不同手术时机行宫颈环扎术对宫颈机能不全孕妇宫内感染的影响  

Effects of cervical cerclage at different surgical timings on intrauterine infection in pregnant women with cervical insufficiency

作　　者：沈娟 于文亮 Shen Juan;Yu Wenliang(Department of Obstetrics and Gynecology,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang Sichuan 621000,P.R.China)

机构地区：[1]电子科技大学医学院附属绵阳医院绵阳市中心医院妇产科,四川绵阳621000

出　　处：《中国计划生育和妇产科》2025年第3期58-61,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的 探究不同手术时机行宫颈环扎术(CC)对宫颈机能不全(CIC)孕妇宫内感染的影响。方法 回顾性选取2021年9月至2023年9月绵阳市中心医院收治的79例因CIC行CC的孕妇为研究对象,根据手术时机的不同将患者分为择期组、应急组和紧急组。分析所有患者的临床资料,对比3组孕妇的术后情况、妊娠结局以及新生儿情况,分析不同手术时机行CC对CIC孕妇宫内感染的影响以及对孕妇妊娠结局和新生儿的影响。结果 3组年龄、BMI、孕周、妊娠次数、流产次数、宫腔镜手术史、宫颈手术史、术前外周血WBC、CRP比较,差异无统计学意义(P>0.05);择期组的孕周延长时间、手术成功率高于应急组和紧急组,住院时间低于应急组和紧急组(P<0.05);比较3组孕妇羊水感染相关指标发现,细菌、支原体检测结果均为阴性,择期组羊水CRP、WBC、IL-8、TNF-α低于应急组和紧急组(P<0.05);择期组的宫内感染、产褥感染、胎膜早破、新生儿呼吸窘迫、黄疸率低于应急组和紧急组,新生儿1 min Apgar评分高于应急组和紧急组(P<0.05)。结论 在孕早中期择期对孕妇行CC的效果优于应急和紧急行CC,发生宫内感染的概率较低,而紧急行CC的效果较差,发生宫内感染的概率较大。Objective To explore the effects of cervical cerclage(CC) at different surgical timings on intrauterine infection in pregnant women with cervical insufficiency(CIC).Methods We retrospectively selected 79 pregnant women who underwent CC due to CIC who were admitted to Mianyang Central Hospital from September 2021 to September 2023 as the research subjects.The patients were divided into elective group,response group and emergency group according to the timing of surgery.The clinical data of all patients were analyzed,the postoperative conditions,pregnancy outcomes,and neonatal conditions of 3 groups of pregnant women were compared,and the impact of CC performed at different surgical timings on intrauterine infection in pregnant women with CIC and its impact on pregnancy outcomes and neonates were analyzed.Results There was no statistically significant difference in age,BMI,gestational age,number of pregnancies,number of miscarriages,history of hysteroscopy surgery,history of cervical surgery,preoperative peripheral blood WBC,and CRP between the 3 groups(P>0.05);the weekly extension time and surgical success rate in elective group were higher than those of the response group and the emergency group,and the hospitalization time was lower than those of the response group and the emergency group(P<0.05);comparing the amniotic fluid infection-related indicators of 3 groups of pregnant women,it was found that the test results for bacteria and mycoplasma were all negative.The amniotic fluid CRP,WBC,IL-8,and TNF-α of the elective group were lower than those of the response group and emergency group(P<0.05);the rates of internal infection,puerperal infection,premature rupture of membranes,neonatal respiratory distress,and jaundice in elective group were lower than those in the response group and the emergency group,and the neonatal 1 min Apgar score was higher than that of the response group and emergency group(P<0.05).Conclusion The effect of elective CC on pregnant women in the first and second trimester is better than t

关 键 词：手术时机 子宫颈环扎术 子宫颈机能不全 孕妇 宫内感染 

分 类 号：R619.3[医药卫生—外科学] R713.4[医药卫生—临床医学]