ObjectiveTo explore the clinical characteristics of different types of prolactinoma and the therapeutic effect of bromocriptine.MethodsThe medical records of patients with prolactinoma treated by bromocriptine from January 2010 to December 2016 were retrospectively analyzed, and the patients were followed up.ResultsA total of 106 cases of prolactinoma were included, in whom 67 were microprolactinomas, 31 were macroprolactinomas, and 8 were giant prolactinoma. There were differences in the distributions of gender and age, prolactin level, clinical manifestations and the effective dose of bromocriptine among the three groups (P<0.05). After the treatment of bromocriptine, the level of serum prolactin was restored to normal in 61 cases in microprolactinoma group, 26 cases in macroprolactinoma group and 6 cases in giant prolactioma group. For improvement of the main symptoms, there were 63 patients in microprolactinoma group, 27 in macroprolactinoma group and 6 in giant prolactioma group. Furthermore, the shrink or disappearance was achieved in 28 patients in microprolactinoma group, 23 in macroprolactinoma group, and 8 in giant prolactioma group. The statistical results showed no significant difference in normal prolactin level and improvement of symptoms among the three groups (P>0.05), but the reduction of tumor volume were statistically different (P<0.05).ConclusionsMicroprolactinomas and macroprolactinomas are mostly seen in childbearing-aged women with main manifestations of menstrual disorders and lactation, while giant prolactinomas are mostly seen in middle-aged men, with main manifestations of headaches and visual field disorders. Bromocriptine has a good effect on prolactin adenomas with various sizes. Therefore bromocriptine should be the first choice for different types of prolactinomas.
Objectives To analyze the efficacy and safety of different operation methods for patients with cesarean scar diverticulum. Methods The clinical data of patients with cesarean section scar diverticulum treated in West China Second University Hospital from July 2012 to December 2016 was collected and followed up. The data of the previous perioperative period data, recovery, the improvement of the symptoms and postoperative condition of incision healing were analyzed by SPSS 22.0 software. Results A total of 125 patients were included, in which 74 cases received hysteroscopy surgery for diverticulum electro section and electric coagulation (ESEC group), and 51 cases received other surgery focused on diverticulum dissection and sewing operations (DS group). Statistical analysis showed that, compared with DS group, bleeding, operation time, time of anal exsufflation and hospitalization duration after the operation of hysteroscopy in ESEC group were significantly reduced (P<0.001). In addition, the results showed that hysteroscopy group had optimal results in hemorrhage volume, operation time, anal exhaust time and hospitalization time indicators. However, the results of laparotomy group was not significant. Conclusions For the treatment of CSD, surgical treatment of this pathology by operative hysteroscopy may represent the best choice in symptomatic women because of its minimal invasiveness and beneficial therapeutic results. Hysteroscopy isthmoplasty appears to be the most popular treatment.