非孕期腹腔镜下宫颈峡部环扎术治疗宫颈机能不全的疗效分析  

Analysis of the efficacy of laparoscopic cervical-isthmus cerclage in the treatment of non-pregnant patients with cervical insufficiency

作　　者：王国宁 王永春 李扬 魏延菊 WANG Guo-ning;WANG Yong-chun;LI Yang(Weifang Hospital of Traditional Chinese Medicine,Weifang 261000,China)

机构地区：[1]潍坊市中医院,261000

出　　处：《中国现代药物应用》2024年第12期15-19,共5页Chinese Journal of Modern Drug Application

基　　金：宫颈机能不全患者孕前经腹腔镜宫颈内口环扎术临床分析(项目编号:WFWSJK-2022-031)。

摘　　要：目的分析对宫颈机能不全者实施非孕期腹腔镜下宫颈峡部环扎术治疗的临床效果及对日后妊娠结局的影响。方法选取77例非孕期行腹腔镜下宫颈峡部环扎术治疗的宫颈机能不全患者作为观察组,另选择52例孕期行经阴道宫颈环扎术治疗的宫颈机能不全患者作为对照组。对比两组手术相关指标、分娩情况、妊娠结局以及新生儿结局。结果观察组的手术时间(33.27±16.05)min长于对照组的(26.63±14.34)min(P<0.05);两组术中出血量差距不大,无统计学意义(P>0.05);观察组的住院时间(5.08±0.56)d短于对照组的(12.12±5.88)d(P<0.05)。观察组术后分娩成功率96.30%明显高于对照组的76.92%(P<0.05)。观察组的足月分娩率明显高于对照组(77.78%VS 51.92%),自然流产率明显低于对照组(3.70%VS 23.08%)(P<0.05);两组的早产率差距不大,无统计学意义(P>0.05)。对照组的活产儿出生体重与新生儿重症加强护理病房(NICU)住院率分别为(2971.38±825.12)g、20.00%,观察组分别为(3192.75±410.37)g、7.69%。两组的活产儿出生体重与NICU住院率无统计学意义(P>0.05)。结论对非孕期宫颈机能不全患者采用腹腔镜下宫颈峡部环扎术进行治疗,可以使妊娠结局得到良好改善,实际应用过程中效果优良,值得推广应用。Objective To explore and analyze the impact of laparoscopic cervical-isthmus cerclage in non-pregnant patients with cervical insufficiency and its influence on future pregnancy outcome.Methods A total of 77 non-pregnant patients with cervical insufficiency who underwent laparoscopic cervical-isthmus cerclage were selected as the observation group,and 52 pregnant patients with cervical insufficiency who underwent vaginal cervical cerclage were selected as the control group.The operation related indexes,delivery status,pregnancy outcome and neonatal outcome were compared between the two groups.Results The observation group had longer operation time of(33.27±16.05)min than(26.63±14.34)min in the control group(P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).The observation group had shorter hospitalization time of(5.08±0.56)d than(12.12±5.88)d in the control group(P<0.05).The success rate of postoperative delivery in the observation group was 96.30%,which was significantly higher than 76.92%in the control group(P<0.05).The observation group had significantly higher term delivery rate than that in the control group(77.78%VS 51.92%),and significantly lower spontaneous abortion rate than that in the control group(3.70%VS 23.08%)(P<0.05).There was no significant difference in the premature birth rate between the two groups(P>0.05).The birth weight of live births and neonatal intensive care unit(NICU)hospitalization rate in the control group were(2971.38±825.12)g and 20.00%,and those in the observation group were(3192.75±410.37)g and 7.69%.There was no statistical difference in the birth weight of live births and NICU hospitalization rate between the two groups(P>0.05).Conclusion The treatment of non-pregnant patients with cervical insufficiency by laparoscopic cervical-isthmus cerclage can improve the pregnancy outcome,and the effect is excellent in the actual application process,which is worthy of popularization and application.

关 键 词：非孕期 腹腔镜 宫颈峡部环扎术 宫颈机能不全 妊娠结局 

分 类 号：R713.4[医药卫生—妇产科学]