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Characteristics and Surgical Success of Patients Presenting for Repair of Genitourinary Fistula in VVF Center of a Tertiary Hospital 某三级医院VVF中心泌尿生殖系统瘘修复患者的特点及手术成功率
Pub Date : 2017-10-12 DOI: 10.3329/BJOG.V31I1.34274
R. Ara, A. Amin, Shadiqul Hoque, Setara Binte Kasem
Objective(s): To carry out a prospective review of patients who had undergone surgical repair of genitourinary fistula to determine patients’ characteristics and to explore success of surgery in relation to aetilogy of fistula and attempt of surgery. Materials and Methods : This cross-sectional study was carried out in patients attending the Fistula centre in Dhaka Medical College and Hospital (DMCH) from April 27 th to July25 th , 2013. Out of 47 patients 27 were recruited for this study. Detailed history was taken about socio-demographic character, gestational age, duration of labour, mode of delivery, conduction of labour and foetal outcome. Causes of fistula, information about fistula repair and success rate were noted. Main outcome measures were successful repair and correlation of success with aetiology of fistula, attempt of surgery. Data were analyzed by SPSS package. A p value of <0.5 was considered as significant. Results: Mean age of the patients was 33.73± 10.73 years with a range of 17 to 58 years and mean height was 144.67±3.013cm. Most of the women (66.7%) were from lower social class. The most common fistula 19 (70.37%) was obstetric due to obstructed labour and in 8 (25.93%) cases it was due to consequence of gynaecological surgery. Mean gestational age of the foetus were 38.57±1.409 weeks and duration of labour was 34.83±14.618 hours. Out of 27 patients, 7 had prior fistula repair without success, 4 patients had prior 2 attempts and 3 had previous 3 and 4 attempts. In 21 patients surgical repair was done through vaginal route while 6 required abdominal approach. Local repair was done in 18 (66.67%) cases and grafting was done in 5(18.52%) cases. Fifteen (55.56%) patients had successful repair and success rate was more when it was first attempted (90%) and 20% in repeat attempt but it was statistically significant p<0.05. Success of repair was more when causes of fistula was gynaecological (87.50%) than when it was obstetrical (42.11%), p<0.05. Conclusion: Success of surgery of genitourinary fistula depends upon so many factors. Gynaecological fistula can be repaired more successfully than obstetrical one. First attempt of surgery is the best attempt, so must be done at skilled hand. Bangladesh J Obstet Gynaecol, 2016; Vol. 31(1) : 34-39
目的:对行泌尿生殖系统瘘手术修复的患者进行前瞻性回顾,以确定患者的特征,并探讨手术成功与瘘的病因和手术尝试的关系。材料与方法:本横断面研究于2013年4月27日至7月25日在达卡医学院和医院(DMCH)瘘管中心就诊的患者进行。在47名患者中,有27人被招募参加这项研究。详细记录了社会人口特征、胎龄、分娩持续时间、分娩方式、分娩传导和胎儿结局。记录了瘘管的原因、瘘管修复的信息和成功率。主要观察指标为修复成功及与瘘的病因、手术次数的关系。数据采用SPSS软件包进行分析。p值<0.5为显著性。结果:患者平均年龄33.73±10.73岁,年龄范围17 ~ 58岁,平均身高144.67±3.013cm。大多数女性(66.7%)来自社会底层。最常见的瘘管19例(70.37%)是由于难产造成的,8例(25.93%)是由于妇科手术造成的。平均胎龄38.57±1.409周,产程34.83±14.618小时。27例患者中,7例既往行瘘管修补未果,4例既往2次,3例既往3次和4次。21例经阴道行手术修复,6例经腹部行手术修复。局部修复18例(66.67%),移植5例(18.52%)。15例(55.56%)患者修复成功,首次修复成功率高于90%,再次修复成功率高于20%,差异有统计学意义p<0.05。妇科瘘的修复成功率(87.50%)高于产科瘘的修复成功率(42.11%),p<0.05。结论:泌尿生殖系统瘘手术的成功与否与诸多因素有关。妇科瘘管的修复比产科瘘管更成功。手术的第一次尝试是最好的尝试,所以必须由熟练的手来完成。孟加拉国妇产科杂志,2016;Vol. 31(1): 34-39
