非孕期和孕期腹腔镜下宫颈环扎术对宫颈功能不全的临床疗效比较  

Laparoscopic cervical cerclage effects on cervical incompetence at pregnancy and non pregnancy:Clinical comparison

作　　者：张瑜[1,2] 朱前勇[1] 郭楠楠[1,2] 王哲[1,2] 张新恒[1,2] 

机构地区：[1]解放军153医院妇产科,河南郑州450042 [2]新乡医学院,河南新乡在读研究生453000

出　　处：《实用医药杂志》2017年第8期704-706,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨非孕期、孕早期、孕中期行腹腔镜下宫颈环扎术对治疗宫颈功能不全临床疗效的影响。方法选取2012年6月—2015年12月笔者所在医院收治的45例宫颈功能不全患者因反复流产,行阴道环扎术或宫颈环扎术。结果非孕期22例,孕早期(12 w前)14例、孕中期(16 w前)9例手术均进展顺利,1例孕中期患者术中出血量大影响视野中转开腹。孕中期手术时间、住院时间比非孕期、孕早期长,并发症发生率也高于非孕、孕早期;非孕期、孕早期(12 w前)手术时间、术后恢复时间、并发症发生率的比较,差异无统计学意义(P>0.05);非孕期平均胎龄30.2 w,胎儿存活率90.9%,与孕早期、孕中期平均胎龄(分别为31.6 w、31.1 w)、胎儿存活率(92.8%、88.9%)比较,差异无统计学意义(P>0.05)。结论腹腔镜下宫颈环扎术手术时机的不同并不影响妊娠结果,但孕前、孕早期手术并发症少,操作安全又简单,更宜行腹腔镜下宫颈环扎术。Objective To investigate the clinical effect of laparoscopic cervical cerclage for cervical incompetence at pregnancy and non pregnancy. Methods The 45 patients with cervical incompetence admitted in author＇s hospital from June 2012 to December 2015 ,who were failed with vaginal cerclage or voluntarily turned to chose cervical cerclage because of recurrent abortion. According to the time of pregnancy they were divided into three groups,non-pregnancy （22 cases）,early pregnancy （12 weeks ago） （14 cases）,the second trimester （16 weeks ago） 9 cases,their operation time,complications and pregnancy outcomes of the three groups were observed and compared. Results The operation of three groups were performed smoothly,however 1 case in the second trimester was transferred to opening surgery because of massive bleeding. The operative time,postoperative hospitalization time and complication incidence in the second trimester were higher than that of non pregnancy and early pregnancy;the postoperative hospitalization time and complication incidence at non-pregnancy and early pregnancy were no significant difference（P〉0.05）;at non-pregnancy,early pregnancy,the second trimester mean gestational age was 30.2 weeks, 31.6 weeks, 31.1 weeks,respectively; the fetus survival rate was 90.9%,92.8%,88.9%,respectively ; the difference was not statistically significant （P〉0.05）. Conclusion The operation time of laparoscopic cervical cerelage does not affect pregnancy outcome,but laparoscopic cervical cerclage at non-pregnancy and early pregnancy is favored with small pregnancy complications ,as well of safe and simple operation mode.

关 键 词：非孕期 孕期 腹腔镜下宫颈环扎术 宫颈功能不全 

分 类 号：R713.4[医药卫生—妇产科学]