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Jingdong book

宫腔镜学及图谱(第3版)

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宫腔镜学及图谱,自出版以来,就受到妇科和宫腔镜从业人员的喜爱,此次是第3版,收集了zui新的图片与资料,再现了各类典型病例,便于读者理解和掌握。本书是医学院校师生和各级医疗单位临床妇科医护人员不可多得的优秀参考专著。
Content Description

《宫腔镜学及图谱(第3版)》共分十六章,系统介绍宫腔镜技术的发展史、宫腔镜的设备和器械、宫腔镜应用解剖及组织学、膨宫介质及灌流系统、手术的麻醉等;重点阐述宫腔镜诊断和宫腔镜手术在妇科疾病中的应用,以及宫腔镜与腹腔镜联合手术、超声监控下的宫腔镜手术;并对宫腔镜手术的技术培训和未来发展趋势做了精辟的论述。书后还附有宫腔镜检查报告单、宫腔镜中心病房医嘱常规、宫腔镜手术前签字单、宫腔镜电切术操作手册,有助于读者结合实际情况规范宫腔镜检查、诊断和手术治疗。本书本书注重理论与实际相结合,科学、严谨。书中的700余幅彩色图片清晰地再现了各类典型病例,便于读者理解和掌握,可供医学院校的师生和各级医疗单位的临床妇科医护人员学习和参考。
Author Description

夏恩兰教授,1955年毕业于西北医学院,从事妇产科临床、教学、科研工作50余年。现任首都医科大学妇产科教授,硕士研究生导师,首都医科大学附属复兴医院宫腔镜诊治中心主任,北京国际宫腔镜培训中心主任,美国妇科腹腔镜医师协会会员,国际妇科内镜协会终身会员,《中华妇产科杂志》《中国实用妇科与产科杂志》《实用妇产科杂志》《国外医学:妇产科学分册》等杂志编委。获卫生部、北京市科委、北京市卫生局及西城区政府等各级科技进步奖22项,于1992年开始享受政府特殊津贴。在她的推动下,“宫腔镜技术”2000年被列为我国卫生部十年百项推广项目和2001年、2003年的重点推广项目。《宫腔镜的临床应用与基础研究》获2004年度国家科技进步二等奖。
Catalogue

第一章 宫腔镜技术的发展史
第二章 宫腔镜的设备和器械
第一节 宫腔镜的设备
第二节 宫腔镜检查、治疗的器械
第三节 宫腔镜手术的器械
第四节 宫腔镜的清洁、消毒和保养
第三章 宫腔镜应用解剖及组织学
第四章 宫腔镜术前预处理用药及妇科常用药物对子宫内膜的影响
第五章 宫腔镜手术中高频电的应用及其对组织的热效应
第六章 宫腔镜的膨宫介质
第七章 宫腔镜手术的麻醉
第八章 宫腔镜诊断
第一节 宫腔镜检查术
第二节 宫腔镜诊断在妇科疾病的应用
第九章 宫腔镜手术
第一节 宫腔镜电切术总论
第二节 子宫内膜切除术及子宫内膜去除术
第三节 宫腔镜子宫肌瘤切除术
第四节 宫腔镜子宫内膜息肉切除术
第五节 宫腔镜子宫畸形矫形术
第六节 宫腔镜宫腔粘连切除术
第七节 宫腔镜宫腔异物取出术
第八节 其他宫腔镜电切术
第九节 其他方法的子宫内膜去除术
第十章 宫腹腔镜联合手术
第十一章 超声监导宫腔镜手术
第十二章 宫腔镜手术并发症
第一节 脏器损伤
第二节 体液超负荷
第三节 术中及术后出血
第四节 感染
第五节 静脉空气栓塞
第六节 宫腔粘连
第七节 妊娠
第八节 子宫内膜去除-输卵管绝育术后综合征
第九节 电意外损伤
第十节 其他并发症
第十三章 宫腔镜的其他用途
第十四章 宫腔镜手术的培训
第十五章 宫腔镜手术的未来
第十六章 内窥镜影像的数字化存储与应用
附录
附一 宫腔镜中心病房医嘱常规
附二 实用宫腔镜电切术操作手册
附三 宫腔镜手术知情同意书
附四 宫腔镜检查术知情同意书
附五 宫腔镜B超联合检查手术报告单
索引

