产科手术学(原书第4版)

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产科手术学(原书第4版)

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产科手术学(原书第4版)

产科手术学(原书第4版)

$104.55

编辑推荐引进自美国CRC出版社,是由全球40余家医(学)院及母胎医学中心的80余位医学专家联袂编写的高质量母胎医学专著。??新第4版,历经20余年的不懈修订,堪称全球产科、母胎和围产医学临床诊断、治疗手段的国际性著作,为母胎医学和产科手术的实践作出了巨大贡献,备受关注。??全书共40章,340余幅全彩图片,阐述全面细腻,除介绍常规产科手术外,还将绒毛取样、羊膜腔穿刺、胎儿输血、脐血穿刺、妊娠期恶性肿瘤、妊娠期滋养细胞疾病等单列成章,可谓考...
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编辑推荐
引进自美国CRC出版社,是由全球40余家医(学)院及母胎医学中心的80余位医学专家联袂编写的高质量母胎医学专著。??新第4版,历经20余年的不懈修订,堪称全球产科、母胎和围产医学临床诊断、治疗手段的国际性著作,为母胎医学和产科手术的实践作出了巨大贡献,备受关注。??全书共40章,340余幅全彩图片,阐述全面细腻,除介绍常规产科手术外,还将绒毛取样、羊膜腔穿刺、胎儿输血、脐血穿刺、妊娠期恶性肿瘤、妊娠期滋养细胞疾病等单列成章,可谓考虑周全、用心良苦。
 
内容简介
母胎医学是一门致力于母婴健康、减少出生缺陷、提高出生人口素质的新学科,其从医学角度将母体与胎儿置于同等地位。近10年来,欧美的母胎医学已获得了长足的发展,而在亚洲的发展还处在起步阶段。本书是引自美国CRC出版社的高质量母胎医学著作,由来自全球40余家医(学)院的80余位母胎医学专家联袂编写。历经20余年的不懈修订,全新第4版对母胎医学的发展现状及治疗趋势进行了全面描述,并细致阐述了盆腹腔解剖、正常分娩、助产技术、剖宫产、多胎分娩、产科麻醉等专业内容,深入讲解了子宫瘢痕妊娠、妊娠期妇科肿瘤、外科并发症的处理技巧,详细展示了介入性产前诊断操作技术、宫内微创胎儿治疗、开放性胎儿手术等母胎医学领域的新进展。
作者简介

刘俊涛,男,临床医学博士,北京协和医院妇产科学系副主任、产科中心主任,主任医师,博士研究生导师,全国产前诊断技术专家组成员。主要研究方向为产前诊断与母胎医学,对产科手术具有丰富的临床经验。兼任中华医学会围产医学分会常委,中国优生科学协会副会长,北京医学会围产医学分会副主委,中国医师协会遗传医师分会产前诊断专委会主任委员等职务。1999—2000年,作为高级访问学者去往澳大利亚 Royal Women's Hospital工作。承担及参与、省部级课题共10余项,科研成果获国家医学科技奖二等奖。

周希亚,女,中国协和医科大学临床医学系医学博士,北京协和医院产科中心副主任医师,主要研究方向为母胎医学。兼任中华医学会儿科分会出生缺陷防治委员会委员,中国医师协会遗传分会产前诊断委员会委员,北京医学会围产医学分会委员,北京医学会早产与早产儿分会委员等。2011年于英国King's College Hospital胎儿医学研究中心学习。参与国家“十五”“十一五”科技攻关及科技支撑课题研究,主持国家自然科学基金项目1项。

目  录
目录
第 1 章 前腹壁、子宫及盆腔器官的解剖
一、前腹壁 1
二、子宫 7
三、输卵管 14
四、卵巢 14
五、子宫的韧带 15
六、子宫的血管、淋巴和神经 15
七、输尿管的盆腔部分 17
八、膀胱和尿道 18
九、乙状结肠、直肠和肛管 19
十、妊娠期肥胖 19
第 2 章 _x005f 会阴、外阴、阴道的局部解剖
一、外阴 22
媒体评论
产科手术与普通妇科、妇科肿瘤手术有什么异同?或者说,这本译著有哪些值得赞赏的特点?我认为有以下三点值得称道。重:这里的重不独在于病情严重,因为有时孕产妇的状况并不危笃,这里的重乃为重要之意。涉及妊娠分娩的进程,时间就是生命;涉及母亲、胎儿的安危,牵动众多;涉及人文伦理的锁键,掌控的不仅是技术。所幸,这些问题在书中都得到体现和阐述,更构成了本书的重点。?急:产科的手术多数很急迫,甚至是在危急情势逼迫下进行的。产妇、胎儿、产道三大要素有一异常者,或因各要素相互影响同时“发难”者,具体的处理或手术均有所不同。因此,手术的风险骤然上升,产科医生需要更加果敢、机敏。诚然,选择性的、计划性的产科手术也有,或者我们更应争取做到“选择”和“计划”。还是要回到预防为主的方针,谨记林巧稚院士的名言?:妊娠不是病,妊娠要防病。?危:危险之危。胎儿窘迫、产后出血、产科感染、产科损伤……都会危及母胎生命安全。这里有“老”的产科问题,如各种难产。有的难产,如头位难产、肩难产、臀位难产等似乎减少了;而有的问题却多起来,如子宫破裂、前置胎盘,特别是剖宫产瘢痕妊娠的植入性胎盘或凶险性前置胎盘。有学者将其称为21世纪的“人为医学状态”,是新问题、新观念、新挑战。——郎景和
在线试读
第 3 章 临床骨盆测量
Clinical pelvimetry
Elaine K. Diegmann  Rhonda Nichols