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引用次数: 2
Efficacy and Safety of Para Cervical Block in Manual Vacuum Aspiration (MVA) - in Low Resource Setting 颈旁阻滞在低资源环境下进行手动真空抽吸(MVA)的有效性和安全性
Pub Date : 2017-10-12 DOI: 10.3329/BJOG.V31I2.34213
Nafisa Jesmin
Objective (s): To determine the safety and effectiveness of para-cervical block for cervical dilatation and uterine evacuation by MVA. Materials and methods: This descriptive (cross-sectional) study was conducted in a low resource set-up at Homna, Upzilla Health Complex Comilla between January 2016 and June 2016. Forty five patients of 1 st trimester incomplete abortion of 12 weeks gestation were the target population for manual vacuum aspiration (MVA) for this study. All patients received para cervical block before MVA procedure. Three minutes after application of block, suction and evacuation of uterus was done. Perioperative oral analgesic (Ibuprofen) and anxiolytic (diazepam) were used 30 minutes before procedure in all patients. Before the procedure, all the women were asked to evaluate the level of pain on a visual analog scale ranged from 0-10. Thirty minutes after the procedure, the patient was asked to describe the pain that she had been feeling during MVA by using the same visual analog scale. Visual analog scale was described by: no pain (0 points), slight pain (1-3 points), moderate pain (4-6 points) and severe pain (7-10 points). Patients were followed up for 7 days and were evaluated for complications before leaving the facility and on the 7th day after procedure. A routine USG of lower abdomen was done on 7 th post-evacuation day in all patients, which revealed completeness of the procedure. Informed consent was taken from all the patients. Results: All were first trimester incomplete abortion cases. MVA was performed with para cervical block. Para cervical block reduced pain sensation on cervical dilatation. According to VAS 30 (66.67%) patients had mild pain, 3(6.67%) patients had moderate pain and 12(26.67%) patients had no pain during the procedure. Six (13.33%) patients had mild pain and others had no pain after the procedure. There was no severe pain before or after the procedure. Thirty (75.56%) patients discharged before 4 hours and 11 (24.44%) patients discharged after 4 hours of the procedure. No patients had any complications like pervaginal bleeding, infection or retention of product. The cost was minimum and patient’s satisfaction was high. Conclusion: Paracevical block is effective in reducing pain sensation during MVA with a reasonable cost of the procedure. Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 70-74
目的:确定颈旁阻滞用于MVA宫颈扩张和子宫排空的安全性和有效性。材料和方法:这项描述性(横断面)研究于2016年1月至2016年6月在科米拉Upzilla Health Complex Homna的低资源环境中进行。本研究的目标人群为45名妊娠12周的第1个妊娠期不完全流产患者。所有患者在MVA手术前均接受颈旁阻滞。应用阻滞后3分钟,进行子宫抽吸和排空。所有患者在手术前30分钟使用围术期口服镇痛药(布洛芬)和抗焦虑药(地西泮)。手术前,所有女性都被要求在0-10的视觉模拟量表上评估疼痛程度。手术后30分钟,患者被要求使用相同的视觉模拟量表描述她在MVA期间感受到的疼痛。视觉模拟量表描述为:无疼痛(0分)、轻度疼痛(1-3分)、中度疼痛(4-6分)和重度疼痛(7-10分)。患者接受了7天的随访,并在离开设施前和手术后第7天评估并发症。所有患者在撤离后第7天进行了下腹部常规USG检查,结果表明手术是完整的。所有患者均取得知情同意书。结果:均为妊娠早期不完全流产病例。MVA采用颈旁阻滞。宫颈旁阻滞可减轻扩张术后的疼痛感。根据VAS评分,30名(66.67%)患者有轻度疼痛,3名(6.67%)患者有中度疼痛,12名(26.67%)患者在手术过程中没有疼痛。6名(13.33%)患者在手术后有轻微疼痛,其他患者没有疼痛。手术前后均未出现剧烈疼痛。30名(75.56%)患者在4小时前出院,11名(24.44%)患者在手术4小时后出院。没有患者出现任何并发症,如经阴道出血、感染或产品滞留。费用最低,患者满意度高。结论:颈旁阻滞能有效减轻MVA患者的疼痛感,手术费用合理。孟加拉国妇产科杂志,2016;第31卷(2):70-74
