OBJECTIVE: To probe into the clinical manifestation, diagnosis, as well as treatment of pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester. METHODS: Analysis of 14 p...OBJECTIVE: To probe into the clinical manifestation, diagnosis, as well as treatment of pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester. METHODS: Analysis of 14 patients with pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester was made after conservative treatment by drugs from January 1996 to December 1999. RESULTS: The 14 patients with a pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester were painless, had slight vaginal bleeding, and concurrently had increased serum beta-subunit human chorionic gonadotropin (beta-HCG). Doppler ultrasonic examination revealed an obvious enlargement of the previous cesarean section cicatrix in the uterine isthmus, and found a gestational sac or mixed mass attached to the cicatrice, with a very thin myometrium between the gestational sac and bladder walls. Among the 14 patients, 12 patients had crystalline trichosanthes injected into the cervix, mifepristone taken orally, or methotrexate in the form of intramuscular injection. Following this procedure, their serum beta-HCG dropped to normal. The other 2 patients had a total hysterectomy. CONCLUSIONS: Pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester is a complication of cesarean section. Early diagnosis and effective conservative treatment by drugs are instrumental in decreasing the potential occurrence of uterine rupture, which is also conducive to preserving the patient's future fertility.展开更多
缝合是外科的基本操作,随着公众对于瘢痕的认识不断加深,临床中对美容缝合技术的需求日益增加,而减张缝合是实现美容缝合的重要途径之一。本文系统综述了减张缝合技术的原理,常用方法及各方法的适应症,重点探讨了LBD减张缝合(looped,bro...缝合是外科的基本操作,随着公众对于瘢痕的认识不断加深,临床中对美容缝合技术的需求日益增加,而减张缝合是实现美容缝合的重要途径之一。本文系统综述了减张缝合技术的原理,常用方法及各方法的适应症,重点探讨了LBD减张缝合(looped,broad,and deep buried suturing technique)、合肥缝合法、章氏超减张缝合、皮下心形缝合等技术的操作要点、优势及应用范围。同时,还介绍了超减张缝合在面部外伤修复、体表肿物切除及瘢痕修复等整形美容手术中的应用,旨在为整形美容外科医生提供相应的技术参考,推动超减张缝合技术在整形美容领域的更广泛应用和进一步发展。通过系统检索PubMed、Web of Science、IEEE Xplore及CNKI数据库(2015-2025年),采用复合关键词(“suture”or“suture method”)联合功能化术语(“scar”),限定文献类型为临床研究、临床试验、Meta分析、多中心研究或观察性研究。初筛共获得2262篇文献,经去重及标题/摘要筛选后,根据纳入与排除标准①纳入前瞻性、回顾性临床研究、多中心临床研究,Meta分析以及与缝合方法密切相关的基础研究;②研究主题聚焦整形外科缝合技术;③中、英文全文可获取,最终纳入246篇核心文献进行综述。结果表明,在选择伤口缝合材料和缝合技术时,必须考虑许多因素,包括伤口张力、伤口边缘外翻的期望、所需的止血、修复类型、患者护理伤口和返回拆线的能力、皮肤完整性和伤口位置。仔细考虑这些因素并正确执行缝合技术是获得理想美容效果的重要保障。展开更多
文摘OBJECTIVE: To probe into the clinical manifestation, diagnosis, as well as treatment of pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester. METHODS: Analysis of 14 patients with pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester was made after conservative treatment by drugs from January 1996 to December 1999. RESULTS: The 14 patients with a pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester were painless, had slight vaginal bleeding, and concurrently had increased serum beta-subunit human chorionic gonadotropin (beta-HCG). Doppler ultrasonic examination revealed an obvious enlargement of the previous cesarean section cicatrix in the uterine isthmus, and found a gestational sac or mixed mass attached to the cicatrice, with a very thin myometrium between the gestational sac and bladder walls. Among the 14 patients, 12 patients had crystalline trichosanthes injected into the cervix, mifepristone taken orally, or methotrexate in the form of intramuscular injection. Following this procedure, their serum beta-HCG dropped to normal. The other 2 patients had a total hysterectomy. CONCLUSIONS: Pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester is a complication of cesarean section. Early diagnosis and effective conservative treatment by drugs are instrumental in decreasing the potential occurrence of uterine rupture, which is also conducive to preserving the patient's future fertility.
文摘缝合是外科的基本操作,随着公众对于瘢痕的认识不断加深,临床中对美容缝合技术的需求日益增加,而减张缝合是实现美容缝合的重要途径之一。本文系统综述了减张缝合技术的原理,常用方法及各方法的适应症,重点探讨了LBD减张缝合(looped,broad,and deep buried suturing technique)、合肥缝合法、章氏超减张缝合、皮下心形缝合等技术的操作要点、优势及应用范围。同时,还介绍了超减张缝合在面部外伤修复、体表肿物切除及瘢痕修复等整形美容手术中的应用,旨在为整形美容外科医生提供相应的技术参考,推动超减张缝合技术在整形美容领域的更广泛应用和进一步发展。通过系统检索PubMed、Web of Science、IEEE Xplore及CNKI数据库(2015-2025年),采用复合关键词(“suture”or“suture method”)联合功能化术语(“scar”),限定文献类型为临床研究、临床试验、Meta分析、多中心研究或观察性研究。初筛共获得2262篇文献,经去重及标题/摘要筛选后,根据纳入与排除标准①纳入前瞻性、回顾性临床研究、多中心临床研究,Meta分析以及与缝合方法密切相关的基础研究;②研究主题聚焦整形外科缝合技术;③中、英文全文可获取,最终纳入246篇核心文献进行综述。结果表明,在选择伤口缝合材料和缝合技术时,必须考虑许多因素,包括伤口张力、伤口边缘外翻的期望、所需的止血、修复类型、患者护理伤口和返回拆线的能力、皮肤完整性和伤口位置。仔细考虑这些因素并正确执行缝合技术是获得理想美容效果的重要保障。
