重组人粒细胞刺激因子联合咖啡酸片治疗宫颈癌同步放化疗致白细胞减少患者的疗效观察

【目的】探讨重组人粒细胞刺激因子（rhG-CSF）联合咖啡酸片治疗宫颈癌同步放化疗致白细胞减少患者的疗效观察。【方法】选择本院经病理证实的晚期宫颈癌患者120例，经1个同步放化疗周期内出现白细胞计数减少，采用随机数字表法分为对照组和观察组，每组各60例。对照组给予rhG-CSF治疗，直至两次白细胞计数〉4．0×10^9／L时停止用药；观察组在对照组基础上加用咖啡酸片，至白细胞计数减少恢复正常且维持2周，或持续用药21d。治疗21d后，比较两组临床疗效、rhG-CSF用量、感染发生率及不良反应发生率及白细胞计数。【结果】观察组有效率为91．67％（55／60），显著高于对照组的78．33％（47／60），其差异有统计学意义（χ^2=4．183，P=0．041）；两组治疗后7d、21d白细胞计数均上升，与治疗前比较差异有统计学意义（P〈0．05），且观察组上升更为明显，差异有统计学意义（P〈0．05）。观察组治疗7d、21drhG-CSF用量分别为（5．94±1．31）支／人、（1．10±0．38）支／人，均明显少于对照组的（6．71±1．56）支／人、（2．68±0．54）支／人，其差异有统计学意义（t=2．927，P=0.004；t=18．535，P=0.000）。两组继发感染率、不良反应发生率比较差异无统计学意义（P〉0．05）。【结论】咖啡酸片联合rhpcsF治疗宫颈癌放化疗致白细胞计数减少，可升白细胞计数，能减少rhG-CSF用量，且不增加不良反应发生率。

子宫颈癌与HPV、HSV Ⅱ、CMV、梅毒感染的关系

目的:探讨子宫颈癌与人乳头状瘤病毒(HPV)、单纯疱疹型病毒(HSV)、巨细胞病毒(CMV)、梅毒感染的关系。方法:对109例子宫颈癌患者的宫颈癌灶组织、癌灶分泌物、治疗前静脉血清三种标本,分别进行组织的HPV分型基因芯片检测、分泌物的HSV、CMVPCR荧光定量检测、血清梅毒螺旋体抗体的ELISA检测。结果:HPV阳性率98.17%、梅毒阳性率30.28%、HSVII阳性率36.69%、CMV阳性率33.03%;其中四种病原体同时阳性为18.35%、三种病原体同时阳性11.01%、二种病原体同时阳性21.10%、一种病原体阳性49.54%。结论:HPV感染与子宫颈癌关系密切,子宫颈癌中HSV、CMV、梅毒的感染率亦较高。

纳美芬对老年妇科肿瘤患者术后呼吸抑制的拮抗作用

目的:探讨纳美芬对老年妇科肿瘤患者术后呼吸抑制拮抗作用的有效性及安全性。方法:将行根治性手术的妇科肿瘤患者84例随机分为3组,A组(空白对照组)在手术结束待自主呼吸恢复后给予生理盐水;B组(纳洛酮组)给予纳洛酮;C组(纳美芬组)给予纳美芬,待病人清醒后拔除喉罩。比较观察3组患者的血流动力学变化,以及意识恢复时间、拔管时间、定向力恢复时间,拔管后5min意识状况评分,拔管30min后镇痛评分等指标。结果:应用纳美芬拮抗组和纳洛酮拮抗组意识恢复时间、拔管时间及定向力恢复时间均明显短于对照组(P<0.05),纳美芬拮抗组和纳洛酮拮抗组之间无显著性差异(P>0.05)。3组在用药时、用药后5min、10min、30min等4个时间点的血流动力学均无显著性差异(P>0.05)。Ramsay评分及VAS评分3组无显著性差异(P>0.05)。结论:纳美芬对老年妇科肿瘤患者术后呼吸抑制的拮抗作用效果确切,安全有效。

