目的 分析妊娠期慢性乙型肝炎病毒携带者病毒载量与孕妇肝功能、妊娠并发症的相关性。方法 将本院2015年1月—12月间在本院住院并于本院分娩的携带慢性乙型肝炎病毒(HBV)的86例孕妇作为本次研究对象,于住院期间分娩前测定孕妇HBV脱氧核糖核酸(HBV-DNA)定量,依据HBV-DNA定量测定结果将全部患者分为阴性组与阳性组,分别对比2组患者的临床资料、肝功能、妊娠并发症发生率及母婴结局;分析HBV-DNA载量与孕妇妊娠期肝功能及妊娠并发症的相关性。结果 2组孕妇的年龄、BMI、孕次与产次均无差异,P>0.05;阴性组患者妊娠期肝功能指标优于阳性组,P<0.01。阴性组中羊水量异常(偏多或偏少)发生率高于阳性组,P<0.05;其他妊娠期并发症发生率2组均未见差异,P>0.05。2组母婴结局均未见统计学差异,P>0.05。HBV载量与ALT肝功能指标均呈正相关,0<r<1,说明HBV-DNA越高则ALT越高,孕妇的肝功能越差。HBV载量与并发症发生间基本不相关,|r|<0.3,P>0.05。结论 慢性乙型肝炎病毒携带者妊娠期时随着病毒载量的升高,孕妇的肝功能有所下降仍可维持在正常标准,但与妊娠并发症的发生无相关性;提示对HBV-DNA阳性的孕妇给予密切监护,通过临床常规对症治疗能够保证母婴安全。

Objective To analyze the correlation between viral load of chronic hepatitis B virus infection and liver function and pregnancy complications. Methods We selected 86 cases of pregnant women with chronic hepatitis B virus(HBV)in our hospital from January 2015 to December 2015 as the research objects, and then during the hospitalization to test the quality of the HBV deoxyribonucleic acid (HBV-DNA)for them before delivery. According to the HBV-DNA quantitative results, all patients were divided into low dosage group and high dosage group, and then the clinical data, liver function, the incidence rate of pregnancy complications and the outcomes of the two groups were compared; at last we analyzed the correlation among the HBV-DNA load, liver function of pregnant women during pregnancy and pregnancy complications. Results There was no difference between the two groups of pregnant women in the age, BMI, pregnancy and birth time, P>0.05; the low dose group was better than the high dose group in the liver function index during the pregnancy, P<0.01. The incidence of abnormal amniotic fluid volume (more or less) in the low dose group was higher than that in the high dose group, P<0.05; there was no significant difference between the two groups in the incidence of other complications, P>0.05. There was no statistical difference between the two groups in maternal and neonatal outcomes, P>0.05. The HBV load was positively correlated with the two liver function indexes ALT, 0<r<1, indicating that the higher the HBV-DNA, the higher theALT, the worse the liver function of the pregnant women. There was no correlation between HBV load and complications, |r|<0.3, P>0.05. Conclusion Chronic hepatitis B virus carriers during pregnancy with increasing viral load, liver function of pregnant women declined to maintain in normal level, but not associated with pregnancy complications; that of HBV-DNA positive pregnant women given close monitoring of disease through clinical routine treatment can ensure the safety of mother and child.

目的 分析个体化营养指导对双胎妊娠的结局影响。方法 将2014年2月—2015年12月在新疆喀什疏附县人民医院分娩的80例双胎妊娠,接受过个体化营养指导的42例为治疗组;未能或不自愿接受个体化营养指导的38例为对照组,观察比较对照组和治疗组的妊娠结局。结果 治疗组妊娠期糖尿病(GDM)、贫血、妊娠期高血压疾病、产后出血、新生儿窒息、低出生体重儿发生率小于对照组差异有统计学意义(P<0.05)。结论 利用个体化营养指导双胎妊娠孕妇饮食,可以减少并发症,取得理想的妊娠结局。

目的 探讨经阴道三维彩色能量多普勒成像在诊断子宫瘢痕妊娠(CSP)中的应用价值。方法 回顾性分析245例临床怀疑瘢痕妊娠(CSP)患者的二维彩色超声(2D-CDFI)及经阴道三维彩色能量多普勒成像的表现,与病理结果进行对比,总结分析它们对子宫瘢痕妊娠(CSP)的灵敏度、特异度及阳性检出率。结果 2D-CDFI 诊断CSP的灵敏度、特异度及阳性检出率分别为73.7%、68.75%及74.44%;经阴道三维彩色能量多普勒成像诊断CSP的灵敏度、特异度及阳性检出率分别为87.06%、73.33%及88.10%;两者在诊断CSP的准确率差异有统计学意义(P=0.0026,P<0.05)。结论 经阴道三维彩色能量多普勒成像检查能清晰显示包块与子宫的空间立体结构,也能够多角度多方面显示瘢痕妊娠与子宫肌层间的异常血管,是早期诊断CSP的首选方法之一,具有重要的临床价值。

