救援性宫颈托治疗紧急宫颈环扎术后再次宫颈缩短和/或宫口扩张的临床观察  

Clinical Observations on the Treatment of Recurrent Cervical Shortening and/or Uterine Dilatation after Emergency Cervical Cerclage with a Rescue Cervical Tray

作　　者：田思萌 杜凌君 孙欣 林琳[2] TIAN Si-meng;DU Ling-jun;SUN Xin;LIN Lin(First Clinical Medical College of Harbin Medical University,Harbin,Heilongjiang,150060,China;Obstetrics and Gynecology Department,First Clinical Medical College of Harbin Medical University,Harbin,Heilongjiang,150060,China)

机构地区：[1]哈尔滨医科大学附属第一临床医学院,黑龙江哈尔滨150060 [2]哈尔滨医科大学附属第一临床医学院妇产科,黑龙江哈尔滨150060

出　　处：《现代生物医学进展》2024年第11期2197-2200,共4页Progress in Modern Biomedicine

摘　　要：目的:观察救援性宫颈托治疗在治疗紧急宫颈环扎术后发生进一步宫颈缩短和/或宫口开大患者的临床结局。方法:2021年05月31日至2022年01月13日于哈尔滨医科大学附属第一医院产科行紧急宫颈环扎术的患者,术后超声监测宫颈长度、内诊,对于超声提示宫颈缩短和/或宫口扩张,经阴道检查可见宫颈管扩张伴胎胞暴露的患者(单胎)进行救援性宫颈托治疗(11例)。随访观察其妊娠结局及不良反应。结果:进行紧急宫颈环扎术孕周为107-201天(平均165.5±34.9天);救援性宫颈托放置孕周为169-262天(平均205.9±26.1);分娩孕周为193-269天(平均249.5±24.9天);延长天数为18-160天(平均84.0±46.3天)。未出现医源性胎膜早破及绒毛膜羊膜炎。11例患者中10例患者获得新生儿。存活的10例新生儿4例于新生儿科住院治疗,均后期顺利出院,新生儿存活率为100%。结论:本组病例使用救援性宫颈托明显延长紧急宫颈环扎术后宫颈缩短和/或宫口扩张患者的孕周,改善妊娠结局。Objective:To observe the clinical outcome of rescue cervical tray therapy in treating patients with further cervical shortening and/or cervical opening after emergency cervical cerclage.Methods:Patients who underwent emergency cervical cerclage in the Department of Obstetrics of the First Affiliated Hospital of Harbin Medical University from 31 May 2021 to 13 January 2022,with postoperative ultrasonographic monitoring of cervical length,internal diagnosis,and rescue cervical tray treatment were performed in patients with ultrasonographic indications of shortening of cervix and/or dilatation of uterine opening,and dilatation of the cervical canal with exposure of the fetus cysts(singleton fetus)by transvaginal examination(11 cases).Their pregnancy outcome and adverse effects were followed up.Results:Gestational weeks for emergency cervical cerclage were 107-201 days(mean 165.5±34.9 days);gestational weeks for rescue cervical tray placement were 169-262 days(mean 205.9±26.1);gestational weeks for delivery were 193-269 days(mean 249.5±24.9 days);and prolonged days ranged from 18-160 days(mean 84.0±46.3 days).There was no medically induced premature rupture of membranes or chorioamnionitis.10 out of 11 patients obtained newborns.Four of the surviving 10 neonates were admitted to the neonatal unit and all were successfully discharged at a later stage,giving a neonatal survival rate of 100%.Conclusion:The use of rescue cervical supports significantly prolonged gestational weeks and improved pregnancy outcomes in patients with shortened cervix and/or dilated uterine opening after emergency cervical cerclage in this group of cases..

关 键 词：宫颈机能不全 紧急宫颈环扎术 宫颈托 早产 

分 类 号：R714.2[医药卫生—妇产科学]