目的：初步分析影响妇科良性疾病盆腔积液的相关因素。方法：选择2012年5-10月于北京协和医院接受腹腔镜检查和（或）治疗的育龄期患者,术中留取游离的盆腔积液,测量盆腔积液量并记录临床资料。结果：入组112例患者,平均年龄为31.74...目的：初步分析影响妇科良性疾病盆腔积液的相关因素。方法：选择2012年5-10月于北京协和医院接受腹腔镜检查和（或）治疗的育龄期患者,术中留取游离的盆腔积液,测量盆腔积液量并记录临床资料。结果：入组112例患者,平均年龄为31.74±6.85岁,收集的盆腔积液量平均为7.39±6.72 ml,范围为0.3-44.0 ml。主要临床问题包括不育、盆腔粘连、子宫内膜异位症、子宫肌瘤、输卵管积水、畸胎瘤、子宫内膜息肉、子宫腺肌病。与腹腔镜下未发现子宫内膜异位病灶的患者相比,子宫内膜异位症患者的盆腔积液量增加（P〈0.05）。与无相应疾病的患者相比,输卵管积水、盆腔粘连患者的盆腔积液量有减少的趋势,子宫内膜息肉、子宫腺肌病患者的盆腔积液量有增加的趋势,但差异均无统计学意义（P〉0.05）。不育患者与生育力无异常的患者相比,盆腔积液量（7.27±6.71 ml vs 7.83±6.90 ml）差异无统计学意义（P〉0.05）。多因素线性回归分析提示：体重指数增加,盆腔积液量减少;年龄增加,盆腔积液量增加;子宫腺肌病患者盆腔积液量增加;输卵管积水患者盆腔积液量减少。结论：子宫内膜异位症患者的盆腔积液量增加,其他妇科良性疾病及不育患者中未发现盆腔积液量的明显变化。临床中诊断和处理盆腔积液时,应结合疾病及患者的年龄、体重指数进行综合评价。展开更多
<正>1病例2014.11.21门诊第一次就诊王某某,女,51岁,G2P1 LMP:2013.11主诉:绝经1年现病史:平素月经规律,1443050,4/30天,量偏多,痛经(—);2013年冬天连续两晚(19:00~19:40)出现极度恐慌感;半年前减肥(20斤/2个月),后出现发热、呕...<正>1病例2014.11.21门诊第一次就诊王某某,女,51岁,G2P1 LMP:2013.11主诉:绝经1年现病史:平素月经规律,1443050,4/30天,量偏多,痛经(—);2013年冬天连续两晚(19:00~19:40)出现极度恐慌感;半年前减肥(20斤/2个月),后出现发热、呕吐;BP:190/100 mm Hg,到消化科治疗,后转心内科;在心内科住院期间(1月前)又出现连续两早晨呼吸急促。展开更多
Objective:To explore the relationship among body mass index(BMI),dosage of progesterone(P) and serum progesterone concentration,and provide reference for the clinical use of oral progesterone. Methods:This was a rando...Objective:To explore the relationship among body mass index(BMI),dosage of progesterone(P) and serum progesterone concentration,and provide reference for the clinical use of oral progesterone. Methods:This was a random,open-label,prospective clinical trial.Eighty women meeting the criteria for enrollment were recruited from July 2010 to March 2011 in outpatient clinic of Peking Union Medical College Hospital and given oral progesterone therapy for consecutive 10 days.They were randomly assigned into four groups according to the different doses of progesterone:group A 100 mg/day,group B 200 mg/day,group C 300 mg/day and group D 400 mg/day. Results:Seventy four patients(92.5%,74/80) accomplished the study.It can be observed that administration of different dosage of P could significantly increase serum P concentration(all P<0.001).And there was a positive correlation between the increase of P concentration and dosage(r_p=0.613,P<0.001).Furthermore,the medians of the increase of serum P concentration in 4 groups were 14.71 nmol/L in group A,28.47 nmol/L in group B, 58.89 nmol/L in group C,72.69 nmol/L in group D.When BMI<24 kg/m^2(42 cases),the median of the increase of P levels was 13.90 nmol/L,37.22 nmol/L,62.55 nmol/L,and 119.02 nmol/L in group A,B,C and D, respectively,while BMI≥24 kg/m^2(32 cases),the median of increase was 8.93 nmol/L,24.82 nmol/L,24.87 nmol/L,and 63.48 nmol/L,respectively.In addition,significant difference was found only in group D between women with BMI<24 kg/m^2 and with BMI≥24 kg/m^2(P = 0.010). Conclusions;Serum progesterone levels go up linearly with the dosage increasing.The greater BMI the patient have,the larger dosage may be needed to achieve the same serum progesterone concentration.The individual dosage of oral progesterone needed can be roughly calculated in the light of the result of this study.展开更多