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引用次数: 0
A Ovarian Serous Cyst Adenocarcinoma Presented as Post-Menopausal Bleeding 一例卵巢浆液性囊肿腺癌表现为绝经后出血
Pub Date : 2017-04-01 DOI: 10.3329/bjog.v32i1.56734
Qumrun Nassa Ahmed, K. Nahar, J. Roy, Lima Shompa, Kazi Foyeza Akther, Husne Jahan Sultana, R. Sultana
The various malignant forms of epithelial tumors of the ovary, in practice, are usually grouped together as ovarian adenocarcinoma. These tumors tends to occur in women aged 45-60 years and are commonly asymptomatic until they are achieved a considerable bulk: most common complaints are of increasing abdominal girth, lower abdominal pain or discomfort and the presence of pelvic mass. Urinary symptoms due to pressure on bladder are quite frequent while disturbance of menstrual cycle or post-menopausal bleeding are unusual. Here we present a case of a 60 years old postmenopausal lady with the complaints of post-menopousal bleeding, and heaviness & lump in the lower abdomen. She was clinically diagnosed as a case of ovarian tumor (ovarian malignancy) & went through laparotomy followed by surgical staging. Then TAH with BSO with infracolicomentectomy with pelvic lymphadenectomy was done. Histopathology revealed serous cyst adenocarcinoma (left ovary) without any metastasis to the opposite ovary or any other organs. In our case one of the most common ovarian neoplasm presented with the rarest symptom made the case interesting to report. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 42-44
在实践中,卵巢上皮肿瘤的各种恶性形式通常被归类为卵巢腺癌。这些肿瘤往往发生在45-60岁的女性身上,在达到相当大的体积之前通常没有症状:最常见的症状是腰围增加、下腹疼痛或不适以及盆腔肿块。膀胱压力引起的泌尿系统症状非常常见,而月经周期紊乱或绝经后出血则不常见。本文报告一位60岁的绝经后妇女,其主诉为月经后出血、下腹部沉重和肿块。她被临床诊断为卵巢肿瘤(卵巢恶性肿瘤),并进行了剖腹手术,随后进行了手术分期。然后进行TAH和BSO,并进行结肠下网膜切除术和盆腔淋巴结切除术。组织病理学显示浆液性囊肿腺癌(左卵巢)没有任何转移到对侧卵巢或任何其他器官。在我们的病例中,最常见的卵巢肿瘤之一表现出最罕见的症状,这使该病例值得报道。孟加拉国妇产科杂志,2017;第32卷(1):42-44
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引用次数: 0
Occurrence and Histopathological Patterns of Ovarian Tumours in a Tertiary Hospital 某三级医院卵巢肿瘤的发生及组织病理学特征
Pub Date : 2017-04-01 DOI: 10.3329/bjog.v32i1.56726
S. Begum, F. Begum, Mohammad Hedayetul Islam, S. Haque, Farhana Jahan
Background: Ovarian tumours are common problem in gynaecology and have varied clinical presentation and histopathological appearances. Objectives: This study was undertaken to find out the occurrence and different histopathological types of the tumours originating from the ovaries. Methods: A retrospective study was carried out in the Department of Obstetrics and Gynaecology and Department of Pathology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, between May 2010 and December 2014. Five hundred forty seven (547) cases of ovarian tumours were studied in respect to their histopathological appearance. Results: Out of total gynaecological admission of 5633 patients during the study period, 613 patients admitted with a clinical diagnosis of ovarian tumours: so, the occurrence was 10.9%. Out of 613 patients 547 did histopathology in the department of pathology of our institution. Of the 547 cases, majority were benign (n=379, 