腹腔镜术后患者的尿潴留发生率，但能有效降低拔尿管时患者的不适感 ，减少尿道损伤，缓解疼痛，加快患者自主排尿，具有积极临床实践意义
目的 探讨妇科肿瘤围手术期发生静脉血栓栓塞症（VTE）的高危因素及预防措施。方法 回顾性分析2018年1月—2021年5月于中山市人民医院妇科收治的围手术期VTE患者38例（9例术前发生血栓、29例术后发生血栓）的临床特征、诊疗过程,并根据高危因素提出针对性的预防措施。结果 9例术前血栓的患者,其中恶性肿瘤、血浆D-二聚体阳性（>500 mg/L）与对照组比较差异有统计学意义（P<0.05）,而年龄、BMI、合并内科疾病与对照组比较,差异无统计学意义（P>0.05）;29例术后血栓的患者,BMI>25 kg/m2、恶性肿瘤、合并内科疾病、手术时间大于3小时、术后使用止血药物与对照组比较差异有统计学意义（P<0.05）;而年龄与手术方式与对照组比较差异无统计学意义（P>0.05）。结论 恶性肿瘤、血浆-D二聚体阳性、手术时间大于3小时、术后使用止血药物均为妇科围手术期血栓发生的高危因素,针对上述高危因素积极预防可显著降低VTE的发生。
Objective To study the high-risk factors and preventive measures of venous thromboembolism in gynecological periopreative surgery．Methods The clinical characteristics and the diagnosis and treatment of thirty-eight cases with perioperative deep venous thrombosis（nine cases with preoperative deep venous thrombosis and twenty-nine cases with postoperative deep venous thrombosis）in the department of gynecology of Zhongshan People's Hospital were analyzed retrospectively．Targeted preventive measures were put forward according to high risk factors．Results Compared with the control group,there were significance differences in malignant tumor,positive D-dimer（>500 mg/L）in nine cases with preoperative thrombosis（P<0.05）,but no significance differences in age,body mass index（BMI）,complicated with internal diseases（P>0.05）．BMI>25,malignant tumor,complicated with internal diseases,operation time more than 3 hours,postoperative usage of hemostatics in twenty-nine cases with postoperative deep venous thrombosis had statistical significance compared with the control group（P<0.05）．But age and surgery method had no statistical significance（P>0.05）between the two groups．Conclusions Malignant tumor,positive D-dimer（>500 mg/L）,operation time more than 3 hours,postoperative usage of hemostatics were the high-risk factors in gynecological periopreative surgery,active prevention against these high-risk factors can significantly reduce the incidence of venous thromboembolism.
目的 探讨观察静吸复合麻醉与全凭静脉麻醉对中老年妇科腹腔镜手术的作用。方法 以2016年8月—2018年8月为时间段,选择我院收治的86例中老年妇科腹腔镜手术患者,将其随机分成对照组、实验组,各组43例患者。对照组采取静吸复合麻醉方式,实验组采取全凭静脉麻醉方式。对比观察两组患者的麻醉效果,比较手术中的血流动力学指标,另外统计不良反应及术后认知功能障碍。结果 实验组麻醉起效时间、睁眼时间及拔管时间比对照组短,不良反应发生率及认知功能障碍发生率低于对照组,二组比较差异有统计学意义(P<0.05);手术中心率、氧饱和度、收缩压与舒张压比较,组间差异无统计学意义(P>0.05)。结论 和静吸复合麻醉比较,全凭静脉麻醉在中老年妇科腹腔镜手术中的应用价值更高,建议推广。
目的 探讨中医妇科门诊患者的焦虑及抑郁的发生情况,优化诊治工作,更好地服务患者。方法 采用焦虑自评量表(SAS)和 抑郁自评量表(SDS)评定190名中医妇科门诊患者的心理状态。结果 中医妇科患者焦虑均分高于正常常模组(P＜0.05),抑郁评分与全国常模相比则无统计学差异(P＞0.05),有焦虑及抑郁症状的患者分别为6.3%及10%。结论 中医妇科门诊患者的焦虑症状较正常人群高,医生在临床诊治过程应重视对患者心理状态的评价,并进行相应的心理干预及人文关怀, 以提高患者对治疗的依从性和满意度,为其身体及心理健康打下良好基础。
Objective To explore the occurrences of anxiety and depression in female TCM gynecology outpatients, and thus to make improvements in diagnosis, treatment, and service for the patients. Methods We adopted Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) to evaluate the mental status of 190 TCM gynecology outpatients. Results Anxiety scores in TCM gynecology group were higher than those in the normal group (P＜0.05), while there was no statistical difference in depression scores between these two groups (P＞0.05). Among the outpatients, 6.3% had symptoms of anxiety, and 10% had symptoms of depression. Conclusion TCM gynecology outpatients show more anxiety symptoms than normal people. We should pay attention to the assessment of those patients' mental status in the process of diagnosis and treatment, and offer psychological intervention and humane care to those patients accordingly. In this way, we could enhance patients' compliance and satisfaction, and help them build a solid foundation in physical health as well as in mental health.
