Menarche,Menstruation, and Gender Identity: Retrospective Accounts from Women Who Have Undergone Premenopausal Hysterectomy

Hysterectomy (the surgical removal of the uterus) precipitates the end of menstrual cycles in premenopausal women. In this article I explore whether that premature termination of menstrual function negatively affects women's subjective gender identities. Using the grounded theory research approach, I conducted in-depth interviews with 40 diverse respondents who had undergone premenopausal hysterectomy. These women generally acknowledged that, since the time of menarche, they had closely associated menstruation with their gender identities. However, despite some regrets, respondents' primary reaction was almost unanimous relief that they had ceased menstruating. This finding must be viewed in the context of overwhelming and uncontrollable menstrual pain and bleeding that many respondents had previously experienced. Contrary to expressing remorse that they no longer identified with normal women, who menstruate, most respondents sought to disassociate themselves from the normalized suffering that they perceived is endured by all menstruating women.     

基本人权保障与智障者节育手术开展可能性讨论——着眼“南通儿童福利院智障少女子宫切除事件”分析

分析国内外智障者节育手术多年实践提炼出共识:遵循法律规定开展此手术有利于保障而非侵害智障者基本人权。建议我国应出台相关规定为合法开展此类手术提供保障。     

早期宫颈癌术式选择的比较研究

根治性子宫切除术与保留生育功能的根治性宫颈切除术均可用于早期宫颈癌患者的手术治疗。根据生物-心理-社会医学模式的要求,本文采用比较治疗学的方法,对这两种手术方式,从适应证、手术方式、并发症、疗效等方面进行比较,为宫颈癌临床科学决策提供借鉴。     

实施子宫切除手术中的人文关怀

子宫切除术是妇科手术中的一种常见术式,随临床技术的发展,目前已有许多可供选择的不同方式。实施子宫切除手术中,临床医生应采用哲学的辩证思维方法并尊重患者的自主选择,全面客观地评估患者的情况;更多从人文关怀的角度出发,做出符合患者个体术式的决策,力争达到最佳的治疗效果。     

腹腔镜全子宫切除术学习曲线探讨

为探讨腹腔镜下全子宫切除术学习曲线,收集我院自2011年6月至2012年6月由同一组医师连续开展最初50例腹腔镜下全子宫切除术病例,以每10例为一个手术阶段,分析记录其平均手术时间、出血量、并发症情况等.结果显示成功施行腹腔镜全子宫切除术50例,各组病例在年龄、BMI、既往有无腹部手术史等一般情况比较无明显差异.不同阶段术中出血量、手术时间比较差异有统计学意义(P＜0.05);进一步两两比较结果显示,第1阶段与第3、4、5阶段术中出血量比较差异有统计学意义,第2阶段与第3、4、5阶段术中出血量比较差异有统计学意义(P＜0.05),其余各阶段术中出血量无明显差异(P＞0.05).第1阶段与第2、3、4、5阶段手术时间比较差异有统计学意义(P＜0.05).其余各阶段手术时间比较无明显差异(P＞0.05).由此推断腹腔镜下全子宫切除术学习曲线大约为10例～20例,即可达到较熟练水平和稳定程度.     

急症产科子宫切除36例临床分析

分析导致产科临床急症子宫切除的原因,探讨降低产科子宫切除的可能性方法.回顾分析我院产科2006年1月～2012年1月间36例急症子宫切除病例,胎盘因素占55.6％,子宫收缩乏力占27.8％,羊水栓塞占5.6％,子宫破裂占8.3％,晚期产后出血占2.8％.剖宫产术后行子宫切除31例,占剖宫产人数的0.39％;阴道分娩后5人行子宫切除,占阴道分娩总数的0.05％.为减少产后出血的发生,应严格掌握剖宫产指征,降低剖宫产率.     

Yet Another Revised DDE? A Note on David K. Chan's DDEd

David K. Chan wants to save the DDE from the considerable criticism levelled against it, by making the moral distinction it refers to rest on a difference in desire instead of in intention. I argue that the revised version, too, is counter-intuitive and confuses the blameworthiness of an actor with the wrongness of the act. It also invites abuse instead of preventing it. Besides, Chan's DDE omits three of the four criteria of the traditional DDE, and it is couched in terms of lesser objectionability, while the traditional DDE is couched in terms of permission. Therefore, Chan's DDE has so little in common with the traditional DDE that it should not even count as a revised version of it.     

急症产科子宫切除术知情同意的分析

为保留产妇的生命权而牺牲其生育权的子宫切除术,仍是控制产科出血的最后手段。产科急症时,患者本人无法做出意思表示,子宫切除术的知情同意权由其法定代理人行使。子宫切除围术期,实施知情同意,仍存在许多法律盲点及实践困难。本文阐述了产科子宫切除术告知的法律义务、行为主体,以及告知患者子宫切除的方式。     

保留子宫动脉筋膜内子宫切除术对卵巢功能的影响

为了探讨保留子宫动脉上行支筋膜内子宫切除术对卵巢功能的影响,将90例符合条件的患者,随机分成研究组（行保留子宫动脉上行支筋膜内子宫切除术）和对照组（行筋膜内子宫切除术）,重点观察两组手术对卵巢功能的影响。对照组血卵泡刺激素（FSH）、雌二醇（E2）术后与术前相比,差异有统计学意义（P＜0．05）。两组更年期症状的发生率差异有统计学意义（P＜0．05）。保留子宫动脉上行支筋膜内子宫切除术术后近期卵巢功能影响小,远期效果有待观察。     

宫颈癌根治术前预处理减少输尿管损伤及下肢静脉血栓临床观察

通过对术前考虑盆腔粘连可能比较严重的宫颈癌根治术（RH）术中穿着医用弹力袜行双下肢弹力加压,并经膀胱镜放置输尿管导管作预处理,减少下肢静脉血栓及输尿管损伤的临床效果。回顾性研究在我院行手术治疗的术前考虑盆腔粘连可能比较严重的宫颈癌患者364例,其中182例接受广泛子宫切除及盆腔淋巴结清扫术,术中穿着医用弹力袜行双下肢弹力加压,作为研究组,另182例单纯接受广泛子宫切除及盆腔淋巴结清扫术,未作预处理,作为对照组。结果研究组无一例损伤输尿管,对照组2例发生输尿管损伤（P ＜0．05）。因此,术前考虑盆腔粘连可能比较严重的 RH 术中穿着医用弹力袜行双下肢弹力加压,并经膀胱镜放置输尿管导管常规作预处理,可明显减少下肢静脉血栓、尿潴留及输尿管损伤,值得临床推广应用。