宫颈环扎术后抗生素应用与妊娠结局间的关系:一项单中心研究  

Relationship between antibiotic use after cervical cerclage and pregnancy outcomes:A single center study

作　　者：庄彩霞 刘浩[1] 李艳芳[1] 龚丽云[1] 路军丽[1] ZHUANG Cai-xia;LIU Hao;LI Yan-fang;GONG Li-yun;LU Jun-li(Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020)

机构地区：[1]首都医科大学附属北京朝阳医院,北京100020

出　　处：《生殖医学杂志》2025年第2期171-178,共8页Journal of Reproductive Medicine

摘　　要：目的探讨抗生素对宫颈环扎术治疗效果的影响,以期对孕期抗生素的规范应用提供更多参考。方法回顾性分析2019年1月至2023年12月间在北京朝阳医院接受非挽救性宫颈环扎术的100例孕妇的临床资料。纳入孕妇根据宫颈环扎术后抗生素应用时间分为应用≤24 h组(22例)及>24 h组(78例)。主要观察结局是术后分娩孕周,次要结局包括手术时住院时间、术后延长妊娠时间、胎膜早破率、剖宫产分娩率、新生儿转重症监护(NICU)率、不良结局率。比较两组的治疗结局,并分析妊娠结局的相关影响因素。结果两组孕妇的年龄、孕次、产次、宫颈操作次数、不良孕产史,以及宫颈环扎术操作情况(包括手术孕周、宫颈管≤1 cm比例)比较均无统计学差异(P>0.05)。两组间治疗结局(包括分娩孕周、术后延长孕周、新生儿转NICU率、不良结局率)比较亦均无统计学差异(P>0.05)。多因素Logistic回归分析结果显示,影响妊娠结局的因素包括宫颈管≤1 cm[OR=13.338,95%CI(1.851,96.119),P=0.010]、手术孕周晚[OR=1.621,95%CI(1.185,2.218),P=0.003]、发生胎膜早破[OR=0.095,95%CI(0.015,0.602),P=0.012],而术后抗生素的应用时间长短对妊娠结局的影响无统计学意义[OR=3.164,95%CI(0.473,21.148),P=0.235]。结论本研究中,非挽救性的宫颈环扎术后延长抗生素应用并未明显延长妊娠孕周、提高足月分娩率及降低新生儿转NICU率。Objective:To explore the effect of antibiotics on the treatment of cervical cerclage,in order to provide more references for the standardized use of antibiotics during pregnancy.Methods:A retrospective analysis was conducted on the clinical data of 100 pregnant women who underwent non salvage cervical cerclage surgery at Beijing Chao-yang Hospital from January 2019 to December 2023.Pregnant women were divided into two groups based on the duration of antibiotic use after cervical cerclage as a≤24-hour usage group(22 cases)and a>24-hour usage group(78 cases).The primary outcome was the gestational week of postoperative delivery,while secondary outcomes included the length of hospital stay during surgery,prolonged pregnancy time after surgery,premature rupture of membranes rate,cesarean section delivery rate,neonatal transfer to intensive care unit(NICU)rate,and adverse outcome rate.The treatment outcomes of two groups were compared and the relevant influencing factors of pregnancy outcomes were analyzed.Results:There were no statistically significant differences(P>0.05)in the age,gravity and parity,the number of cervical surgeries,the history of adverse pregnancy and childbirth,and cervical cerclage procedure(including gestational week at the time of surgery and the proportion of cervical canal≤1 cm)between the two groups.There were no statistically significant differences in treatment outcomes between the two groups,including gestational week at delivery,postoperative gestational week extension,neonatal transfer to NICU rate,and adverse outcome rate(P>0.05).The results of multiple logistic regression analysis showed that factors affecting pregnancy outcomes include cervical canal≤1 cm[OR=13.338,95%CI(1.851,96.119),P=0.010],late gestational week at the time of surgery[OR=1.621,95%CI(1.185,2.218),P=0.003],and the occurrence of premature rupture of membranes[OR=0.095,95%CI(0.015,0.602),P=0.012].However,the duration of postoperative antibiotic use had no statistically significant effect on pregnancy outcomes[OR=

关 键 词：宫颈环扎术 孕期抗生素暴露 妊娠丢失 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]