阴式宫颈环扎术在单胎妊娠孕中期的应用效果  

Clinical Application of Vaginal Cervical Cerclage

作　　者：林丽斌 LIN Libin(Department of Obstetrics,Putian Ninety-five Hospital of China Rongtong Medical Health Corporation,Putian 351100,China)

机构地区：[1]中国融通医疗健康集团莆田九十五医院产科,莆田351100

出　　处：《中国医药指南》2024年第14期124-127,共4页Guide of China Medicine

摘　　要：目的探讨单胎妊娠孕中期行阴式宫颈环扎术(McDonald术式)的临床应用效果和妊娠结局。方法回顾性分析2014年3月—2022年2月于中国融通医疗健康集团莆田九十五医院行阴式宫颈环扎术的单胎妊娠孕妇59例。根据不同手术指征分为三组:以病史为指征的环扎组(病史组)23例、以超声诊断结果为指征的环扎组(超声组)25例、以体格检查结果为指征的环扎组(体检组)11例。分析并比较三组的临床效果及妊娠结局。结果病史组、超声组、体检组延长孕周比较,病史组长于超声组,超声组长于体检组,差异均有统计学意义(P<0.05)。病史组、超声组的分娩孕周、流产率、足月率、活产率差异无统计学意义(P>0.05)。体检组的分娩孕周、流产率、足月率、活产率与病史组、超声组比较,差异有统计学意义(P<0.05)。超声组、体检组的早产率差异无统计学意义(P>0.05)。病史组的早产率与超声组、体检组比较,差异有统计学意义(P<0.05)。结论宫颈环扎术能有效改善宫颈机能不全单胎妊娠患者的妊娠结局。Objective To explore the effect and pregnancy outcome of vaginal cervical cerclage(McDonald's procedure)in the second trimester of singleton pregnancy.Methods A retrospective analysis was performed on 59 singleton pregnant women who underwent vaginal cervical cerclage in Putian Ninety-five Hospital of China Rongtong Medical Health Corporation from March 2014 to February 2022.The patients were divided into three groups according to different indications for surgery:23 cases in the cerclage group with medical history as the indication(medical history group),25 cases in the cerclage group with ultrasonic findings as the indication(ultrasound group),and 11 cases in the cerclage group with physical examination as the indication(physical examination group).The clinical effects and pregnancy outcome of three groups were analyzed.Results There was significant difference in prolonged gestational weeks all between the medical history group,the ultrasound group and the physical examination group,prolonged gestational weeks in the medical history group was higher than that in the ultrasound group and that in the ultrasound group was higher than that in the physical examination group(P<0.05).There was no significant difference in gestational weeks,abortion rate,term birth rate and live birth rate between the medical history group and the ultrasound group(P>0.05).There was significant difference in gestational weeks,abortion rate,term birth rate and live birth rate between the physical examination group and the medical history group as well as the ultrasound group(P<0.05).There was no significant difference in the preterm birth rate between the ultrasound group and the physical examination group(P>0.05).There was significant difference in the preterm birth rate between the medical history group and the ultrasound group as well as the physical examination group(P<0.05).Conclusions Cervical cerclage can effectively improve the pregnancy outcome of singleton patients with cervical insufficiency.

关 键 词：宫颈机能不全 手术指征 宫颈环扎术 妊娠结局 

分 类 号：R714.1[医药卫生—妇产科学]