宫颈环扎术的临床疗效及影响因素分析  

Analysis of the clinical efficacy and the influencing factor of cervical cerclage

作　　者：苏婧[1,2] 张艳红 高晓丽 李增彦[1,2] SU Jing;ZHANG Yan-hong;GAO Xiao-li;LI Zeng-yan(Department of Gynecology and Obstetrics,Tianjin Medical University General Hospital,Tianjin 300052,China;Tianjin Key Laboratory of Female Reproductive Health and Eugenics;Department of Gynecology and Obstetrics,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai)

机构地区：[1]天津医科大学总医院妇产科,天津300052 [2]天津市女性生殖健康与优生重点实验室 [3]上海市复旦大学附属中山医院青浦分院妇产科

出　　处：《中国城乡企业卫生》2022年第11期1-5,共5页Chinese Journal of Urban and Rural Enterprise Hygiene

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

摘　　要：目的探讨宫颈环扎术对宫颈功能不全患者妊娠结局的影响,分析影响宫颈环扎术临床疗效的相关因素。方法选取天津医科大学总医院妇产科2012年6月—2021年1月收治的98例妊娠期宫颈功能不全患者的临床资料进行回顾性分析,按是否行宫颈环扎术分为手术治疗组72例和保守治疗组26例,比较两组的妊娠结局,并对影响宫颈环扎术治疗效果的相关因素进行单因素分析及多因素logistic回归分析。结果手术治疗组分娩孕周为(35.16±6.17)周,优于保守治疗组的(31.22±7.96)周,差异有统计学意义(P<0.05)。手术治疗组流产率及早产率明显低于保守治疗组,足月产率明显高于保守治疗组,差异均有统计学意义(P<0.05)。行宫颈环扎术的患者成功率为83.33%。单因素分析示:成功组宫颈长度为(2.86±0.77)cm,优于失败组的(2.35±0.78)cm,差异有统计学意义(P<0.05);多因素logistic回归分析示:宫颈长度是影响宫颈环扎术治疗效果的危险因素(OR=2.588,P<0.05)。结论宫颈长度可影响宫颈环扎术的治疗效果,临床上对于宫颈功能不全患者,应争取做到早诊断、早治疗,在宫颈缩短前行宫颈环扎术,以改善患者的妊娠结局。Objective To investigate the effect of cervical cerclage on pregnancy outcome of patients with cervical insufficiency and to analyze the related factors influencing the clinical efficacy of cervical cerclage.Methods The clinical data of 98 cervical insufficiency patients during pregnancy treated in Tianjin Medical University General Hospital from June 2012 to January 2021 were retrospectively analyzed.All the patients were divided into surgical treatment group with 72 cases and conservative treatment group with 26cases according to whether cervical cerclage was performed.The pregnancy outcomes of the two groups were compared,and the related factors influencing cervical cerclage’s therapeutic effect were analyzed by univariate analysis and multivariate logistic regression analysis.Results The gestational week was(35.16±6.17)weeks in the surgical treatment group,which was better than(31.22±7.96)weeks in the conservative treatment group,and the difference was statistically singificnt(P<0.05).In the surgical treatment group,the rates of abortion and premature delivery were considerably lower than those in the conservative treatment group,and the rate of full-term delivery was significantly higher than that in the conservative treatment group,and the differences were statistically significant(P<0.05).The success rate of patients undergoing cervical cerclage was 83.33%.According to univariate analysis,the cervical length of the successful group was(2.86±0.77)cm,which was better than(2.35±0.78)cm in the failure group,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis revealed that cervical length was identified as a risk factor for cervical cerclage effectiveness(OR=2.588,P<0.05).Conclusion Cervical length could impact therapeutic effect of cervical cerclage.In clinical practice,early diagnosis and treatment should be made for patients with cervical insufficiency.Cervical cerclage should be performed before cervical shortening to improve the pregnancy outcome of pati

关 键 词：宫颈功能不全 宫颈环扎术 妊娠结局 相关因素 

分 类 号：R714[医药卫生—妇产科学]