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临床诊疗指南·辅助生殖技术与精子库分册

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《辅助生殖技术与精子库分册:临床诊疗指南》共17章,分辅助生殖技术管理、临床、实验室和精子库四篇。管理部分内容主要涉及辅助生殖技术伦理要求和原则、行为准则、知情同意、随访和病案管理等各项规章制度;临床部分除阐述了导致不孕症的各种疾病的诊治方案和原则外,还包含了人工授精、体外受精一胚胎移植及其各类衍生技术的适应证和禁忌证、术前准备、治疗周期准备、手术方法和步骤,以及辅助生殖技术并发症及其诊治原则;实验室部分说明了辅助生殖技术实验室设置及技术人员基本要求、质量控制标准等;精子库部分说明了精子库设置要求、供者/自身精液的冷冻保存与管理。
本指南受973项目“胚胎操作安全性评估研究”支持,由全国生殖医学专家组成的编委会集国内外先进的诊疗方案和原则、结合我国实际、遵循卫生部有关条例规定编写而成,系我国第一部辅助生殖技术-9精子库临床诊疗指南。其作为我国相关行业日常工作必备的参考书之一,希望能规范各级各类相关从业或管理人员、单位的医疗及工作行为,为广大不孕家庭提供优质的辅助生殖服务。
Catalogue

第一篇 管理部分
第一章 人类辅助生殖技术伦理要求
第一节 人类辅助生殖技术伦理委员会
第二节 伦理决议形成
第三节 人类辅助生殖技术伦理规范
第四节 医患关系与伦理
第五节 科学研究与伦理

第二章 人类辅助生殖技术规章制度
第一节 实施技术人员的行为准则
第二节 临床工作人员要求和常规工作制度
第三节 实验室工作人员要求和常规工作制度
第四节 知情同意制度
第五节 随访制度
第六节 病案管理制度

第二篇 临床部分
第三章 不孕症的检查步骤与诊断
第一节 女性不孕的检查步骤与诊断
第二节 男性不育的检查与诊断

第四章 不孕症治疗方法
第一节 药物治疗
第二节 手术治疗
第三节 辅助生殖技术

第五章 人工授精
第一节 适应证和禁忌证
第二节 人工授精前的准备
第三节 人工授精方法
第四节 人工授精的并发症

第六章 体外受精与胚胎移植及其衍生技术
第一节 常规体外受精与胚胎移植
第二节 配子、合子或胚胎输卵管内移植
第三节 卵细胞浆内单精子注射
第四节 植入前胚胎遗传学诊断
第五节 卵子赠送
第六节 人类配子、胚胎的冷冻和复苏
第七节 囊胚培养
第八节 辅助孵化

第七章 辅助生殖技术并发症及其诊治原则
第一节 卵巢过度刺激综合征
第二节 多胎妊娠
第三节 异位妊娠
第四节 取卵后出血与感染
第五节 脏器损伤
第六节 卵巢扭转
第七节 胚胎移植后的阴道出血

第八章 特殊疾病的不孕症诊治
第一节 输卵管阻塞及盆腔炎性疾病后遗症
第二节 盆腔或子宫内膜结核
第三节 子宫内膜异位症
第四节 多囊卵巢综合征
第五节 卵巢低反应
第六节 先天性卵巢发育不良和卵巢早衰
第七节 下丘脑、垂体和卵巢性闭经
第八节 闭经溢乳综合征或高泌乳素血症
第九节 不明原因不孕
第十节 复发性流产
第十一节 染色体异常
第九章 辅助生殖技术的护理常规

第三篇 辅助生殖技术实验室
第十章 实验室设置及技术人员基本要求
第一节 人工授精实验室设置及要求
第二节 体外受精实验室设置及要求
第三节 植入前遗传学诊断实验室的设置及要求
第四节 辅助生殖医学中男性学实验室设置及要求
第五节 辅助生殖血清激素检测实验室的设置及要求
第六节 技术人员基本要求

第十一章 实验室质量控制
第一节 胚胎培养环境的质量控制
第二节 培养系统质量控制的方法及指标

第十二章 实验室单项技术
第一节 精液分析和处理
第二节 卵子的收集及评估
第三节 受精
第四节 胚胎培养
第五节 移植和冻融胚胎的选择
第六节 胚胎辅助孵化
第七节 胚胎冷冻及解冻
第八节 植入前遗传学诊断
第十三章 实验室特殊情况处理

第四篇 人类精子库
第十四章 人类精子库设置及基本要求
第一节 建立人类精子库的目的
第二节 人类精子库的伦理原则
第三节 人类精子库的准入标准
第四节 人类精子库的制度化管理体系

