孕前应用Mersilene带行不同术式宫颈环扎效果观察  

Observation of the effect of different cervical cervicalysis with Mersilene band before pregnancy

作　　者：吴超英[1] 马文琴[1] 赵丹梅[1] WU Chaoying;MA Wenqin;ZHAO Danmei(Department of Gynaecology,Changzhou Maternal and Child Health Care Hospital,Changzhou Medical Center,Nanjing Medical University,Changzhou 213000,Jiangsu,China)

机构地区：[1]南京医科大学常州医学中心常州市妇幼保健院妇科,常州213000

出　　处：《医学研究与战创伤救治》2023年第12期1261-1265,共5页Journal of Medical Research & Combat Trauma Care

基　　金：江苏省社科应用研究精品工程项目(22SCB-59);常州市科技局应用基础研究指导性项目(CJ20239028)。

摘　　要：目的探讨在孕前应用Mersilene带行腹腔镜下子宫颈环扎术和经阴道子宫颈环扎术治疗宫颈机能不全的临床应用效果。方法回顾性分析2020年1月-2023年5月在常州市妇幼保健院孕前应用Mersilene带进行宫颈环扎术的41例患者的临床资料。按不同的手术方式分为2组,其中腹腔镜下宫颈环扎术组(腹腔镜组)24例,经阴道宫颈环扎术组(经阴道组)17例。统计并比较2组患者术中出血量、手术时间、术后住院时间、术后白细胞计数、术中术后并发症发生情况、术后1年以内妊娠人数及分娩孕周情况。结果经阴道组较腹腔镜组患者手术时间短[(46.47±4.92)min vs(53.96±6.42)min],差异有统计学意义(P<0.01)。经阴道组术后次日白细胞计数指标高于腹腔镜组[(10.14±0.93)×10^(9)/L vs(9.07±1.06)×10^(9)/L],差异有统计学意义(P<0.01)。经阴道组术中出血量(31.76±6.83)mL较腹腔镜组(28.13±10.41)mL稍多,但差异无统计学意义(P>0.05)。2组患者术后住院天数、术中术后并发症、术后1年以内受孕人数及分娩孕周相比,差异均无统计学意义(P>0.05)。结论孕前应用Mersilene带行腹腔镜下宫颈环扎术和经阴道宫颈环扎术是治疗宫颈机能不全的有效治疗方法,术前应根据患者病史、宫颈条件,充分评估,结合患者自身意愿有针对性地选择相应手术方式,才能达到最佳治疗效果。Objective To investigate the clinical effects of laparoscopic cervical cerclage and transvaginal cervical cervical cerclage in the treatment of cervical incompetence with Mersilene band before pregnancy.Methods From January 2020 to May 2023,the clinical data of 41 patients who underwent cervical cerclage with Mersilene band before pregnancy in Changzhou Maternal and Child Healthcare Hospital were retrospectively analyzed.They were divided into 2 groups according to different surgical methods,of which 24 cases were in laparoscopic cervical cerclage group(laparoscopic group)and 17 cases in transvaginal cervical cervical cerclage group(transvaginal group).Intraoperative blood loss,operation time,postoperative hospital stay,postoperative white blood cell count,intraoperative and postoperative complications,number of pregnancies within 1 year after operation and gestational week of delivery were statistically compared between the two groups.Results The operation time in the transvaginal group was shorter than that in the laparoscopic group[(46.47±4.92)min vs(53.96±6.42)min],and the difference was statistically significant(P<0.01).The WBC count index of the transvaginal group was higher than that of the laparoscopic group the next day after surgery[(10.14±0.93)×10^(9)/L vs(9.07±1.06)×10^(9)/L],and the difference was statistically significant(P<0.01).The intraoperative blood loss in the transvaginal group(31.76±6.83)mL was slightly more than that in the laparoscopic group(28.13±10.41)mL,but the difference was not statistically significant(P>0.05).There were no significant differences in postoperative hospitalization days,intraoperative and postoperative complications,number of pregnancies within 1 year after surgery and gestational weeks of delivery between 2 groups(P>0.05).Conclusion Laparoscopic cervical cerclage with Mersilene band and transvaginal cervical cervix cerclage before pregnancy are effective treatments for cervical incompetence.Before surgery,we should fully evaluate the patient's medical history

关 键 词：宫颈机能不全 腹腔镜下子宫颈环扎术 经阴道子宫颈环扎术 Mersilene带 

分 类 号：R713.4[医药卫生—妇产科学]