产力、胎儿和产道,是控制分娩过程的三大要素。骨盆的尺寸保持不变。了解骨盆的作用,记住基本骨盆类型、径线大小和分娩预后具有极为重要的意义,因为医务人员要决定分娩方式,这对母亲和婴儿的结局至关重要。因此,本章将重点关注骨性盆腔结构,这是对出生结局佳的预测因素。了解骨盆是否足够大是决定试产和计划阴道分娩的基本要素。
一、骨盆解剖
骨盆由两块髋骨(每块髋骨又进一步分为髂骨、坐骨和耻骨)、骶骨和尾骨组成(图 3-1)。
每块髋骨都有几个点具有产科意义。髂骨有骶骨坐骨大切迹,位于髂前下棘和坐骨棘之间。坐骨有坐骨棘,是骨盆小直径的标志 ;坐骨结节,位于坐骨的下缘 ;坐骨棘与坐骨结节之间是骶骨坐骨小切迹。正常骨盆的坐骨侧壁轻微内聚。
耻骨连接着两块髋骨,形成前面的耻骨联合,其下缘是耻骨弓的。耻骨降支形成了耻骨弓的侧壁,耻骨弓具有重要的解剖意义,它的角度是能否成功阴道分娩的一个重要预测因素。
骶骨组成了骨盆后方的界限。它有 5 块融合的椎骨,其角度和倾斜度有助于预测出生结局。骶岬是第 1 骶椎的前表面。它是具有重要产科意义的骨盆标志点。
尾骨由 4 块退化的椎骨组成,形成“尾巴骨”,与骶骨连接。
有 4 个关节连接着盆骨。在两侧,骶髂关节将骶骨和两侧髋骨的髂骨部分相连接。在前面,耻骨联合连接着髋骨的耻骨部分。在后面,骶尾关节连接着骶骨和尾骨。骶棘韧带跨过骶骨尾骨大切迹,它起自第5 骶椎和第 1 尾椎的连接处,止于坐骨棘。骶骨坐骨大切迹是决定后骨盆腔容量的标志。骶结节韧带向后附着于第 3、4、5 骶椎,向前附着于坐骨结节。这两条韧带形成了阴部管(Alcock’s canal)的侧壁,阴部神经从此经过。
二、产科骨盆
骨盆分为假骨盆和真骨盆。骨盆界限,也称为髂耻线,是划分两者的结构边界。假骨盆
书摘插画
插图

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编辑推荐
引进自美国CRC出版社,是由全球40余家医(学)院及母胎医学中心的80余位医学专家联袂编写的高质量母胎医学专著。??新第4版,历经20余年的不懈修订,堪称全球产科、母胎和围产医学临床诊断、治疗手段的国际性著作,为母胎医学和产科手术的实践作出了巨大贡献,备受关注。??全书共40章,340余幅全彩图片,阐述全面细腻,除介绍常规产科手术外,还将绒毛取样、羊膜腔穿刺、胎儿输血、脐血穿刺、妊娠期恶性肿瘤、妊娠期滋养细胞疾病等单列成章,可谓考虑周全、用心良苦。
 
内容简介
母胎医学是一门致力于母婴健康、减少出生缺陷、提高出生人口素质的新学科,其从医学角度将母体与胎儿置于同等地位。近10年来,欧美的母胎医学已获得了长足的发展,而在亚洲的发展还处在起步阶段。本书是引自美国CRC出版社的高质量母胎医学著作,由来自全球40余家医(学)院的80余位母胎医学专家联袂编写。历经20余年的不懈修订,全新第4版对母胎医学的发展现状及治疗趋势进行了全面描述,并细致阐述了盆腹腔解剖、正常分娩、助产技术、剖宫产、多胎分娩、产科麻醉等专业内容,深入讲解了子宫瘢痕妊娠、妊娠期妇科肿瘤、外科并发症的处理技巧,详细展示了介入性产前诊断操作技术、宫内微创胎儿治疗、开放性胎儿手术等母胎医学领域的新进展。
作者简介

刘俊涛,男,临床医学博士,北京协和医院妇产科学系副主任、产科中心主任,主任医师,博士研究生导师,全国产前诊断技术专家组成员。主要研究方向为产前诊断与母胎医学,对产科手术具有丰富的临床经验。兼任中华医学会围产医学分会常委,中国优生科学协会副会长,北京医学会围产医学分会副主委,中国医师协会遗传医师分会产前诊断专委会主任委员等职务。1999—2000年,作为高级访问学者去往澳大利亚 Royal Women's Hospital工作。承担及参与、省部级课题共10余项,科研成果获国家医学科技奖二等奖。