文摘目的：初步分析影响妇科良性疾病盆腔积液的相关因素。方法：选择2012年5-10月于北京协和医院接受腹腔镜检查和（或）治疗的育龄期患者,术中留取游离的盆腔积液,测量盆腔积液量并记录临床资料。结果：入组112例患者,平均年龄为31.74±6.85岁,收集的盆腔积液量平均为7.39±6.72 ml,范围为0.3-44.0 ml。主要临床问题包括不育、盆腔粘连、子宫内膜异位症、子宫肌瘤、输卵管积水、畸胎瘤、子宫内膜息肉、子宫腺肌病。与腹腔镜下未发现子宫内膜异位病灶的患者相比,子宫内膜异位症患者的盆腔积液量增加（P〈0.05）。与无相应疾病的患者相比,输卵管积水、盆腔粘连患者的盆腔积液量有减少的趋势,子宫内膜息肉、子宫腺肌病患者的盆腔积液量有增加的趋势,但差异均无统计学意义（P〉0.05）。不育患者与生育力无异常的患者相比,盆腔积液量（7.27±6.71 ml vs 7.83±6.90 ml）差异无统计学意义（P〉0.05）。多因素线性回归分析提示：体重指数增加,盆腔积液量减少;年龄增加,盆腔积液量增加;子宫腺肌病患者盆腔积液量增加;输卵管积水患者盆腔积液量减少。结论：子宫内膜异位症患者的盆腔积液量增加,其他妇科良性疾病及不育患者中未发现盆腔积液量的明显变化。临床中诊断和处理盆腔积液时,应结合疾病及患者的年龄、体重指数进行综合评价。
文摘<正>1病例2014.11.21门诊第一次就诊王某某,女,51岁,G2P1 LMP:2013.11主诉:绝经1年现病史:平素月经规律,1443050,4/30天,量偏多,痛经(—);2013年冬天连续两晚(19:00~19:40)出现极度恐慌感;半年前减肥(20斤/2个月),后出现发热、呕吐;BP:190/100 mm Hg,到消化科治疗,后转心内科;在心内科住院期间(1月前)又出现连续两早晨呼吸急促。
文摘Objective:To explore the relationship among body mass index(BMI),dosage of progesterone(P) and serum progesterone concentration,and provide reference for the clinical use of oral progesterone. Methods:This was a random,open-label,prospective clinical trial.Eighty women meeting the criteria for enrollment were recruited from July 2010 to March 2011 in outpatient clinic of Peking Union Medical College Hospital and given oral progesterone therapy for consecutive 10 days.They were randomly assigned into four groups according to the different doses of progesterone:group A 100 mg/day,group B 200 mg/day,group C 300 mg/day and group D 400 mg/day. Results:Seventy four patients(92.5%,74/80) accomplished the study.It can be observed that administration of different dosage of P could significantly increase serum P concentration(all P<0.001).And there was a positive correlation between the increase of P concentration and dosage(r_p=0.613,P<0.001).Furthermore,the medians of the increase of serum P concentration in 4 groups were 14.71 nmol/L in group A,28.47 nmol/L in group B, 58.89 nmol/L in group C,72.69 nmol/L in group D.When BMI<24 kg/m^2(42 cases),the median of the increase of P levels was 13.90 nmol/L,37.22 nmol/L,62.55 nmol/L,and 119.02 nmol/L in group A,B,C and D, respectively,while BMI≥24 kg/m^2(32 cases),the median of increase was 8.93 nmol/L,24.82 nmol/L,24.87 nmol/L,and 63.48 nmol/L,respectively.In addition,significant difference was found only in group D between women with BMI<24 kg/m^2 and with BMI≥24 kg/m^2(P = 0.010). Conclusions;Serum progesterone levels go up linearly with the dosage increasing.The greater BMI the patient have,the larger dosage may be needed to achieve the same serum progesterone concentration.The individual dosage of oral progesterone needed can be roughly calculated in the light of the result of this study.
