经阴道超声、高分辨MRI检查对后盆部深部子宫内膜异位症的诊断价值

目的分析经阴道超声、高分辨磁共振成像(MRI)对后盆部深部子宫内膜异位症的诊断价值。方法选择2018年7月至2020年6月收治的73例后盆部深部子宫内膜异位症患者作为研究对象,均行经阴道超声和高分辨MRI检查。比较单独经阴道超声、高分辨MRI及联合检查对不同解剖部位病灶的检出阳性率。比较单独经阴道超声、高分辨MRI及联合检查对右侧宫骶韧带、直肠-乙状结肠病灶的诊断价值。结果病理学检查结果显示,73例患者共有197个病灶,其中左侧宫骶韧带42个,右侧宫骶韧带65个,直肠阴道隔28个,直肠-乙状结肠62个。经阴道超声检查对左侧宫骶韧带、右侧宫骶韧带、直肠阴道隔、直肠-乙状结肠病灶的检出阳性率分别为38.07%、41.62%、30.46%、42.64%;高分辨MRI检查对左侧宫骶韧带、右侧宫骶韧带、直肠阴道隔、直肠-乙状结肠病灶的检出阳性率分别为38.58%、43.15%、31.47%、43.65%;经阴道超声联合高分辨MRI检查对左侧宫骶韧带、右侧宫骶韧带、直肠阴道隔、直肠-乙状结肠病灶的检出阳性率分别为40.10%、45.69%、31.98%、46.70%。单独经阴道超声、高分辨MRI及联合检查对左侧宫骶韧带、右侧宫骶韧带、直肠阴道隔、直肠-乙状结肠病灶的检出阳性率无显著差异(P>0.05)。经阴道超声联合高分辨MRI诊断右侧宫骶韧带、直肠-乙状结肠病灶的灵敏度、特异度、准确度均高于经阴道超声及高分辨MRI单独检查,差异具有统计学意义(P<0.05)。结论相较于单一经阴道超声或高分辨MRI,经阴道超声联合高分辨MRI对后盆部深部子宫内膜异位症的诊断价值更高,可更准确、更及时地发现病灶所在,值得临床进一步推广和应用。

子宫内膜癌组织中C-erbB-2基因蛋白的表达及意义

目的 探讨子宫内膜癌的发生及发展与癌基因C -erbB - 2表达的关系。方法 应用免疫组化法测定了 5 8例子宫内膜癌组织中癌基因C -erbB - 2的表达。结果 5 8例中阳性表达 2 6例 (4 4 8%) ,C -erbB - 2阳性表达与组织学分级密切相关 ,而与分期、病理类型、肌层浸润无关。结论 C -erbB - 2与子宫内膜癌的发生、发展及分化密切相关 ,可以作为评估其恶性生物学行为的指标。

腹腔镜下全子宫切除术的子宫内膜癌患者进行快速康复护理的效果

目的本文旨在对腹腔镜下全子宫切除术的子宫内膜癌患者进行快速康复护理,探究其效果。方法本次50例研究者,均是来自2018年1月-2019年12月,在本院进行治疗的腔镜下全子宫切除术的子宫内膜癌患者,并对其进行快速康复护理,经过患者同意后分为两组,A组(常规治疗)与B组(快速康复护理),比较两组病人的治疗效果。结果在采取不同治疗后,B组病人的临床效果优势显著;另外B组患者在术后排便、排气、住院的时间也比A组病人偏低,两组之间数据对比差异显著,具有统计学意义。结论由此,将快速康复护理治疗纳入全子宫切除术的子宫内膜癌患者中,可以一定程度上减少病人在术后排便、排气及患者的住院时间,有助于节省患者的费用,值得广泛应用。

p73蛋白在子宫内膜增生期、增生过长及内膜样腺癌中的表达及意义

采用免疫组织化学 S-P法 ,在 13例子宫内膜增生期、42例增生过长及 38例内膜样腺癌组织中检测 p73蛋白的表达情况。结果显示 ,检测 p73蛋白有助于鉴别子宫内膜良恶性病变 ,子宫内膜癌的发生发展可能与

紫杉醇致过敏性休克1例

患者女，69岁。因“子宫颈管乳头状浆液性腺癌Ib1期术后，拟静脉化疗”入院。患者于2007年8月21日在全麻下行次广泛全予宫＋双附件切除术＋盆腔淋巴结切除术＋腹主动脉旁淋巴结活检术。病理回报：子宫颈管乳头状浆液性腺癌伴坏死，3-3cm，侵及宫颈管〈1／2，已累及颈管全周，向上累及子宫下段子宫内膜腺体及间质，未累及宫颈穹窿，绝经期子宫内膜部分腺体增生，阴道断端及左右宫旁未见癌累及。双侧附件未见异常，淋巴结未见癌转移。术后诊断：子宫颈管乳头状浆液性腺癌Ib1期。

Acute small bowel obstruction caused by endometriosis:A case report and review of the literature

Gastrointestinal involvement of endometriosis has been found in 3%-37% of menstruating women and exclusive localization on the ileum is very rare(1%-7%).Endometriosis of the distal ileum is an infrequent cause of intestinal obstruction,ranging from 7% to 23% of all cases with intestinal involvement.We report a case in which endometrial infiltration of the small bowel caused acute obstruction requiring emergency surgery,in a woman whose symptoms were not related to menses.Histology of the resected specimen showed that endometriosis was mainly prevalent in the muscularis propria and submucosa and that the mucosa was not ulcerated but had inflammation and glandular alteration.Endometrial lymph node involvement,with a cystic glandular pattern was also detected.

Gallbladder endometriosis as a cause of occult bleeding

A 17-year-old girl with colicky abdominal pain andchronic anemia presented to the gastrointestinal serviceof the University Hospital of Essen. In the routineworkup, there were no pathological findings despitethe anemia. Because of the fluctuation of symptomswith a climax at the time of menstruation, consecutiveultrasound studies were performed revealing a visiblemass inside the gallbladder. This finding was confirmedby a magnetic resonance imaging (MRI) study performedat the same time. Because of the severe anemia by thattime, a cholecystectomy was performed, and histologyreconfirmed the diagnosis of isolated gallbladderendometriosis. The patient recovered well and has hadno recurrence of the disease to date.

宫内节育环取出钳的临床应用

放置宫内节育器（IUD）是目前我国育龄妇女的主要避孕措施，在我国，采用IUD避孕者占已婚育龄并采取避孕措施妇女总数的近50％、约占全世界使用节育环妇女的70％^[1]。放置于宫内的IUD常由于各种原因需要将其取出，而临床多采用取环钩钩取IUD。由于绝经后妇女的子宫已逐渐萎缩，且因IUD置入宫内时间长，致使部分IUD被子宫内膜部分或全部包埋而固定不动等；