摘要
目的:探讨宫颈紧急环扎术治疗宫颈机能不全(cervical incompetence,CI)的效果。方法:将我院2005-06-2009-12收治妊娠期宫颈机能不全患者20例分为:选择性环扎组7例,紧急环扎组7例,另外6例纳入保守治疗组作为对照(简称对照组)。入院后完善相关检查,全部手术组实施宫颈环扎术及药物保胎治疗,对照组仅给予保胎药物治疗。上述处理后观察5～7d,无流产征兆者出院,规律产检,随访至妊娠终止。观察其平均保胎天数、新生儿出生体重、新生儿存活、>34周分娩、>37周分娩、胎膜早破发生情况,对结果进行统计分析。结果:保胎天数:选择性环扎组(154.86±10.51)d,紧急环扎组(34.86±46.84)d,对照组(94.75±30.93)d;新生儿平均出生体重:选择性环扎组(3171.43±424.12)g,紧急环扎组(1557.14±907.11)g,对照组(2812.50±383.79)g;新生儿存活:选择性环扎组7例,紧急环扎组2例,对照组6例;>34周者分娩:选择性环扎组7例,紧急环扎组2例,对照组6例;>37周分娩:选择性环扎组4例,紧急环扎组1例,对照组3例;胎膜早破的发生:选择性环扎组0例,紧急环扎组4例,对照组0例。结论:宫颈机能不全是导致妊娠晚期流产和早产的常见原因,预防性宫颈环扎可延长保胎天数、增加>34周分娩、减少胎膜早破的发生、增加新生儿平均出生体重,但并不能减少早产的发生。对CI的低危患者,保守治疗也能取得较好的妊娠结局和新生儿结局。
Objective：To analyze the curative effect of cervical cerclage on cervical incompetence.Method：A total of 20women with cervical incompetence（CI） were enrolled in this study from June 2005to December 2009.Patients with CI were treated with preventive cervical cerclage,emergent cervical cerclage,or non-cervical cerclage treatment.After admission,patients were arranged to fulfill relating examinations.Preventive and emergent groups accepted cervical cerclage operation,while conservative group accepted tocolytics therapy.Patients were discharged if there were no signs of abortion 5to 7days after treatment.After discharge,patients should do prenatal examination regularly,and they were followed up until termination of pregnancy.Outcomes observed were as follows：（1） prolongation of pregnancy in weeks after cervical cerclage or conservative management,（2） birth weight of newborns（BW）,（3） presence of survival newborns,（4） presence of giving birth after the 34th week,（5） presence of fullterm labor,（6） presence of premature of membranes.Statistical analysis was done with the observed data.Both groups received multifactorial treatment with bed rest,tocolytic agents,broad-spectrum antibiotics.Result：（1） Prolongation of pregnancy：preventive cervical cerclage：154.86±10.51d,emergent cervical cerclage：34.86±46.84d,non-cervical cerclage：94.75±30.93d.（2） BW：preventive cervical cerclage：3 171.43±424.12g,emergent cervical cerclage：1 557.14±907.11g,non-cervical cerclage：2 812.50±383.79g.（3） Neonatal survival：preventive cervical cerclage：7cases,emergent cervical cerclage：2cases,non-cervical cerclage：6cases.（4） Presence of giving birth after the 34th week：preventive cervical cerclage：7cases,emergent cervical cerclage：2cases,non-cervical cerclage：6cases.（5） Presence of full-term labor：preventive cervical cerclage：4cases,emergent cervical cerclage：1cases,noncervical cerclage：3cases.（6） Presence of premature of membranes：preventiv
出处
《临床急诊杂志》
CAS
2013年第7期340-343,共4页
Journal of Clinical Emergency
关键词
宫颈机能不全
宫颈环扎术
紧急环扎术
早产
出生体重
cervical incompetence
cervical cerclage
emergency cerclage
preterm labor
birth weight
