预防性McDonald术对宫颈纵隔切开术后宫颈机能不全的治疗效果  

Efficacy of preventive McDonald cervical cerclage for patients with cervical incompetent after cervical septum incision

作　　者：毛萌[1] 刘亚娜 付翰林 王倩[1] 白晶[1] 郭瑞霞[1] MAO Meng;LIU Yana;FU Hanlin;WANG Qian;BAI Jing;GUO Ruixia(Department of Gynecology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院妇科,郑州450052

出　　处：《郑州大学学报（医学版）》2024年第1期12-15,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省中青年卫生健康科技创新领军人才培养项目(YXKC2020012);河南省自然科学基金青年基金项目(222300420339)。

摘　　要：目的:探讨预防性宫颈环扎术对宫颈纵隔切开术后宫颈机能不全(CIC)的治疗效果。方法:收集2012年9月至2022年12月在郑州大学第一附属医院行预防性McDonald术的宫颈纵隔切开术后CIC的患者共20例(纵隔组),均为单胎妊娠。从同时间段在该院行预防性McDonald术的非子宫畸形单胎妊娠的CIC患者中,采用倾向性评分匹配法(最近邻匹配法,1∶1匹配)选取20例(非畸形组)。比较两组的疗效,包括妊娠结局、分娩方式及新生儿情况等。结果:两组基线资料差异无统计学意义。纵隔组和非畸形组的活产率分别为15/20和18/20,低出生体重儿率分别为6/15和5/18,差异均无统计学意义(P>0.05)。纵隔组的足月产率(25%)低于非畸形组(60%,P<0.05)。结论:预防性McDonald术对宫颈纵隔切开术后CIC患者是可行的,宫颈纵隔切开术后和非子宫畸形的CIC患者预防性McDonald术的疗效无明显差异。Aim:To investigate the efficacy of preventive McDonald cervical cerclage for patients with cervical incompetent(CIC)after cervical septum incision.Methods:A total of 20 patients diagnosed as CIC after cervical septum incision in the First Affiliated Hospital of Zhengzhou University between September 2012 and December 2022(septum group)were selected,and 20 patients diagnosed as CIC without uterine malformation were enrolled using propensity score matching method(non-uterine malformation group).All the 40 patients had single pregnancy and underwent preventive McDonald cervical cerclage.The pregnancy and fetal outcomes were compared.Results:The baseline clinical characteristics were similar in the two groups.The live birth rate in the septum group was 15/20 and 18/20 in the non-uterine malformation group,respectively,without significant difference,while the term delivery rate in the septum group was lower than that in the non-uterine malformation group(25%vs 60%,P<0.05).The rate of birth weight<2500 g had no difference between the two groups(6/15 vs 5/18).Conclusion:Preventive McDonald cervical cerclage is feasible for the patients with CIC after cervical septum incision,and the efficacy has no significant difference between the septum group and non-uterine malformation group.

关 键 词：宫颈纵隔切开术 宫颈机能不全 预防性McDonald术 

分 类 号：R713.4[医药卫生—妇产科学]