早期宫颈癌局部巨块型患者行阴式广泛子宫切除术的并发症相关研究

目的总结分析早期宫颈癌局部巨块型患者行阴式广泛子宫切除术并发症发生情况,探讨降低并发症发生率的方法。方法收集石家庄市第一医院2011年6月至2016年6月期间收治早期宫颈癌病例(ⅠA2-ⅡA期)资料,筛选出行阴式广泛子宫切除术+腹腔镜盆腔淋巴结清扫术者共258例,分为观察组(局部巨块组)和对照组(常规组),比较两组手术相关并发症发生情况,以及先期化疗对局部巨块型患者并发症的影响情况。结果观察组(ⅠB2/ⅡA2期)93例发生并发症26例(27.9%),高于对照组(ⅠA2/ⅠBl/ⅡA1期)165例中的28例(17.0%),差异有统计学意义(P<0.05);观察组膀胱损伤发生率高于对照组(5例vs 2例),差异有统计学意义(P<0.05),其余并发症发生率差异无统计学意义(P>0.05)。对于局部巨块型早期宫颈癌患者,先期化疗组并发症发生率为6例(15.8%),低于单纯手术组的20例(36.4%),差异有统计学意义(P<0.05);先期化疗组输尿管损伤发生率低于单纯手术组(0例vs 6例),差异有统计学意义(P<0.05),两组其余并发症发生率差异无统计学意义(P>0.05)。结论局部巨块型(ⅠB2/ⅡA2期)早期宫颈癌患者行阴式广泛子宫切除术并发症发生率较高,先期化疗能够缩小病灶体积,减少病灶充血,降低手术并发症发生率。

子宫肌瘤对OS-IUI治疗的不明原因不孕症患者妊娠结局的影响

[目的]探讨子宫肌瘤对促排卵联合宫腔内人工授精(Ovarian stimulation with intrauterine insemina-tion,OS-IUI)治疗的不明原因不孕症患者妊娠结局的影响。[方法]选取2015年6月至2018年6月在西北妇女儿童医院生殖中心接受OS-IUI治疗的不明原因不孕症患者584例作为研究对象,根据是否合并子宫肌瘤分为观察组(合并子宫肌瘤,n=66)和对照组(未合并子宫肌瘤,n=518)。收集两组临床指标,并对妊娠结局进行随访,分析合并子宫肌瘤对OS-IUI治疗患者的临床妊娠率、妊娠丢失、活产率、早产率的影响。[结果]两组不孕持续时间、既往受孕情况、流产史、活产率和既往不孕治疗史等比较差异无统计学意义(P>0.05)。与对照组患者相比,观察组患者年龄、体重指数(BMI)、血清卵泡刺激素(Follicle Stimulating Hormone,FSH)水平、子宫体积、甲状腺过氧化物酶抗体(TPOAb)、衣原体抗体、注射HCG前E_(2)峰值更高,抗穆勒氏管激素(Anti-Mullerian Hormone,AMH)、窦卵泡、活动精子数更少,其差异均有统计学意义(均P<0.05)。与对照组患者相比,合并子宫肌瘤患者临床妊娠率和活产率更低,妊娠丢失率更高,其差异有统计学意义(P均<0.05)。多因素Logistic回归分析显示:子宫肌瘤患者OS-IUI治疗后临床妊娠率[OR(95%CI):0.82(0.75~0.96)]和活产率[OR(95%CI):0.93(0.77~0.97)]降低,妊娠丢失率升高[OR(95%CI):1.26(1.12~1.36)]。[结论]子宫肌瘤对OS-IUI治疗患者妊娠结局产生不良影响,应引起临床医生重视。

宫颈癌合并妊娠2例分析

我院分别于2006-05-2008-03收治妊娠合并宫颈癌患者2例,分析如下。 1病历摘要 例1：女,32岁。因停经11＋5周,阴道不规则出血2d后出现腹痛流产就诊,行妇科检查示宫颈直径4cm,表面呈菜花样改变,触血（＋）,子宫如孕12周,左侧骶韧带增厚,但尚有弹性,宫颈阴道镜下活检示宫颈中分化鳞状细胞癌,浸润间质。

Therapeutic observation of acupuncture plus navel acupuncture for urinary retention after radical hysterectomy for cervical cancer