Introduction

2008年第2版《宫腔镜学及图谱》出版,至今已经6年了。在此期间宫腔镜的临床应用进展快速。宫腔镜检查和定位活检是现代诊断宫腔内病变的金标准,宫腔镜手术创伤比值小,效价比值高,疗效有不可替代性等理念得到普遍认可,被誉为现代微创手术成功的典范,成为妇科常用的四大基本手术(宫腔镜、腹腔镜、开腹、阴式)之一。6年来发表的有关宫腔镜文稿,检索:“清华同方数据库”共7 925篇,Medline1 520篇。足见宫腔镜领域的学术之活跃,应用之广泛。今就撰写第3版《宫腔镜学及图谱》之际,参考近些年来国内外的基础研究和临床应用进展,结合我中心自己的实践经验,进行了增添和修改。希望对学习、掌握和开展宫腔镜技术及教学有所裨益。
全书共十六章,66万余字,收录760帧照片。修改的内容为第二章第四节宫腔镜的清洁、消毒和保养。第2版介绍的是宫腔镜器械消毒方法,包括抑菌和灭菌方法。第3版介绍的是宫腔镜器械灭菌方法,抑菌方法已经淘汰。新增内容包括:①子宫畸形的新分类:2013年欧洲人类生殖和胚胎学会(European Society of Human Reproduction and Embryology, ESHRE)和欧洲妇科内镜学会(European Society for Gynaecological Endoscopy, ESGE)联合发布的新女性生殖系统发育异常的分类方法。此分类方法简单易记,实用性强,得到许多临床医师的肯定。②罕见畸形子宫的矫形手术:包括斜隔子宫、完全双角子宫、单角子宫和“T”型子宫。宫腔镜子宫壁切开术(Transcervical uterine incision,TCUI)是切除位于子宫侧壁过多的肌肉组织,或切开一侧或两侧壁肥厚的肌层,改善子宫形态,扩展宫腔面积,减轻宫内压,改善子宫内膜血流,以利于受精卵着床及防止流产,改善生殖预后。宫腹腔镜联合完全双角子宫融合术是在腹腔镜监护下,用宫腔电切镜切开子宫内隔板和子宫底,达浆膜层,形成人工穿孔,然后在腹腔镜下横向切开宫底全层,再将创面纵向缝合,使宫腔形态正常,增加生育机会。这些合并不孕的畸形子宫在首都医科大学附属复兴医院宫腔镜诊治中心矫形后,均有生育健康婴儿者。③子宫腺肌病诊治的进展:包括宫腔镜的镜下所见,有可能早期诊断此症;囊性子宫腺肌病的宫腔镜手术治疗替代子宫体或部分子宫切除,为患者赢得生育机会;间苯三酚窄带成像宫腔镜、左炔诺孕酮宫内缓释系统 ( Levonorgestrel releasing intrauterine system,LNG-IUS,商品名曼月乐) 与GnRH-a和宫腔镜子宫内膜电切术(TCRE)联合应用治疗子宫腺肌病,可巩固GnRH-a及TCRE的疗效,满足患者保留子宫的愿望。④弥漫性子宫肌瘤病的经宫颈切除子宫肌瘤切除术,术后2~3个月子宫内膜修复,月经改善率为93.5%,复发率为32.3%,有生育者。⑤经宫颈宫腔粘连切除术(TCRA)术后再粘连的预防:对术后的激素治疗、宫内球囊放置、人类羊膜宫腔植入、宫腔内透明质酸钠凝胶注入、预防性抗生素的应用及宫腔镜二探等辅助治疗方法进行了探讨。⑥窄带成像(narrow band imaging,NBI)宫腔镜:利用血红蛋白对特定波长光的吸收特性,增强黏膜浅层血管的对比度,更好地显现黏膜的细微结构,以利于识别黏膜的不典型病变,用于宫腔镜,可以早期发现子宫黏膜病变,定位活检,提高子宫内膜癌前病变和子宫内膜癌的发现率。⑦间苯三酚宫颈预处理:间苯三酚为亲肌性非阿托品非罂粟碱类纯平滑肌解痉药,应用于宫腔镜检查及手术,有止痛和松弛宫颈的效果。⑧静脉空气栓塞可导致气体进入左心的反向栓塞:2008年Rademaker等用实例首次报道栓塞的气体经过房室间隔缺损、未闭的卵圆孔、肺动静脉畸形或动静脉瘘由右心进入左心,从而形成致命的反向栓塞。
感谢在编辑此书过程中,帮助我们的本院科研处李菁、钟勤处长和支持我们的前日本Olympus销售服务有限公司外科部刘学刚先生、何百江先生和现任张震女士;感谢我科全体同仁、进修医生、研究生们的通力合作!
由于水平有限,错误和不足之处,还望读者指正和原谅!
夏恩兰

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