69.3%); followed by malignant (n=38, 7%); borderline (n=4, 0.7%); and others (n=126, 23%). Most commonly occurring benign ovarian tumours were serous cystadenoma (115; 30.3%); mature cystic teratoma (76; 20.1%) and mucinous cyst adenoma (66;17.4%). Common malignant tumours were serous cyst adenocarcinoma (21; 55.3%); mucinous cystadenocarcinoma (5; 13.2%) and dysgerminoma(4; 10.5%). Conclusion: Nine out of ten ovarian tumours were nonmalignant. Epithelial tumours were most common among both benign and malignant ovarian tumours. Overall, most common was serous cyst adenoma in benign group and serous cyst adenocarcinoma in malignant group. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 5-9
背景:卵巢肿瘤是妇科常见的疾病,具有多种临床表现和组织病理表现。目的:探讨卵巢肿瘤的发生及不同的组织病理类型。方法:2010年5月至2014年12月在达卡萨里穆拉爵士医学院和米特福德医院的妇产科和病理学部进行回顾性研究。本文对547例卵巢肿瘤的病理组织学表现进行了研究。结果:在研究期间妇科住院5633例患者中,临床诊断为卵巢肿瘤的有613例,发生率为10.9%。在613例患者中,547例在我院病理科做了组织病理学检查。547例中,绝大多数为良性(n=379, 69.3%);其次为恶性(n= 38.7%);边缘性(n=4, 0.7%);其他(n=126, 23%)。最常见的良性卵巢肿瘤是浆液性囊腺瘤(115;30.3%);成熟囊性畸胎瘤(76;20.1%)和粘液囊肿腺瘤(66例;17.4%)。常见恶性肿瘤为浆液囊肿腺癌(21例;55.3%);粘液囊腺癌(5例;13.2%)和生殖细胞异常瘤(4%;10.5%)。结论:10例卵巢肿瘤中有9例是非恶性的。上皮性肿瘤在良性和恶性卵巢肿瘤中最常见。总体而言,良性组以浆液囊肿腺瘤最为常见,恶性组以浆液囊肿腺癌最为常见。孟加拉国妇产科杂志,2017;Vol. 32(1): 5-9
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引用次数: 0
Evaluation of Osteopenia and Osteoporosis among Female Doctors 女性医生骨质疏松症和骨质疏松症的评价
Pub Date : 2017-04-01 DOI: 10.3329/bjog.v32i1.56730
Setara Binte Kasem, F. Begum, Shaikh Abdur Razzaque, Raisa Adiba, Selma Anika
Osteopenia and Osteoporosis are increasing health care problems due to increased life expectancy. Women are specially vulnerable to osteoporosis at their later ages of lives. Among the working population of Bangladesh, female doctors make a big contribution for nation, so focusing on their wellbeing is very much important. In this study BMD (Bone Mineral density) were measured among 80 female doctors Objective: To find out the Bone Mineral Density (BMD) among working female doctors of Bangladesh. Materials and Methods: A cross sectional study was conducted on 80 female doctors aged between 25-80 years at their reproductive, premenopausal and postmenopausal age group, at a conference venue over a period of two days. Measurement of bone mineral density was done by quantitative ultrasound densitometry1. Result: Majority of women were between 30-64 years of age; 71(88.75%) women had normal BMD, 9(11.25%) women had osteopenia and none of them had osteoporosis. Among women with age between 25-44 years age (total 30) none was suffering from osteopenia or osteoporosis. Between 45-64 years (total 47), 8(17.02%) were suffering from osteopenia and between 65-80 years (total 3), 1(33.33%) was suffering from osteopenia. Nobody had osteoporosis. Conclusion: Among the working female gynaecologists of Bangladesh there were no osteopenia or osteoporosis in reproductive and premenopausal (25-44 years) age group.Only 17.04% of premenopausal women and women at early menopause ( 45-64 years) suffer from osteopenia and 33.33% of women at late menopause (65-80years) had osteopenia. None had osteoporosis. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 25-28
