宫颈机能不全与宫颈环扎术  

Cervical Insufficiency and Cervical Cerclage

作　　者：苏婧[1] 高晓丽[1] 李增彦[1] SU Jing;GAO Xiao-li;LI Zeng-yan(Department of Obstetrics and Gynecology,Tianjin Key Laboratory of Female Reproductive Health and Eugenics,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院妇产科,天津市女性生殖健康与优生重点实验室,300052

出　　处：《国际生殖健康／计划生育杂志》2022年第6期514-518,共5页Journal of International Reproductive Health/Family Planning

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK-031A)。

摘　　要：宫颈机能不全的特点是在妊娠中、晚期出现的无痛性宫颈扩张和缩短,是引起反复晚期流产及早产的常见原因。由于宫颈机能不全的诊断难以精准,其发病机制尚不明确,国内外尚无统一的规范。作为一种监测手段,经阴道超声监测宫颈长度对治疗有一定的指导作用。宫颈环扎术是宫颈机能不全最简单有效的治疗方式,根据手术方式可分为经阴道宫颈环扎术和经腹宫颈环扎术,根据手术指征可分为病史指征的宫颈环扎术、超声指征的宫颈环扎术和紧急环扎术。宫颈环扎术的术后管理及拆线时机需进行个性化选择。Cervical insufficiency is characterized by painless cervical dilatation and shortening in the second and third trimester of pregnancy,which is a common cause of recurrent second trimester loss or spontaneous preterm birth.Currently,there is no unified guideline for cervical insufficiency because the diagnosis criteria and pathogenesis are unclear.The transvaginal ultrasound for monitoring cervical length plays a guiding role in the treatment of cervical insufficiency.Cervical cerclage is a simple and effective treatment for the cervical insufficiency.According to the surgical methods,it can be divided into the transvaginal cervical cerclage and the transabdominal cervical cerclage.It also can be categorized based on surgical indications,such as the history-indicated cerclage,ultrasound-indicated cerclage,and emergency cerclage.The postoperative management and the optimal timing of suture removal of cervical cerclage should be individual.

关 键 词：宫颈机能不全 宫颈长度测量 环扎术 宫颈 流产 自然 早产 个体化治疗 

分 类 号：R713.4[医药卫生—妇产科学]