不同时机行宫颈环扎术对宫颈长度10~20 mm双胎妊娠孕妇妊娠及围生儿结局的影响  

Influence of cervical cerclage at different time on pregnancy and perinatal outcomes of pregnant women with twin pregnancy and cervical length of 10-20 mm

作　　者：王丽平[1] 陶玲玲 伦巍巍[1] 班彦杰 许雅娟[1] Wang Liping;Tao Lingling;Lun Weiwei;Ban Yanjie;Xu Yajuan(Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第三附属医院妇产科,450000

出　　处：《中国实用医刊》2021年第12期14-17,共4页Chinese Journal of Practical Medicine

摘　　要：目的:探讨不同时机行宫颈环扎术对宫颈长度10~20 mm双胎妊娠孕妇妊娠及围生儿结局的影响。方法:抽取2016年1月至2020年1月郑州大学第三附属医院收治的宫颈长度10~20 mm双胎妊娠孕妇82例,均行宫颈环扎术。根据宫颈环扎术时机分为研究组32例(孕14~17+6周)和对照组50例(孕18~28周)。回顾性比较两组孕妇手术效果相关指标、妊娠及围生儿结局。结果:研究组术后感染率、住院时间少于对照组(χ^(2)=4.342、P=0.037,t=7.619、P=0.001),孕周延长时间长于对照组(t=10.794,P=0.001)。研究组产妇顺产率、>34周分娩率高于对照组(χ^(2)=4.344、9.325,P=0.035、0.002)。研究组晚期流产、宫内感染、胎儿生长受限、胎儿窘迫发生率低于对照组(χ^(2)=8.144、4.119、7.552、10.857,P=0.004、0.042、0.006、0.001),足月生产率高于对照组(χ^(2)=4.682,P=0.030)。研究组新生儿Apgar评分、体质量高于对照组(t=4.795、2.178,P=0.001、0.032),转NICU率及病死率低于对照组(χ^(2)=6.866、4.342,P=0.009、0.037)。结论:早期对宫颈长度10~20 mm双胎妊娠孕妇行宫颈环扎术,能提高临床治疗效果,有利于妊娠及围生儿结局改善。Objective To investigate the influence of cervical cerclage at different time on pregnancy and perinatal outcomes of pregnant women with twin pregnancy and cervical length of 10-20 mm.Methods A total of 82 pregnant women with twin pregnancy and cervical length of 10-20 mm who were admitted to the Third Affiliated Hospital of Zhengzhou University from January 2016 to January 2020 were selected.All of them underwent cervical cerclage.According to the timing of cervical cerclage,32 cases were divided into the study group(14-17+6 weeks of pregnancy)and 50 cases in the control group(18-28 weeks of pregnancy).The indexes related to the surgical effect,pregnancy and perinatal outcomes of the two groups of pregnant women were retrospectively compared.Results The postoperative infection rate and length of hospital stay in the study group were less than those in the control group(χ^(2)=4.342,P=0.037,t=7.619,P=0.001),and the gestational weeks prolonged time was longer than that in the control group(t=10.794,P=0.001).The rate of normal delivery and delivery over 34 weeks in the study group were higher than those of the control group(χ^(2)=4.344,9.325,P=0.035,0.002).The incidence of late abortion,intrauterine infection,fetal growth restriction,and fetal distress in the study group were lower than those in the control group(χ^(2)=8.144,4.119,7.552,10.857,P=0.004,0.042,0.006,0.001),and the full-term delivery rate was higher than that in the control group(χ^(2)=4.682,P=0.030).The Apgar score and body weight of the newborns in the study group were higher than those in the control group(t=4.795,2.178,P=0.001,0.032),and the rate of transfer to NICU and fatality rate were lower than those in the control group(χ^(2)=6.866,4.342,P=0.009,0.037).Conclusions Early cervical cerclage for pregnant women with twin pregnancy and cervical length of 10-20 mm can improve the clinical treatment effect and pregnancy and perinatal outcomes.

关 键 词：宫颈 双胎妊娠 宫颈环扎术 妊娠结局 围生儿结局 

分 类 号：R714.23[医药卫生—妇产科学]