改良Shirodkar宫颈环扎术影响孕周延长的多因素分析  

Multi-factor analysis of modified Shirodkar cervical cerclage affecting gestational age

作　　者：高媛媛 郑旭 刘宏健 沈青 GAO Yuan-yuan;ZHEN Xu;LIU Hong-jian;SHEN Qing(Department of Obstetrics and Gynecology,Cangzhou Hebei 061000,P.R.China;Ultrasonic Department,the People's Hospital of Cangzhou,Cangzhou Hebei 061000,P.R.China)

机构地区：[1]沧州市人民医院妇产科,河北沧州061000 [2]沧州市人民医院彩超室,河北沧州061000

出　　处：《中国计划生育和妇产科》2019年第11期77-80,90,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的改良Shirodkar宫颈环扎术影响孕周延长的相关因素。方法选取2008年12月至2017年12月在沧州市人民医院运用改良Shirodkar宫颈环扎术治疗宫颈机能不全的120例单胎孕妇进行回顾性分析,对影响其延长孕周的相关因素进行单因素分析,并在此基础上进行非条件Logistic回归分析,筛选影响改良Shirodkar宫颈环扎术治疗宫颈机能不全的影响因素。结果 120例孕妇中,孕周延长≥14周组86例,胎儿存活84例,孕周延长<14周34例,胎儿存活25例。两组患者在年龄、宫颈长度、未足月胎膜早破、宫内感染和子宫异常等方面比较,差异有统计学意义(P<0.05);多因素Logistic回归分析发现,年龄(OR=2.164,95%CI 1.179-3.973)、宫颈长度(OR=5.058,95%CI 2.208-11.589)、未足月胎膜早破(OR=4.923,95%CI 2.952-8.212)、宫内感染(OR=6.253,95%CI 2.687-14.522)和子宫异常(OR=2.321,95%CI 1.051-3.367)依然是影响改良Shirodkar宫颈环扎术临床效果的影响因素。结论年龄、宫颈长度、未足月胎膜早破、宫内感染和子宫异常是影响改良Shirodkar宫颈环扎术治疗宫颈机能不全的影响因素。Objective To explore the related factors affecting the effect of modified Shirodkar cervical cerclage on the prolongation of gestational age. Methods A retrospective analysis of 120 single-fetal patients treated with modified Shirodkar cervical cerclage for the treatment of cervical insufficiency in the People’s Hospital of Cangzhou from December 2008 to December 2017 was conducted to analyze the factors affecting the prolonged gestational age. Based on this analysis, unconditional logistic regression analysis was performed to screen the influencing factors of modified Shirodkar cervical cerclage for cervical insufficiency. Results Among 120 pregnant women, 86 patients with prolonged gestational age ≥14 weeks, 84 patients with fetal survival, 34 patients with prolonged gestational weeks <14 weeks, and 25 patients with fetal survival. The differences between the two groups in terms of age, cervical length, premature rupture of membranes, intrauterine infection and uterine abnormalities were statistically significant(P<0.05). Multivariate logistic regression analysis found that age(OR=2.164, 95 % CI 1.179-3.973), cervical length(OR=5.058, 95 % CI 2.208-11.589), premature rupture of membranes(OR=4.923, 95 % CI 2.952-8.212), intrauterine infection(OR= 6.253, 95 % CI 2.687-14.522) and uterine abnormalities(OR=2.321, 95 % CI 1.051-3.367) remained the influencing factors affecting the clinical outcome of modified Shirodkar cervical ring surgery. Conclusion Age, cervical length, premature rupture of membranes, intrauterine infection and uterine abnormalities are the influencing factors of modified Shirodkar cervical cerclage for cervical insufficiency.

关 键 词：改良Shirodkar宫颈环扎术 宫颈机能不全 宫内感染 宫颈长度 

分 类 号：R711.74[医药卫生—妇产科学]