67例紧急宫颈环扎术疗效及影响因素分析  

Effect of Emergency Cervical Cerclage on Pregnancy Outcome and Its Contributing Factors: 67 Cases Analysis

作　　者：沈庆君 王蕴慧[1] 刘颖琳[1] 张睿[1] 谭剑平[1] 

机构地区：[1]中山大学孙逸仙纪念医院,广东广州510120

出　　处：《实用妇产科杂志》2014年第4期270-273,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：评价紧急宫颈环扎术的治疗效果及影响因素。方法：回顾性分析2007年1月至2012年12月于中山大学孙逸仙纪念医院确诊为宫颈机能不全，宫口开大1～7cm并行紧急宫颈环扎术的67例患者的临床资料，并比较手术成功组（44例）和失败组（23例）的影响因素。结果：67例患者中，23例出现流产或新生儿死亡，44例新生儿存活，手术成功率为65．67％。成功组术前宫口开大程度、术后最高C反应蛋白（CRP）均值和双胎、术前宫缩、宫口开大≥3cm所占比例均小于失败组（P〈0．05，P〈0．01）；而成功组手术孕周、延长孕周均值大于失败组（P〈0．01）。结论：紧急宫颈环扎术是宫颈机能不全宫口已经扩张的补救措施，但双胎妊娠、术前宫口扩大程度（尤其是扩大≥3cm）、术前宫缩及感染是手术失败的影响因素。Objective：To evaluate the outcomes of midtrimester emergency cerclage and to find out its contributing factors. Methods：Records of patients with cervical dilation （ range from 1 - 7 cm） who were trea- ted with emergency cervical cerclage, from January 2007 to December 2012 at the Sun Yat-sen Memorial Hospital, Sun Yat-sen University,, were retrospectively analyzed. The differences between the contributing factors of the successful group （n =44） and the failure group （n =23） were compared. Results：Among the 67 patients with ECC, 23 patients resulted in abortion or neonatal death, 44 patients resulted in birth of live-born children. The total live birth rate was 65.67%. The mean cervical dilation before operation, highest level of C-reactive, and the proportion of twin pregnancies, contraction before operation, dilated cervix ≥ 3 cm of the successful group were less than the failure group （ P 〈 0.05, P 〈 0.01 ）. To compared with the failure group,the mean gestational age at time of cerclage and pregnancy prolongation of the successful group were greater （ P 〈 0.01 ）. Conclusions： Cervical dilation in the patients with cervical incompetence has a poor outcome which can be improved with emergency cerclage. However, twin pregnancies, dilated cervix ≥3 cm,contraction before operation and infection are frequently associated with failure of the opera- tion.

关 键 词：紧急宫颈环扎术 宫颈机能不全 影响因素 

分 类 号：R719[医药卫生—妇产科学]