目的 探讨妊娠期甲亢患者血清甲状腺功能和免疫含量变化及其临床应用价值。方法 分别取妊娠期与非妊娠期甲亢病例各250例,于孕15周、孕25周以及孕35周时测定两组血清甲状腺功能各项指标与免疫含量。结果 与对照组相比,观察组患者整个妊娠期T3、T4水平明显更高(P＜0.05);孕中晚期两组FT3、FT4水平差异并无统计学意义(P＞0.05)。结论 血清T3、T4在妊娠合并甲亢患者整个妊娠过程中呈高水平表达,临床应高度重视TRAb阳性率、FT3、FT4表达水平,以明确诊断。

目的 探究孕妇血清PAPP-A、IR与妊娠期糖尿病的临床相关性。方法 以我院2013年4月—2014年4月期间收治的160例妊娠期糖尿病孕妇作为观察组,以同期收治的妊娠期正常孕妇作为对照组。对比分析两组孕妇血清PAPP-A含量与IR计算值差异。结果 观察组孕妇血清PAPP-A水平低于对照组,而IR计算值明显高于对照组,差异有统计学意义(P<0.05)。结论 孕妇血清PAPP-A与IR水平与妊娠期糖尿病相关性显著,妊娠期糖尿病患者血清PAPP-A明显降低,而IR则明显增加,可为临床诊断提供参考依据。

Objective To explore the clinical relevance of the pregnant women serum PAPP -a, IR and gestational diabetes. Methods The 160 cases of gestational diabetes mellitus were treated in our hospital from April 2013 to April 2014 as the observation group, and the normal pregnant women were treated as the control group. The differences of serum PAPP-A levels and IR values in the two groups were compared and analyzed. Results The serum PAPP-A level of the observation group was significantly lower than that of the control group, while the IR value was significantly higher than that of the control group, the difference was statistically significant (P<0.05). Conclusion The level of serum PAPP-A and IR in pregnant women is significantly related to the gestational diabetes mellitus. The serum PAPP-A of the patients with gestational diabetes is significantly decreased, while the IR is significantly increased, which can provide reference for clinical diagnosis.

目的 对比观察罗哌卡因及布比卡因应用于患有妊娠期高血压的产妇行剖宫产时腰麻联合硬膜外麻醉的临床效果。方法 将103例择期行剖宫产手术的妊娠期高血压患者随机分为罗哌卡因组51例及布比卡因组52例分别采用对应药物进行麻醉,研究两组阻滞效果、心血管系统变化情况及不良反应发生情况。结果 两组间麻醉镇痛效果及优良率比较,差异没有统计学意义(P>0.05)。罗哌卡因组感觉及运动阻滞起效时间较布比卡因组长,运动阻滞恢复时间较布比卡因组短(P<0.05)。心血管系统变化情况比较,麻醉5min、10min时两组收缩压及平均动脉压均降低,但布比卡因组波动更大,两组间比较差异显著(P<0.05),心率及血氧饱和度比较无差异(P>0.05)。罗哌卡因组不良反应出现时间较布比卡因组晚,同时其不良反应发生率较布比卡因组低(χ²=4.1599,P<0.05)。结论 罗哌卡因及布比卡因在阻滞时间上略有差异,麻醉镇痛效果相当,但鉴于妊高症产妇本身心血管系统存在基础问题,运用罗哌卡因对心血管系统的影响较小,安全性更高,更值得推荐使用。

目的 探讨替罗非班辅助低分子肝素治疗急性冠脉综合征合并妊娠糖尿病的临床疗效及安全性。方法 前瞻性选取本院2012年4月—2015年10月收治的80例急性冠脉综合征合并妊娠糖尿病患者,按随机数字表法分为对照组、实验组,每组40例,实验组采用替罗非班辅助低分子肝素治疗,对照组使用单独低分子肝素治疗方案,比较两组治疗后血浆蛋白-A(PAPP-A)以及超敏C反应蛋白(hs-CRP)水平;比较两组内出血情况以及血小板计数的变化。结果 两组治疗后PAPP-A以及hs-CRP水平均有所下降,实验组下降幅度高于对照组,对比差异有统计学意义(P＜0.05);两组内出血发生率分别为10.0%、40.0%,均无严重出血情况发生,实验组轻度出血3例,中度出血1例,对照组轻度出血10例,中度出血6例,实验组轻中度出血率低于对照组(P＜0.05);两组治疗前血小板计数对比差异无统计学意义(P＞0.05),治疗后实验组血小板计数下降明显,对照组血小板计数无明显变化,两组不同时间点血小板计数差异无统计学意义(P＞0.05)。结论 替罗非班辅助低分子肝素治疗急性冠脉综合征合并妊娠糖尿病患者具有一定的效果,且用药安全性较高。

