孕前“极简式”腹腔镜下宫颈环扎术的临床应用  

Clinical Application of Simplified Laparoscopic Cervical Cerclage

作　　者：赵玉婷[1] 黄晓武[1] 夏恩兰[1] 马宁[1] 郭艳[1] 

机构地区：[1]首都医科大学附属复兴医院宫腔镜中心,北京100038

出　　处：《国际妇产科学杂志》2016年第6期634-637,共4页Journal of International Obstetrics and Gynecology

摘　　要：目的：探讨＂极简式＂腹腔镜下宫颈环扎术（simplified laparoscopic cervical cerclage,SLCC）预防既往经阴道宫颈环扎失败的女性中期流产、早产的效果,并评价手术安全性。方法：分析2010年12月—2015年8月首都医科大学附属复兴医院收治的153例有经阴道宫颈环扎术失败史,实施孕前SLCC的患者临床资料。患者术前孕中期流产平均次数为（2.7±1.2）次,孕周为13-27周,平均孕周（20.0±3.5）周。结果：153例SLCC患者手术顺利,平均手术时间（33.0±1.3）min,术中平均出血量（9.7±8.3）m L,无严重手术并发症。术后共117例患者妊娠,其中8例妊娠2次,总妊娠次数125次;其中包括20次早期流产,2次异位妊娠,1次葡萄胎;截至2015年8月,正在妊娠中19例,已知妊娠结局83例,活产率为96.4%（80/83）,平均终止妊娠孕周为（37.2±2.2）周。结论：对于既往经阴道宫颈环扎失败的宫颈机能不全患者,SLCC是一种简单、安全、有效的治疗方法。Objective：To investigate the efficacy of simplified laparoscopic cervical cerclage（SLCC） in the prevention of miscarriage and preterm delivery in women with cervical incompetence,who failed to have a baby by vaginal cervical cerclage in previous pregnancy.Methods：Evaluate the clinical data of 153 patients who underwent SLCC for cervical incompetence in Fuxing Hospital from December 2010 to August 2015.The mean number of second trimester pregnancy loss was（2.7±1.2）.The mean gestational age of previous second trimester miscarriage was（20.0±3.5） weeks.Results：Among the 153 cases of SLCC,all the patients received a successful operation and no serious complications occurred,the mean surgical time was（33.0±1.3） min,the mean volume of blood loss was（9.7±8.3） m L.117 women conceived after the surgery,8 of them conceived twice.There were125 pregnancies,including 20 early miscarriages and twice ectopic pregnancies and one case of molar pregnancy.There were 19 ongoing pregnancies,and 83 confirmed the final outcome,the live birth rate was 96.4%（80/83）.The mean gestational age at delivery was（37.2±2.2） weeks.Conclusions：The SLCC is a simple,safe,and effective treatment for cervical incompetence who had a failed vaginal cervical cerclage.

关 键 词：宫颈功能不全 环扎术 宫颈 腹腔镜 流产 早产 “极简式”腹腔镜下宫颈环扎术 

分 类 号：R714.2[医药卫生—妇产科学]