目的:把布托啡诺与曲马多联合用于分娩镇痛,观察其效果、副作用及安全性。方法:足月初产妇共40例,随机分为两组。在宫口开大3~4 cm时于腰2~3硬膜外穿刺置管,1%利多卡因4 mL做试探剂量,待出现麻醉平面后,布托啡诺组产妇在硬膜外接受布托啡诺1 mg(2 mL)+0.05%曲马多与0.15%罗哌卡因混合液8 mL;曲马多组接受曲马多100 mg(2 mL)+0.05%曲马多与0.15%罗哌卡因混合液8 mL。记录用药前、用药后5、10、30 min宫缩时疼痛VAS评分、镇静Ramesay评分,新生儿Apgar评分,观察副作用发生率。结果:布托啡诺组在给药后5、10、30 min VAS评分都明显低于曲马多组(P<0.05);镇静Ramesay评分在给药10 min时布托啡诺组明显大于曲马多组(P<0.05);恶心、呕吐发生率曲马多组明显大于布托啡诺组。结论:硬膜外1 mg布托啡诺与曲马多、罗哌卡因混合液用于分娩镇痛效果好,对新生儿安全,减少副作用的发生。
摘要:目的:探讨滋养叶细胞肿瘤的临床特征、治疗、预后。方法:回顾性分析我院1997年1月至2008年12月诊治的28例良、恶性滋养叶细胞肿瘤患者的临床资料。结果:28例中,侵蚀性葡萄胎1例,经化疗后已随访3年无复发征象;2例因“肺部转移”和“持续性葡萄胎”回内地治疗;5例尚在随访中,其余经随访已达临床治愈。结论:妊娠滋养叶细胞肿瘤患病率高;良性葡萄胎预后好,但应警惕其潜在恶变性,应早期发现,早期治疗,以减少其恶变带来的危害;恶性滋养叶细胞肿瘤经积极化学治疗后可达到根治。Abstract: Objective: To explore the clinical feature,treatment and prognosis of gestational trophoblastic tumor. Methods: Retrospectively analyzed the clinical pathological materials of 11 patients with carcinoid and malingnant gestational trophoblastic tumor treated from January.1997 from December 2008 in our hospital. Results: In the 28 cases,1 case of erosive hydatidiform mole did not relapse after the chemical treatment of 3 years’ survey; 2 cases went back to the inland due to “lung transference and continuous hydatidiform mole”; 5 cases was still in the followup survey; the last had been cured after followup survey. Conclusion: Gestational trophoblastic tumor have a higher rate or happening; The carcinoid tumor has a better prognosis, yet people should guard its initial bad change; malignant gestational trophoblastic tumor can be cured after the positive chemical treatment.
Gynecology and obstetrics teaching has strong practicality. Because of the lack of practice on patients who has strong self-protection consciousness and the likely injury due to invasive operation, students and young doctors can’t have many opportunities to make actual clinical operation which limits their abilities of clinical skills. Based on this, the virtual reality medical education in the teaching of obstetrics and gynecology develops fast these days because of its necessity, ethicality, and economical effect, which might be popularized. It plays a very important role in cultivating young doctors’ manipulative ability, training "three basics and three strictness", mastering abstract knowledge, and quantitative assessing effect of clinical teaching.