目的 观察采用桂枝茯苓汤联合甲氨蝶呤治疗异位妊娠的效果。方法 纳入90例异位妊娠患者,随机分为3组各30例,A组服用甲氨蝶呤,B组服用桂枝茯苓汤,C组采用桂枝茯苓汤联合甲氨蝶呤治疗,观察3组的治疗效果及附件包块变化情况。结果 3组治愈率整体比较,差异有统计学意义(P<0.05)。C组的治愈率与A组、B组分别比较,差异均有统计学意义(P<0.05)。3组附件包块治疗有效率整体比较,差异有统计学意义(P<0.05)。C组的有效率与A组、B组分别比较,差异均有统计学意义(P<0.05)。结论 桂枝茯苓汤联合甲氨蝶呤治疗异位妊娠,在降低β-HCG、症状改善、缩小包块方面均有较好效果,且副反应少、经济、方便。

目的 分析复方丹参注射液对轻度子痫前期患者肾功能与妊娠结局的影响。方法 对照组:在1000 mL浓度为5%的葡萄糖注射液中加入60 mL浓度为25%的硫酸镁,每天静滴1次,以连续静滴5 d为一个疗程;观察组:在250 ml浓度为5%的葡萄糖注射液中加入20 mL复方丹参注射液行静脉滴注治疗,每天静滴1次,以连续静滴5 d为一个疗程。结果 观察组的总有效率为96.88%,对照组为78.13%,观察组高于对照组,两组存在差异(P<0.05)。结论 为了有效改善轻度子痫前期患者的妊娠结局及预后,建议在临床中推广使用复方丹参注射液。

Objective The Objective of the investigation was to study how compound danshen injection(CDI)affected the kidney function and pregnant outcomes of patients diagnosed as mild preeclampsia. Methods Samples are randomly divided into two groups:observation group,in which patients were treated with magnesium sulfate,and control group,in which patients were treated with Danshen injection. Results In control group the treatment showed valid effect in 78.13% of the patients,and in observation group the ratio was 96.88%, which was remarkably higher. Conclusion To improve the pregnant outcomes and prognosis of mild preeclampsia,compound danshen injection should be recommended during the clinical practice.

目的 探讨糖化血红蛋白(HbA1c)联合超敏C反应蛋白(hs-CRP)在筛查妊娠期糖尿病(GDM)的临床意义。方法 选择2013年9月1日—2014年8月31日在我院妇产科孕期产前检查及分娩的孕妇,根据糖耐量试验(OGTT)、HbA1c和hs-CRP检查,筛查出92例孕妇为GDM组,并随机抽取OGTT正常的健康孕妇90例为NGT组,25例健康孕龄女性为对照组,分析3组FPG、HbA1c、hs-CRP及OGTT结果。结果 GDM组OGTT、HbA1c、hs-CRP高于NGT组和对照组,差异有统计学意义(P<0.01),NGT组与对照组比较,HbA1c、hs-CRP浓度差异无统计学意义(P>0.05),但3组FPG差异无统计学意义(P>0.05),Pearson相关分析显示,HbA1c与hs-CRP呈正相关(r=0.79,P<0.01)。结论 GDM患者HbA1c、hs-CRP水平升高,HbA1c联合hs-CRP可能成为GDM筛查的良好指标。

Objective To evaluate the feasibility of combination of glycosylated hemoglobin A1c(HbA1c) and high-sensitivity CRP in screening of gestational diabetes mellitus(GDM). Methods According to glucose tolerance test(OGTT),HbA1c and hs-CRP during 24~28 pregnant weeks,92 women with GDM (GDM group) and 90 normal pregnant women (NGT group) were enrolled in this study with another 25 women of child-bearing age as the control group. The results of FBG, OGTT, HbA1c and hs-CRP among three groups were analyzed. Results OGTT, HbA1c and hs-CRP level in GDM group were higher than that in NGT group and control group (P<0.05), but there were no significant differences of the level of FPG of 3 groups(P>0.05).Compare with NGT group and control group, There were no significant differences of the level of HbA1c and hs-CRP(P>0.05). Pearson correlation analysis showed that HbA1c had significant association with hs-CRP(r=0.79, P<0.01). Conclusion HbA1c and hs-CRP level in GDM group were increased, HbA1c combined with hs-CRP could be of some value in screening of GDM.