周希亚,女,中国协和医科大学临床医学系医学博士,北京协和医院产科中心副主任医师,主要研究方向为母胎医学。兼任中华医学会儿科分会出生缺陷防治委员会委员,中国医师协会遗传分会产前诊断委员会委员,北京医学会围产医学分会委员,北京医学会早产与早产儿分会委员等。2011年于英国King's College Hospital胎儿医学研究中心学习。参与国家“十五”“十一五”科技攻关及科技支撑课题研究,主持国家自然科学基金项目1项。

目  录
目录
第 1 章 前腹壁、子宫及盆腔器官的解剖
一、前腹壁 1
二、子宫 7
三、输卵管 14
四、卵巢 14
五、子宫的韧带 15
六、子宫的血管、淋巴和神经 15
七、输尿管的盆腔部分 17
八、膀胱和尿道 18
九、乙状结肠、直肠和肛管 19
十、妊娠期肥胖 19
第 2 章 _x005f 会阴、外阴、阴道的局部解剖
一、外阴 22
媒体评论
产科手术与普通妇科、妇科肿瘤手术有什么异同?或者说,这本译著有哪些值得赞赏的特点?我认为有以下三点值得称道。重:这里的重不独在于病情严重,因为有时孕产妇的状况并不危笃,这里的重乃为重要之意。涉及妊娠分娩的进程,时间就是生命;涉及母亲、胎儿的安危,牵动众多;涉及人文伦理的锁键,掌控的不仅是技术。所幸,这些问题在书中都得到体现和阐述,更构成了本书的重点。?急:产科的手术多数很急迫,甚至是在危急情势逼迫下进行的。产妇、胎儿、产道三大要素有一异常者,或因各要素相互影响同时“发难”者,具体的处理或手术均有所不同。因此,手术的风险骤然上升,产科医生需要更加果敢、机敏。诚然,选择性的、计划性的产科手术也有,或者我们更应争取做到“选择”和“计划”。还是要回到预防为主的方针,谨记林巧稚院士的名言?:妊娠不是病,妊娠要防病。?危:危险之危。胎儿窘迫、产后出血、产科感染、产科损伤……都会危及母胎生命安全。这里有“老”的产科问题,如各种难产。有的难产,如头位难产、肩难产、臀位难产等似乎减少了;而有的问题却多起来,如子宫破裂、前置胎盘,特别是剖宫产瘢痕妊娠的植入性胎盘或凶险性前置胎盘。有学者将其称为21世纪的“人为医学状态”,是新问题、新观念、新挑战。——郎景和
在线试读
第 3 章 临床骨盆测量
Clinical pelvimetry
Elaine K. Diegmann  Rhonda Nichols

产力、胎儿和产道,是控制分娩过程的三大要素。骨盆的尺寸保持不变。了解骨盆的作用,记住基本骨盆类型、径线大小和分娩预后具有极为重要的意义,因为医务人员要决定分娩方式,这对母亲和婴儿的结局至关重要。因此,本章将重点关注骨性盆腔结构,这是对出生结局佳的预测因素。了解骨盆是否足够大是决定试产和计划阴道分娩的基本要素。
一、骨盆解剖
骨盆由两块髋骨(每块髋骨又进一步分为髂骨、坐骨和耻骨)、骶骨和尾骨组成(图 3-1)。
每块髋骨都有几个点具有产科意义。髂骨有骶骨坐骨大切迹,位于髂前下棘和坐骨棘之间。坐骨有坐骨棘,是骨盆小直径的标志 ;坐骨结节,位于坐骨的下缘 ;坐骨棘与坐骨结节之间是骶骨坐骨小切迹。正常骨盆的坐骨侧壁轻微内聚。
耻骨连接着两块髋骨,形成前面的耻骨联合,其下缘是耻骨弓的。耻骨降支形成了耻骨弓的侧壁,耻骨弓具有重要的解剖意义,它的角度是能否成功阴道分娩的一个重要预测因素。
骶骨组成了骨盆后方的界限。它有 5 块融合的椎骨,其角度和倾斜度有助于预测出生结局。骶岬是第 1 骶椎的前表面。它是具有重要产科意义的骨盆标志点。
尾骨由 4 块退化的椎骨组成,形成“尾巴骨”,与骶骨连接。
有 4 个关节连接着盆骨。在两侧,骶髂关节将骶骨和两侧髋骨的髂骨部分相连接。在前面,耻骨联合连接着髋骨的耻骨部分。在后面,骶尾关节连接着骶骨和尾骨。骶棘韧带跨过骶骨尾骨大切迹,它起自第5 骶椎和第 1 尾椎的连接处,止于坐骨棘。骶骨坐骨大切迹是决定后骨盆腔容量的标志。骶结节韧带向后附着于第 3、4、5 骶椎,向前附着于坐骨结节。这两条韧带形成了阴部管(Alcock’s canal)的侧壁,阴部神经从此经过。
二、产科骨盆
骨盆分为假骨盆和真骨盆。骨盆界限,也称为髂耻线,是划分两者的结构边界。假骨盆
书摘插画
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