初次宫颈环扎后宫口再次扩张≤2cm行重复宫颈环扎术的临床观察  

Clinical Observation on Repeated Cervical Cerclage with a Dilation of≤2cm after Initial Cervical Cerclage

作　　者：杨丹林[1] 张钧 潘勉[1] Yang Danlin(Fujian Maternal and Child Health Hospital,Fuzhou Fujian 350005)

机构地区：[1]福建省妇幼保健院,福建福州350005

出　　处：《黑龙江医药》2023年第4期768-771,共4页Heilongjiang Medicine journal

基　　金：福建省科技计划项目(编号:2021Y9175);福建省科技计划项目(编号:2020Y9148);福建省自然科学基金资助项目(编号:2022J011034)。

摘　　要：目的:探究初次宫颈环扎后宫口再次扩张≤2cm行重复宫颈环扎术的临床效果。方法:回顾性分析2016年1月至2020年12月于我院初次行McDonald’s宫颈环扎术后再次出现宫口扩张的36例宫颈机能不全患者的临床资料。所有患者均行重复宫颈环扎术治疗。根据患者初次宫颈环扎后宫口再次扩张≤2cm(15例)和>2cm(21例)分为两组。统计所有患者的妊娠及分娩结局,并比较两组患者的人口统计学特征及妊娠结局。结果:初次宫颈环扎后宫口再次扩张≤2cm患者的重复环扎后孕周延长、从诊断到分娩孕周延长、分娩孕周长于初次宫颈环扎后宫口再次扩张>2cm患者,新生儿出生体重、新生儿存活率均高于初次宫颈环扎后宫口再次扩张>2cm患者,差异有统计学意义(P<0.05);两组患者的年龄、初产妇、顺娩次数、>14周流产次数比较,差异无统计学意义(P>0.05)。结论:初次宫颈环扎后宫口再次扩张≤2cm行重复宫颈环扎术可以延长宫颈机能不全患者的孕周,改善其妊娠结局及新生儿结局。Objective:To investigate the clinical effect of repeated cervical cerclage with a dilation of≤2cm after the initial cervical cerclage.Method:A retrospective analysis was conducted on the clinical data of 36 patients with cervical incompetence who underwent McDonald's cervical cerclage surgery for the first time from January 2016 to December 2020 and experienced cervical dilation again.All patients underwent repeated cervical cerclage surgery.Patients were divided into two groups based on whether the dilation of the cervix was≤2cm(15 cases)and>2cm(21 cases)after the initial cervical cerclage.Calculate the pregnancy and delivery outcomes of all patients,and compare the demographic characteristics and pregnancy outcomes of the two groups of patients.Result:Patients with recurrent dilation of the uterine opening≤2cm after initial cervical cerclage had longer gestational weeks,longer gestational weeks from diagnosis to delivery,and longer gestational weeks after delivery than those with recurrent dilation of the uterine opening>2cm after initial cervical cerclage.The birth weight and survival rate of newborns were higher than those with recurrent dilation of the uterine opening>2cm after initial cervical cerclage,and the difference was statistically significant(P<0.05);There was no statistically significant difference between the two groups in terms of age,primiparous women,number of consecutive deliveries,and number of miscarriages>14 weeks(P>0.05).Conclusion:Repeated cervical cerclage with a dilation of≤2cm after the initial cervical cerclage can prolong the gestational age of patients with cervical incompetence and improve their pregnancy and neonatal outcomes.

关 键 词：宫颈机能不全 重复宫颈环扎 宫口扩张 妊娠结局 

分 类 号：R711.74[医药卫生—妇产科学]