目的 探讨妇科门诊宫颈癌高危人群采取阴道镜检查后配合宫颈细胞学检查对宫颈癌筛查价值。方法 选取2016年2月—2017年4月我院妇科门诊就诊合并宫颈癌高危患者387例为研究对象,所有患者均行阴道镜检查和宫颈细胞学检查,以最终病理检查为诊断“金标准”,探究阴道镜、宫颈细胞学检查在宫颈癌中筛查灵敏度、特异度及阳性符合率。结果 387例纳入研究宫颈癌高危患者,经病理诊断后明确诊断为宫颈癌51例,占13.18%。细胞学检查在宫颈癌中筛查灵敏度为72.55%,特异度为90.48%,阳性符合率为88.11%。阴道镜检查在宫颈癌中筛查灵敏度为50.98%,特异度为94.64%,阳性符合率为88.89%。宫颈癌筛查中,细胞学检查灵敏度高于阴道镜检查,特异度低于阴道镜检查(P＜0.05),两者检查阳性符合率比较差异无统计学意义(P＞0.05)。结论 妇科门诊宫颈癌高危患者宫颈筛查中,阴道镜筛查具有较高特异度,细胞学检查具有较高灵敏度,联合检查能提高筛查价值。
目的 观察喉罩通气下全凭七氟醚吸入麻醉在妇科宫腔镜手术中的应用价值。方法 60例拟行妇科宫腔镜手术的患者随机分为七氟醚和丙泊酚组,每组30例,记录不同时间点两组患者的平均动脉压(MAP),脉搏血氧饱和度(SpO2)、苏醒时间以及术后恶心,呕吐、躁动的发生率。结果 A组患者血流动力学指标波动较少,苏醒时间A组明显短于B组,差异有显著性(P<0.05)。两组患者诱导后MAP,HR均较诱导前显著下降(P<0.05)。B组患者术中MAP,HR值显著低于A组(P<0.05),拔除喉罩即刻两组MAP,HR差异无显著性(P>0.05)。结论 喉罩下全凭七氟醚吸入麻醉对患者的血流动力学的影响较小,适用于妇科宫腔镜手术。
Objective To observe the effect of laryngeal mask airway(LMA) combined with sevoflurane inhalation anaesthesia in gynecological hysteroscopy operation. Methods Sixty patients, classified from ASAⅠtoⅡscheduled for hysteroscopic operation were randomly divided into sevoflurane inhalation anesthesia group (group A) and propofol intravenous anesthesia group(group B).The mean arterial pressure (MAP), pulse oxygen saturation (SpO2), recovery time and the incidence of nausea, vomiting and recovery time were recorded at different time points of the two groups. Results The hemodynamic index of the patient in the group A fluctuated seldom,and the recovery time was significantly shorter than that in the B group, and the differences were significant (P<0.05).The MAP and the HR were all decreased after anesthesia induction compared with those of before in both groups (P<0.05).The MAP and the HR in the group B was significantly lower than that in the group A (P<0.05), there were no significant differences in MAP and HR between the two groups of patients with laryngeal mask airway removal. Conclusion Small hemodynamic influence is taken with the technique of laryngeal mask airway(LMA) combined with sevoflurane inhalation anesthesia. It is suitable for gynecological hysteroscopic operation.
目的 探讨运用目标管理法优化妇科病人的临床护理路径的应用效果。方法 采用历史对照研究,以腹腔镜子宫切除术病人作为研究对象,将2014年1月—2014年12月采用临床护理路径的98例病人作为对照组;2015年1月—2015年12月运用目标管理法优化临床护理路径的105例病人作为研究组,比较两组护理缺陷发生情况、病人满意度、住院时间和住院费用。结果 研究组健康知识知晓水平高于对照组,术后首次功能锻炼时间短于对照组(P＜0.05)。研究组护理缺陷发生率为3.81%,对照组发生率为14.29%(P＜0.05)。研究组对健康教育和基础护理满意度高于对照组(P＜0.05)。结论 目标管理法优化的临床护理路径可使各项操作更加规范细化,提高工作质量,减少护理缺陷,护理质量有一定程度的提高,同时对病人满意度的提高有积极的促进作用。
目的 对社区妇科慢性盆腔炎患者对疾病相关知识的认知情况进行调查,探讨健康宣教对策,提高慢性盆腔炎患者的自我保健意识。方法 对我中心2015年5月—2016年5月收治的100例社区慢性盆腔炎患者采用自制调查表进行盆腔炎疾病相关知识认知情况调查,按照合格与否将患者分为合格组和不合格组,对两组的措施患者的一般资料进行分析,总结影响慢性盆腔炎患者疾病认知的因素,探讨慢性盆腔炎患者健康宣教。结果 100例患者中对疾病认知合格者45例,不合格者55例,合格与不合格患者间在年龄、文化程度、居住地、家庭经济状况方面比较差异有统计学意义,说明这些因素是影响患者对疾病认知水平的相关因素(P＜0.05)。疾病认知相关知识项目中,疾病的定义、高危因素、疾病危害认知不合格率明显高于其它相关知识的不合格率,比较差异有统计学意义(P＜0.05)。结论 慢性盆腔炎临床常见,对患者的远期危害大,针对性健康宣教提高患者对疾病的防范意识,提高患者的自我保健意识,降低疾病对患者健康的不良影响。