由于预期寿命的延长,骨质疏松症和骨质疏松症正在增加医疗保健问题。妇女在晚年特别容易患骨质疏松症。在孟加拉国的劳动人口中,女医生为国家做出了巨大贡献,所以关注她们的健康非常重要。本研究测量了80名女医生的骨密度。目的:了解孟加拉国在职女医生的骨骼密度。材料和方法:在一个会议场所对80名年龄在25-80岁之间的女性医生进行了为期两天的横断面研究,她们属于生殖、绝经前和绝经后年龄组。骨密度的测量是通过定量超声密度计1进行的。结果:大多数女性年龄在30-64岁之间;71名(88.75%)女性BMD正常,9名(11.25%)女性骨质减少,无骨质疏松症。年龄在25-44岁(共30岁)的女性中,没有一人患有骨质减少或骨质疏松症。在45-64岁(共47岁)之间,8人(17.02%)患有骨质减少症,在65-80岁(共3人)之间,1人(33.33%)患有骨质减轻症。没有人患有骨质疏松症。结论:在孟加拉国的职业女性妇科医生中,生殖和绝经前(25-44岁)年龄组没有骨质减少或骨质疏松症。只有17.04%的绝经前妇女和绝经早期(45-64岁)妇女患有骨质减少症,33.33%的绝经晚期(65-80岁)妇女骨质减少症。没有人患有骨质疏松症。孟加拉国妇产科杂志,2017;第32卷(1):25-28
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引用次数: 0
Society News Vol. 32(1) 社会新闻第32卷(1)
Pub Date : 2017-04-01 DOI: 10.3329/bjog.v32i1.56737
F. Begum
Abstract not available Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 50-52
摘要不可用孟加拉国妇产科杂志,2017;第32卷(1):50-52
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引用次数: 0
BJOG yearly CME program Vol. 32(1) 北京奥组委CME年度计划第32卷(1)
Pub Date : 2017-04-01 DOI: 10.3329/bjog.v32i1.56739
F. Begum
Abstract not available Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 55-57
摘要不可用孟加拉国妇产科杂志,2017;第32卷(1):55-57
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引用次数: 0
Iatrogenic Genitourinary Fistula: A Rising Trend 医源性泌尿生殖系统瘘:上升趋势
Pub Date : 2017-04-01 DOI: 10.3329/bjog.v32i1.56727
Taufiqua Hussain, Afrina Begum, N. Akhter, T. Ghani, -. Noorjahan, Dina Layla Hossain, Gul a Anar
Background:Obstetric fistula (OF) is not very uncommon in our country. But recent issue of increase in iatrogenic fistula (IF) creates a field of interest. Objective:To find out the frequency and the cause of iatrogenic genitourinary fistula admitted in National Fistula Centre (NFC), Dhaka. Methods:This prospective study was conducted in NFC, Dhaka from January, 2010 to December, 2012. All cases admitted during the study period were included in this study. All patients were evaluated through detailed history, physical examination, relevant investigations and examination under anaesthesia (EUA). Repair was done through abdominal or vaginal route based on the findings. Results of repair were noted and analyzed. Results:On an average more than 20% cases of genitourinary fistula (GUF) were due to iatrogenic causes. Among them about 90% cases had history of hysterectomy as an offending procedure. A rising trend of iatrogenic fistula is observed with 19.04% in 2010, 15.68% in 2011 and 30% in 2012. Conclusion:This study shows that iatrogenic injuries in women under 40 years of age form major share in the aetiology of GUF. Iatrogenic fistula are increasing day by day. It is the time to check the experience of surgeons doing the gynecological and obstetrical surgeries in a developing country like ours. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 10-13
背景:产科瘘管在我国并不罕见。但最近医源性瘘管(IF)增加的问题引起了人们的兴趣。目的:了解达卡国家瘘管病中心(NFC)收治的医源性泌尿生殖瘘的发生频率和原因。方法:本前瞻性研究于2010年1月至2012年12月在达卡NFC进行。研究期间收治的所有病例均纳入本研究。所有患者均通过详细病史、体格检查、相关调查和麻醉检查(EUA)进行评估。根据研究结果,通过腹部或阴道途径进行修复。记录并分析修复结果。结果:平均超过20%的泌尿生殖道瘘是由医源性原因引起的。其中约90%的病例有子宫切除术的病史。医源性瘘管呈上升趋势,2010年为19.04%,2011年为15.68%,2012年为30%。结论:本研究表明,40岁以下女性的医源性损伤在GUF的病因中占主要份额。医源性瘘管病日益增多。现在是检查外科医生在像我们这样的发展中国家做妇科和产科手术的经验的时候了。孟加拉国妇产科杂志,2017;第32卷(1):10-13
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引用次数: 0
Management of Super-Obese Pregnancy – A Successful Outcome 超级肥胖妊娠的管理——一个成功的结果
Pub Date : 2017-04-01 DOI: 10.3329/bjog.v32i1.56735
