宫颈环扎术治疗妊娠合并宫颈机能不全的疗效分析  

Analysis about the effect of cervical cerclage in the treatment of pregnancy with cervical insufficiency

作　　者：伊丽努尔·阿布力孜 黄莺[1] 冯国惠[1] YILINUER Abulizi;HUANG Ying;FENG Guohui(People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,830001,China)

机构地区：[1]新疆维吾尔自治区人民医院,乌鲁木齐830001

出　　处：《新疆医学》2023年第1期54-57,94,共5页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(项目编号:2021D01C170)。

摘　　要：目的 浅析宫颈机能不全者选取不同医治方法对其妊娠结局的影响。方法 选取本院2019年1月-2020年8月间所接收的75例妊娠并发宫颈机能不全的孕妇,根据治疗方法将分为保守治疗组(15例)与手术治疗组(60例);手术组根据宫颈环扎手术时机不同将其分为手术Ⅰ组(预防性宫颈环扎术组,17例)、手术Ⅱ组(治疗性宫颈环扎术组,26例)和手术Ⅲ组(紧急性宫颈环扎术组,17例)。对不同医治手段对宫颈机能不全病人妊娠结局的影响情况。结果 (1)保守组与手术治疗组比较:新生儿生存率、足月产率、孕周延长时间、流产率上,差异有统计学意义(P <0.05);(2)手术治疗Ⅰ组、Ⅱ组分足月产率、新生儿存活率均高于手术治疗Ⅲ组,手术治疗Ⅰ组、Ⅱ组延长孕周时间均长于手术治疗Ⅲ组,差异均有统计学意义(P <0.05),较Ⅱ组而言,孕周延长时间上Ⅰ组更长些,差异有统计学意义(P <0.05)。结论 (1)宫颈环扎术对宫颈机能不全病人的妊娠结局有一定改善作用;(2)治疗性宫颈环扎术和预防性宫颈环扎术在改善母婴妊娠结局的成效比紧急性宫颈环扎术更优,为此于宫颈变化前开展干预手段可改变妊娠结局。Objective To analyze the effect of different treatment methods on pregnancy outcome in patients with cervical insufficiency. Methods 75 cases undergoing pregnancy complicated with cervical insufficiency in our hospital from January 2019 to August 2020 were selected as the research objects. According to the treatment method, they were divided into conservative treatment group(15 cases)and surgical treatment group(60cases). According to the timing of cervical cerclage, the operation group was divided into group Ⅰ (there were 17 cases who were treated with preventive cervical cerclage), group Ⅱ (there were 26 cases treated with therapeuticcervical cerclage)and group Ⅲ(17 cases treated with acute cervical cerclage). The influence of different treatment methods on pregnancy outcome of patients with cervical insufficiency was analyzed. Results There were statistically significant differences between the conservative group and the operation group in neonatal survival rate, full term birth rate, extended gestation time and abortion rate(P <0.05). Term production rate, newborn survival rates in group Ⅰ and group Ⅱ were higher than those in group Ⅲ, gestation time in groupⅠ and group Ⅱwere longer than the that in group Ⅲ, and the differences were statistically significant(P < 0.05). Compared with groupⅡ, gestation timewas longer in groupⅠ, and the difference was statistically significant(P < 0.05). Conclusion Cervical ceration can improve the pregnancy outcome of patients with cervical insufficiency. Therapeutic and preventive cervical ceration are more effective than emergency cervical ceration in improving maternal and infant pregnancy outcomes. Therefore, intervention before cervical changes can change pregnancy outcomes.

关 键 词：宫颈机能不全 宫颈环扎术 不同手术时机 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]