摘要
目的对比分析极简式腹腔镜下宫颈环扎术(SLCC)与经阴道宫颈环扎术(TVCC)的安全性、有效性及妊娠结局。方法选择2014年12月至2017年6月在安徽省妇幼保健院收治的宫颈机能不全病人52例,回顾性研究孕前SLCC(研究组)与孕期TVCC(对照组)的术中、术后资料及妊娠结局,每组各26例。结果研究组与对照组手术均顺利完成,无术中并发症;研究组手术时间(t=7.982,P<0.001)、出血量(t=2.854,P=0.008)均大于对照组,组间住院时间差异无统计学意义(t=-1.458,P=0.157)。研究组(37.43±1.28)周分娩孕周与对照组(36.52±2.66)周差异无统计学意义(t=1.237,P=0.225),妊娠并发症发生率显著降低(研究组:18.75%,对照组:61.54%),差异有统计学意义(χ^2=7.730,P=0.007);组间的新生儿体质量、产后出血差异无统计学意义(P>0.05);研究组妊娠结局(流产、早产、足月产,Z=-0.807,P=0.420)及新生儿住院率(χ^2=0.158,P=0.691)与对照组差异无统计学意义。结论对反复流产、经阴道环扎失败病人或宫颈缩短病人,SLCC是一种简单、安全、有效、可行的手术方式。
Objective Compare the safety,efficacy and pregnancy outcome of simplified laparoscopic cervical cerclage(SLCC) and transvaginal cervical cerclage(TVCC).Methods From December 2014 to June 2017,a total of 52 patients with cervical incompetence treated in Maternal and Child Health Hospital of Anhui Province:A retrospective study was performed to analyze the different of intraoperative and postoperative data and pregnancy outcomes between two groups,26 patients in each group.Results The operation of SLCC group and TVCC group were completed successfully without complications.The operation time(t=7.982,P<0.001),bleeding volume(t=2.854,P=0.008) of SLCC were greater than TVCC,the difference was statistically significant.There was no significant difference in hospitalization time(t=-1.458,P=0.157).Clinical follow-up analysis of pregnancy outcomes showed gestational age was longer than that of TVCC group,but without statistical difference [SLCC:(37.43±1.28) weeks,TVCC:(36.52±2.66) weeks,t=1.237,P=0.225],complications rate was lower than that of TVCC group with statistical difference(SLCC:18.75%,TVCC:61.54%,χ^2=7.730,P=0.007);No significant differences in newborn weight and postpartum hemorrhage between the two groups.The abortion rate,premature birth rate(Z=-0.807,P=0.420) and neonatal hospitalization rate(χ^2=0.158,P=0.691) were lower than the comparison group,but no significant differences in two groups.Conclusion Simplified laparoscopic cervical cerclage is a simple,safe,effective and feasible surgical method for recurrent abortion patients with vaginal cerclage failure or the shorten cervix,which is worthy of clinical application.
作者
张晓红
李甦斌
张楠
ZHANG Xiaohong;LI Subin;ZHANG Nan(Department of Gynecology,Maternal and Child Health Hospital of Anhui Province,Hefei,Anhui 230000,China)
出处
《安徽医药》
CAS
2019年第8期1579-1582,共4页
Anhui Medical and Pharmaceutical Journal
