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夏燕萍

作品数:3 被引量:22H指数:3
供职机构:复旦大学附属妇产科医院麻醉科更多>>
发文基金:面向21世纪教育振兴行动计划卫生部临床学科重点项目上海市卫生局科研基金更多>>
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妊娠中期母血清唐氏综合征三联筛查4680例与不良妊娠结果分析(英文)被引量:6
2006年
Objective: To investigate the efficiency of maternal serum triple screening for the genetic abnormality in second-trimester and the morbidity of adverse pregnancy outcome in false positive results of the test. Methods: A total of 4 680 pregnant women with singleton pregnancies assigned in Obs & Gyn Hospital, Fudan University, underwent triple screening test (alpha fetoprotein, AFP; human chorionic gonadotropin, HCG and unconjugated estriol, uE3) by fluorescence enzyme immunoassay between 2003 and 2005. The valid MoM (Multiples of Median) value of mid-trimester serum AFP, uE3, and hCG and risk assessments was provided by Beckman Coulter Co. when applied in the prenatal Down syndrome screening service. The study compares the incidence of chromosomal abnormalities with Down syndrome in screen positive women and compares to the MoM value established in the literature. The risks of having a fetus with congenital abnormalities or of developing obstetric complications in the screen positive women with their matched controls.Results:The MoM values for the triple tests of our study are similar to established values of literature. Only 51.01% women with pregnancies agree to receive screening. Amniocentesis utilization rate was 55.12% in the screen-positive pregnancies. The false positive rate was 6.89% and the median of maternal age of the women was 28.13 (range 19 to 49) years old. Chromosomal abnormalities were identified in 21 pregnancies, including 9 cases of trisomy 21.The detection rate was 77.77%. Pregnancies with positive screening results had a significantly higher risk of adverse outcomes than those with negative results (P< 0.05). Whereas there was no difference in the incidences of fetal congenital appearance or skeleton abnormality. Conclusion: Adjusting MoM values of local unaffected populations is limited to increasing the detection rate. Because chromosomal defects have variable exhibitions, amniocentesis utilization is still a choice for screen-positive pregnancies. Screen-positive pregnancies had increase
夏燕萍朱铭伟李笑天周和平王静吕菊香Nanbert ZHONG
关键词:唐氏综合征染色体畸变遗传筛查妊娠中期
脉冲波疗法用于分娩镇痛的疗效分析被引量:12
2006年
目的:研究作用于桡神经、正中神经、T10-L1节段脊髓背根神经的脉冲波疗法的镇痛效果及其对产程、分娩方式、产程干预、母儿并发症的影响。方法:133例初产妇随机分成镇痛组(75例)与对照组(58例),镇痛组在产程中使用GT-4A分娩镇痛工作站。观察两组产妇的镇痛效果、产程、分娩方式、产后出血及镇痛对母儿的不良反应等。结果:镇痛组镇痛前后的疼痛评分差异有显著性(P<0.05),镇痛组与对照组剖宫产率及产程中缩宫素应用率差异有显著性(P<0.05),两组的产程差异无显著性(P>0.05),镇痛组母儿均无明显不良反应。结论:该法操作简单,产妇易接受,对母儿无影响,能降低剖宫产率,减少产程干预,是比较理想的分娩镇痛方法。
范灵玲李勤夏燕萍李笑天
关键词:脉冲波镇痛效果产程干预
胎儿颈部肿块的多学科联合诊治模式探讨:附4例病例报道被引量:4
2012年
目的通过建立包括子宫外产时处理(ex-uterointrapartumtreatment,EXIT)技术的多学科联合诊治模式,提高颈部肿块胎儿的成活率和生存质量。方法对2007年9月至2010年2月共4例产前诊断颈部肿块胎儿采用了多学科联合诊治的模式,包括妊娠期定期监测、产时实施EXIT手术、新生儿再次评估和手术治疗等。结果4例均在妊娠37周后行选择性EXIT手术分娩,平均分娩孕周为37^+4周(37~38^+3周),平均出生体重为2972g(2600-3250g),手术时间(从子宫切开到断脐)平均为4min(2~7min)。初次诊断孕龄为29^+4周(24~34周),颈部肿块最大为6.2cm×5.8cm×6.8cm,最小为3.0em×2.0cm×1.0cm。2例提示有气管移位并羊水过多,2例有气管压迫但羊水量正常。3例患儿出生后依赖机械通气,增强CT提示气管明显受压或移位,在出生后6~8d接受了手术治疗;1例在出生后再次评估时发现肿块没有完全压迫气管,拔管后可自主呼吸,未选择新生儿期手术。术后诊断肠源性囊肿1例、淋巴管瘤2例和梨状窝瘘1例。4例患儿随访情况均良好。结论胎儿颈部肿块的处理是贯穿整个围产期的、多学科联合的诊治过程。为提高颈部肿块胎儿的成活率和生存质量,建立一个多学科联合诊治的团队和模式十分必要。
熊钰沈淳任芸芸夏燕萍段定红浦樱修罗青妍郑珊李笑天
关键词:淋巴管瘤胎儿疾病穿刺抽液术插管法气管内
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