不同指征宫颈环扎术治疗宫颈机能不全的疗效分析  

Analysis of curative effect and pregnancy outcome of cervical ceratectomy for patients with cervical insufficiency under different indications

作　　者：钟静 蓝柳冰[1] ZHONG Jing;LAN Liu-bing(Meizhou People's Hospital,Meizhou 514031,Guangdong)

机构地区：[1]梅州市人民医院,广东梅州514031

出　　处：《安徽医专学报》2023年第6期108-110,共3页Journal of Anhui Medical College

摘　　要：目的:探讨不同指征下宫颈环扎术治疗宫颈机能不全患者的疗效。方法:回顾性分析在医院行McDonald术的143例单胎孕妇的临床资料,根据不同指征分为预防性环扎组(59例)超声指征环扎组(50例)、紧急环扎组(34例)。比较3组手术成功率、母儿结局。结果:紧急环扎组孕妇的手术孕周、分娩孕周、延长孕周、足月分娩率、流产率、手术成功率与预防性环扎组、超声指征环扎组比较,差异均有统计学意义(P<0.05)。超声指征环扎组孕妇的手术孕周、分娩孕周、延长孕周与预防性环扎组比较,差异有统计学意义(P<0.05),而足月分娩率、早产率、流产率及手术成功率比较,两者间差异无统计学意义(P>0.05)。紧急环扎组的新生儿生后1分钟Apgar评分、新生儿出生体质量与预防性环扎组、超声指征环扎组比较,差异有统计学意义(P<0.05);紧急环扎组、超声指征环扎组孕妇的转NICU率与预防性环扎组比较,差异有统计学意义(P<0.05)。结论:宫颈环扎术能够有效地延长宫颈机能不全患者的妊娠周期,且预防性环扎延长的孕周更长、新生儿的出生体质量更好、转NICU率更低。Objective:To explore the therapeutic effect of cervical ceration on patients with cervical insufficiency under dfferent indications and its influence on pregnancy outcome.Methods:The clinical data of 143 singlet pregnant women who received McDonald cervical ceration were retrospectively analyzed.According to different indications,they were divided into preventive ceration group(n=59),ultrasonic indicating ceration group(n=50)and emergency ceration group(n=34),all of which received improved cervical ceration.The operation success rate,pregnancy outcome and neonatal outcome were compared between the three groups.Results:The gestational weeks of operation,delivery,extended gestational weeks,term delivery rate,abortion rate and operation success rate of the emergency group were statistically different from those of the preventive group and the ultrasonic indication group(P<0.05).There were statistical dfferences in the gestational weeks of operation,delivery and extended gestational weeks between the ultrasound indication group and the preventive group(P<0.05),but there were no statistical differences in the rate of full-term delivery,preterm delivery,abortion and surgical success rate(P>0.05).The Apgar score and birth weight of newborns in the first minute after birth of the emergency ligation group were statistically different from those in the preventive ligation group and the ultrasound indication ligation group(P<0.05).There was a statistical difference in the rate of NICU transfer between the emergency group and the ultrasonic indication group and the preventive group(P<0.05).Conclusion:Cervical cervix can effectively prolong the pregnancy cycle of pregnant women with cervical insufficiency.Prophylactic cervical cervix is associated with longer gestational period,heavier birth weight and lower NICU transfer rate.

关 键 词：宫颈机能不全 宫颈环扎术 疗效 妊娠结局 

分 类 号：R714.3[医药卫生—妇产科学]