第十五章 供者精液的冷冻保存与管理
第一节 供精者的筛查
第二节 供者精液冷冻与质量控制
第三节 供者冷冻精液保存与对外供应
第四节 治疗结局的随访、数据管理与咨询服务

第十六章 自存精液的冷冻保存与管理
第一节 自存精液冷冻保存的适应证与禁忌证
第二节 自存精液的精子冷冻、保存方法与质量控制
第三节 自存精液的冷冻保存管理的基本要求

第十七章 辅助生殖技术中的男科临床与实验室
第一节 男科在辅助生殖中的作用与职责
第二节 辅助生殖医学中心男科与实验室设置的基本要求
第三节 男性不育的检查与诊断
第四节 男性不育的实验室检查
第五节 男性不育的诊断与处理
附录供精知情同意书
Book Abstract

为促进生殖医学安全、有效和健康地开展,保障不孕夫妇和出生子代的健康,维护家庭和社会的稳定,以及更有序地在临床实施各种人类辅助生殖技术和在相关的医疗活动中进行各种医学研究,每个医疗机构的辅助生殖医学中心必须成立专门的生殖医学伦理委员会。生殖医学伦理委员会的主要职责是监督、审查、指导生殖医学中心各项医疗和科研活动中的伦理、法律和社会心理等工作。生殖医学伦理委员会工作的目的在于促使人类生殖技术造福于人类的同时,最大限度地减少可能对社会和家庭所带来的不利影响。生殖医学伦理委员会将遵循法律、人权、文化、宗教和社会道德规范准则,以知情、自愿、有利于患者和社会的原则审视医疗活动,以知情、自愿和无伤害原则审视科研活动。
第一节人类辅助生殖技术伦理委员会
一、组织
1.生殖医学伦理委员会由所属的法人医疗机构组织成立,并发文登记备案。
2.医疗机构的生殖医学伦理委员会设主任一名,主持伦理委员会工作;设副主任一名,协助主任工作;设秘书一名,承办日常工作。
3.生殖医学伦理委员会成员由医学伦理学、心理学、社会学、法学、生殖医学、护理专家和群众代表等组成,人数7~11名(单数)。
4.如果工作需要补充人员,需经过医疗机构批准。有特殊问题,可临时聘请有关人员参加工作。
5.生殖医学伦理委员会的工作直接对所在医疗机构负责。
Introduction

《临床诊疗指南》是由国家财政部支持、卫生部领导、中华医学会组织编写的指导全国临床医务人员诊断治疗行为的第一部医学学术巨著。
现代临床医疗工作随着信息技术、生物技术和其他高新技术的发展和应用,临床新技术不断涌现,各相关学科的专业分化和交叉更加明显,对疾病的预防、诊断、治疗和转归、康复的认识更加深入,推动着临床医疗事业日新月异的向前发展。尤其是近年发展起来的循证医学采用信息技术,经过大样本的分析研究,在取得充分可靠证据的基础上,提出科学可靠的诊疗方案,实现优化的临床诊断治疗。人类疾病纷繁复杂,病人的病情千变万化,探求疾病预防、诊断、治疗、转归、康复的规律,是对广大医务人员的挑战,更是面临着新的发展机遇。
随着我国社会主义市场经济和社会事业的协调发展,人民生活水平的不断提高,对医疗服务的质量和水平提出了愈来愈高的要求。医务人员必须具备全面的医学理论知识、熟练的医疗技术操作能力、丰富的临床实践经验和良好的医德;要不断更新知识和技术,提高临床诊断治疗水平才能胜任临床医疗工作;要在医疗过程中对每一个病人进行连续、严密的观察,及时准确地做出分析、判断和处理,提供规范化服务。
为了满足广大医务人员学习提高业务水平的需要,对医务人员临床诊断、治疗工作进行具体的指导,使诊疗行为有章可循、有据可依,以有利于提高医务人员的综合素质,提高医疗服务的质量,有利于加强医疗工作的管理,有利于提高人民群众的健康水平,制定符合我国国情的临床诊断治疗指南,成为我国医疗事业发展过程中的一件大事。正是基于这样的考虑,在国家财政部的支持下,卫生部委托中华医学会组织专家编写了《临床诊疗指南》。
自2001年开始,《临床诊疗指南》在卫生部的领导下,中华医学会牵头组织了中华口腔医学会和临床专业密切相关的56个专科分会,由数千名专家教授历经4年编写而成。《临床诊疗指南》内容丰富翔实,具有科学性、权威性、先进性、指导性的鲜明特点,供全国各级医疗机构及其医疗专业人员在临床医疗工作中参照使用。大家在实践中如发现有什么问题或意见和建议,希望能及时反馈给中华医学会,以便再版时进行修订。
《临床诊疗指南》按学科以分册的形式将陆续出版发行。

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Jingdong book