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Objective@#To investigate the prenatal ultrasonographic features and prognosis of vasa previa, to explore the application value of sector scanning in the intracervical mouth by antenatal ultrasound, then to increase vasa previa detection rate.@*Methods@#Prenatal ultrasound images, clinical characteristics and pregnancy outcome of 35 pregnant women with vasa previa confirmed by surgery and pathology were analyzed retrospectively, the diagnostic effectiveness of sector scanning in the intracervical mouth was evaluated.@*Results@#Thirty-three of the 35 vasa previa cases were detected by sector scanning in the intracervical mouth, with a detection rate of 94.3% (33/35). Of the 35 cases, 20 cases (60.6%) were first contacted in second trimester and 13 cases (39.4%) were first contacted in third trimester. Two cases were missed or misdiagnosed, which were all first contact in third trimester. Among the 35 cases, 25 were velamentous placenta and 4 were battledore placenta. Twenty cases were low-lying placenta or marginal placenta previa. All 35 women underwent cesarean section. No neonatal mortality, 11 term infants, 20 premature infants of more than 34 weeks and 4 premature infants of less than 34 weeks. All placentas underwent pathological examination after delivery, 4 cases placentas underwent vascular casting, and it was found that 2 cases were vasa previa of umbilical artery branch and 2 cases were vasa previa of allantoic veins branch.@*Conclusions@#Vasa previa can be effectively detected by prenatal ultrasonography through sector scanning in the intracervical mouth. Second trimester is the best period to detect vasa previa. Pathomorphological examination on placenta after delivery and vascular casting are helpful to the understanding of vasa previa.
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Objective To investigate the prenatal ultrasonographic features and prognosis of vasa previa,to explore the application value of sector scanning in the intracervical mouth by antenatal ultrasound,then to increase vasa previa detection rate.Methods Prenatal ultrasound images,clinical characteristics and pregnancy outcome of 35 pregnant women with vasa previa confirmed by surgery and pathology were analyzed retrospectively,the diagnostic effectiveness of sector scanning in the intracervical mouth was evaluated.Results Thirty-three of the 35 vasa previa cases were detected by sector scanning in the intracervical mouth,with a detection rate of 94.3 ％ (33/35).Of the 35 cases,20 cases (60.6 ％) were first contacted in second trimester and 13 cases (39.4％) were first contacted in third trimester.Two cases were missed or misdiagnosed,which were all first contact in third trimester.Among the 35 cases,25 were velamentous placenta and 4 were battledore placenta.Twenty cases were low-lying placenta or marginal placenta previa.All 35 women underwent cesarean section.No neonatal mortality,11 term infants,20 premature infants of more than 34 weeks and 4 premature infants of less than 34 weeks.All placentas underwent pathological examination after delivery,4 cases placentas underwent vascular casting,and it was found that 2 cases were vasa previa of umbilical artery branch and 2 cases were vasa previa of allantoic veins branch.Conclusions Vasa previa can be effectively detected by prenatal ultrasonography through sector scanning in the intracervical mouth.Second trimester is the best period to detect vasa previa.Pathomorphological examination on placenta after delivery and vascular casting are helpful to the understanding of vasa previa.
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<p><b>OBJECTIVE</b>To evaluate the efficacy on hemiplegic spasticity after cerebral infarction treated with plum blossom needle tapping therapy at the key points and Bobath therapy.</p><p><b>METHODS</b>Eighty patients were collected, in compliance with the inclusive criteria of hemiplegic spasticity after cerebral infarction, and randomized into an observation group and a control group, 40 cases in each one. In the control group, Bobath manipulation therapy was adopted to relieve spasticity and the treatment of 8 weeks was required. In the observation group, on the basis of the treatment as the control group, the tapping therapy with plum blossom needle was applied to the key points, named Jianyu (LI 15), Jianliao (LI 14), Jianzhen (SI 9), Hegu (LI 4), Chengfu (BL 36), Zusanli (ST 36), Xiyangguan (GB 33), etc. The treatment was given for 15 min each time, once a day. Before treatment, after 4 and 8 weeks of treatment, the Fugl-Meyer assessment (FMA) and Barthel index (BI) were adopted to evaluate the motor function of the extremity and the activity of daily life in the patients of the two groups separately. The modified Ashworth scale was used to evaluate the effect of anti-spasticity.</p><p><b>RESULTS</b>In 4 and 8 weeks of treatment, FMA: scores and BI scores were all significantly increased as compared with those before treatment in the two groups: (both P<0. 05). The results in 8 weeks of treatment in the observation group were significantly better than those in the control group (all P<0. 05). In 4 and 8 weeks of treatment, the scores of spasticity state were improved as compared with those before treatment in the patients of the two groups (all P<0. 05). The result in 8 weeks of treatment in the observation group was significantly better than that in the control group (P<0. 05). In 8 weeks of treatment, the total effective rate of anti-spasticity was 90. 0% (36/40) in the observation group, better than 75. 0% (30/40) in the control group (P<0. 05).</p><p><b>CONCLUSION</b>The tapping therapy with plum blossom needle at the key points combined with Bobath therapy effectively relieves hemiplegic spasticity in the patients of cerebral infarction and improves the motor function of extremity and the activity of daily life.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Acupuncture Therapy , Cerebral Infarction , Combined Modality Therapy , Muscle Spasticity , Rehabilitation , Therapeutics , Treatment OutcomeABSTRACT
Objective To evaluate the effects of exercise therapy for patients with difficult weaning using mechanical ventilation.Methods A total of 63 patients with difficult weaning using mechanical ventilation were randomly divided into the experimental group(33 cases) and the control group(30 cases).The patients in the control group received routine respiratory care,however,the patients in the experimental group received gradual and individualized exercise therapy according to patients' condition and physical strength.The items such as the tidal volume,respiratory rate,PaO2/FiO2 were compared between two groups.Results Compared with the control group,the tidal volume,respiratory rate,PaO2/FiO2 and the score of APACHE Ⅱ were better in the experimental group on the 21th and 28th day after mechanical ventilation,the heart rate was better in the experimental group on the 28th day after mechanical ventilation.In addition,the duration of mechanical ventilation and ICU hospitalization was shorter in the experimental group.But the rate of complications showed no significant difference.Conclusions Exercise therapy has a positive effect on patients with difficult weaning using mechanical ventilation.