Objective: To observe the clinical efficacy of acupuncture plus navel acupuncture for patients with urinary retention after radical hysterectomy for cervical cancer. Methods: A total of 64 patients with urinary retention after radical hysterectomy for cervical cancer was divided into a navel acupuncture group (22 cases), an acupuncture group (18 cases) and an acupuncture plus navel acupuncture group (24 cases). All three groups received bladder function training and neuromuscular electrical stimulation. In addition, navel points were combined in the navel acupuncture group. Electroacupuncture was conducted to Qihai (CV 6), Zhongji (CV 3), Dahe (KI 12), Shuidao (ST 28), Ciliao (BL 32) and Huiyang (BL 35) in the acupuncture group. The acupuncture plus navel acupuncture group received both treatments. The catheter was removed after 3 d of treatment. Spontaneous urination, residual urine volume, urinary catheter dependence and recurrence after 3 d, 6 d and 9 d of treatment in each group were observed, respectively. Results: In the acupuncture plus navel acupuncture group, the markedly effective rates after 3 d, 6 d and 9 d of treatment were significantly higher than those in the navel acupuncture group and the acupuncture group;the urinary catheter dependence was lower than that of the other two groups, and the differences were statistically significant (P<0.05, P<0.01);the spontaneous urination time was shorter than that of the navel acupuncture group and the acupuncture group, and the differences were statistically significant (P<0.05, P<0.01);the residual urine volume was significantly less than that of the navel acupuncture group and the acupuncture group, and the differences were statistically significant (both P<0.01). After the catheter was removed, recurrence was observed from the next day after spontaneous urination was resumed. There were 2 cases of recurrence in the navel acupuncture group, 2 cases in the acupuncture group and 1 case in the acupuncture plus navel acupuncture group. The recurrence rate of the acupuncture plus navel acupuncture group was significantly lower than that of the navel acupuncture group and the acupuncture group (both P<0.01). Conclusion: Acupuncture plus navel acupuncture has satisfactory efficacy for urinary retention after radical hysterectomy for cervical cancer. It can significantly shorten the urinary retention time, reduce the patient's dependence on urinary catheter, and reduce the residual urine volume.

Efficacy observation on acupuncture-moxibustion for urinary retention after surgery for cervical cancer

Objective：To observe the efficacy of acupuncture-moxibustion therapy in treating urinary retention after surgery for cervical cancer. Methods：Fifty eligible patients were randomized into a treatment group and a control group by their visiting sequence, 25 in each group. The control group was intervened by indwelling urethral catheter after gynecological surgery; while the treatment group started to receive acupuncture-moxibustion and cupping treatment at the 7th day after surgery, in addition to the intervention given to the control group. The residual urine volume and total effective rate of the two groups were detected. Results：After 7-day treatments, the total effective rate was 92.0% in the treatment group versus 72.0% in the control group, and the difference was statistically significant （P〈0.05）. Conclusion：Acupuncture-moxibustion treatment plus cupping based on the conventional intervention is effective for urinary retention after surgery for cervical cancer, worth promoting in clinic.

Clinical study on intradermal needle therapy in treating urinary retention after cervical cancer surgery

Objective:To observe the clinical efficacy of intradermal needle therapy for urinary retention after cervical cancer surgery.Methods:A total of 100 patients with urinary retention after cervical cancer surgery were randomized into a control group and an observation group,with 50 cases in each group.The control group was treated with basic nursing only,and the observation group was treated with additional intradermal needle therapy.Both groups were treated for 2 courses of treatment.The main symptom scores and residual urine volume of the two groups were observed before and after treatment,and the inpatient time,catheter indwelling time and the clinical efficacy were compared between the two groups.Results:The total effective rate was 96.0%in the observation group and 88.0% in the control group,and the difference between the two groups was statistically significant(P<0.05).After treatment,the main symptom scores and residual urine volume in both groups decreased significantly(all P<0.0S),and the scores and residual urine volume in the observation group were significantly lower than those in the control group(all P<0.05).The inpatient time and catheter indwelling time in the observation group were significantly shorter than those in the control group(both P<0.05).Conclusion:Intradermal needle therapy has an obvious effect in improving symptoms of urinary retention after cervical cancer surgery,and the effect is significantly more persistent than that of simple basic nursing.

Observations on Electroacupuncture Treatment of 60 Patients with Urine Retention Following Cervical Cancer Operation

Objective： To investigate the curative effect of electroacupuncture on urine retention following cervical cancer operation. Methods. A treatment group was treated with electroacupuncture according to classification based on syndrome differentiation and a control group, by a conventional method. One course of treatment consisted of 5 days. Results： The curative rate and cure rate were 96.67% and 76.67%, respectively, in the treatment group and 70% and 36. 67%, respectively, in the control group. There were significant differences in curative rate and cure rate between the two groups （P〈 0. 01）. Conclusion： Electroacupuncture is a good method for treating urine retention subsequent to cervical cancer operation.