A. Begum, A. Maruf, Sm Shahida
Pregnancy associated with obesity is a challenge1.When surgical delivery is indicated that present a unique challenge2. A case of pregnancy with morbid obesity with a successful outcome is presented here.Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 45-47
与肥胖相关的妊娠是一个挑战1。当需要手术分娩时,这是一个独特的挑战2。本文介绍了一例妊娠合并病态肥胖并取得成功的病例。孟加拉国妇产科杂志,2017;第32卷(1):45-47
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引用次数: 0
Association of Serum Cystatin C with Pre-eclampsia: A Case Control Study 血清半胱氨酸蛋白酶抑制剂C与子痫前期的相关性:一项病例对照研究
Pub Date : 2017-04-01 DOI: 10.3329/bjog.v32i1.56731
N. Akhter, F. Deeba, B. Nasrin, S. B. Chowdhury
Background: Cystatin C, an endogenous marker of renal function, which increases in pregnancy as more so in pre-eclampsia, studies show it may be marker of pre-eclampsia. Objective (s): The objective of the present work was to investigate the association between serum cystatin C levels in normal and pre-eclamptic pregnancy. Methods and material: This case control study was conducted in the department of obstetrics and gynaecology in three tertiary care hospitals of Dhaka city (BSMMU, DMC, BIRDEM ) during the period from January 2009 to December 2010. A total 240 women of 20-40 wks of pregnancy were enrolled in the study. One hundred and twenty four women of pre-eclampsia were recruited as case and 116 healthy pregnant women were enrolled as control. Serum cystatin C was measured in both case and control by a fully automated particle-enhanced immune-turbidimetric assay for cystatin C in undiluted samples. Serum cystatin C level was compared between the groups. P value reached from unpaired student t-test and chi square test by analyzing the data. P value less than 0.05 was considered to be significant. Results: The mean (±SD) serum cystatin C levels in case group was 1.17±0.34 mg/lranged from 0.1-2.2 mg/l. In control groups the mean (±SD) serum cystatin C level was 0.87±0.31 mg/l, ranged from 0.24-1.98 mg/l, which was significantly higher (p<0.001) in case. There was statistically significant association between serum cystatin C and pre-eclampsia. Serum Cystatin C level >1mg/l was found in more than half (69%) of the cases compared to 25% of the control group (p<0.001). Computation of odds ratio reveals that the cases had 6.79 times higher risk of having pre-eclampsia than that of the control group (p<0.001). Conclusion: There is significant association between pre-eclampsia and serum cystatin C Bangladesh J Obstet Gynaecol, 2017; Vol. 32(1): 29-32
背景:半胱氨酸蛋白酶抑制剂C是一种内源性肾功能标志物,在妊娠期会增加,在子痫前期也会增加,研究表明它可能是子痫前期的标志物。目的:本研究的目的是探讨正常妊娠和子痫前期妊娠血清胱抑素C水平之间的关系。方法和材料:本病例对照研究于2009年1月至2010年12月在达卡市三家三级护理医院(BSMMU、DMC、BIRDEM)的妇产科进行。共有240名怀孕20-40周的女性参与了这项研究。124名先兆子痫妇女作为病例,116名健康孕妇作为对照。通过全自动颗粒增强免疫浊度法测定未稀释样品中的胱抑素C,测量病例和对照组的血清胱抑素C。比较两组血清胱抑素C水平。通过对数据的分析,得出未配对学生t检验和卡方检验的P值。P值小于0.05被认为是显著的。结果:病例组血清胱抑素C的平均水平(±SD)为1.17±0.34mg/l,高于0.1~2.2mg/l。对照组血清胱抑素C的平均(±SD)水平为0.87±0.31mg/l,显著高于对照组的25%(p<0.001)(超过一半(69%)的病例中发现p1mg/l)。比值比计算显示,这些病例患先兆子痫的风险是对照组的6.79倍(p<001)。结论:先兆子痫与血清胱抑素C Bangladesh J Obstet Gynaecol之间存在显著相关性,2017年;第32卷(1):29-32
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引用次数: 0
期刊
Bangladesh Journal of Obstetrics and Gynecology
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