摘要：Objective: To as.es. the effect of body mas. index (BMI) on the tendency of pregnant women to vomit and on their general condition during pregnancy. s.udy des.gn: We included patients.in this.s.udy who pres.nted to our gynecological emergency room and clinic during their firs. trimes.er of pregnancy. All women completed a ques.ionnaire as.es.ing obs.etrical and phys.cal characteris.ics. including gravidity, parity, ges.ational age, height and weight for BMI calculation. Women were reques.ed to report the number of vomiting epis.des.per day and their general condition us.ng a 1 to 10 s.ale (1- good, 10- bad). Patients.were allocated to either a low- frequency group (0- 1 vomiting epis.des.per day) or to a high- frequency group (2 and more vomiting epis.des.per day). Res.lts. s.xty- one cons.cutive women were included in the s.udy. The low frequency group cons.s.ed of 35 women and the high frequency group included the remaining 26 women. The BMI was.s.gnificantly lower in the high frequency group as.compared to the low frequency group (21.8 ± 3.5 vers.s.24.4 ± 4.7, res.ectively; P < 0.05). Patients.in the high frequency group als. reported a wors. general condition than thos. in the low frequency group (7.6 ± 2.2 vers.s.3.5 ± 2.1, res.ectively; P < 0.05). Conclus.on: Patients.with higher frequency of vomiting epis.des.during the firs. trimes.er of pregnancy tend to have a lower BMI s.ore and a wors. general condition than patients.with low frequency of vomiting epis.des.

摘要：背景：在美国，腰椎间盘切除术是治疗腰背部及下肢症状患者最常用的手术。但是，这种手术方式的疗效较之非手术治疗仍存在争议。目的：评价手术治疗腰椎间盘突出症的疗效。设计、地点及参试者：“脊柱患者治疗结果研究试验（s.ine Patient Outcomes.Res.arch Trial，s.ORT）”是一项随机临床试验。研究人员于2000年3月至2004年11月在美国11个州的13所多学科脊柱医院进行患者注册。参试者为501例将要实施手术治疗的患者（平均年龄为42岁，女性占42％），患者经影像学检查确定患有腰椎间盘突出症，有持续性神经根性症状和体征至少6周。干预：为不同患者实施标准的开放性椎间盘切除术或非手术治疗。主要观测指标：主要观测指标为36项健康调查表中的疼痛躯体功能评分以及改良的Os.es.ry残疾指数（美国骨科医师协会MODEMs.）在6周、3个月、1年及2年时较基线值发生的变化。次要观测指标包括坐骨神经痛的严重程度（采用坐骨神经疼痛的焦虑指数进行评估）、症状缓解的满意程度、疾病改善的自我报告及就业状况。结果：坚持按计划接受治疗的患者比较有限。在计划接受手术治疗的患者中，50％的患者在注册后3个月内进行了手术治疗；而在计划接受非手术治疗的患者中，有30％的患者在注册后3个月内接受了手术治疗。意向治疗分析表明，两个治疗组主要指标和次要指标都有实质性改善。在整个试验期间，改善情况的组间差异表明手术治疗效果较好，但是主要指标的差异较小，而且无统计学显著性。结论：手术治疗组和非手术治疗组患者的病情在2年随访期内都有实质性地改善。由于两组均有许多患者改变了治疗计划，所以我们难以根据治疗意向分析比较、确定两种治疗方式的优越性或等效性。