摘要
目的探讨中孕期宫颈机能不全孕妇于不同孕周施行紧急宫颈环扎术的临床预后。方法选取因宫颈机能不全于该院施行紧急宫颈环扎术的68例中孕期患者为研究对象。根据孕周,将68例患者分为A组(≤22周)、B组(22+1~24周)及C组(24+1~27周)。对孕妇年龄、孕产史、大月份流产史、宫颈管长度、宽度、漏斗形成及羊膜囊膨出等情况进行统计分析,比较不同孕周行宫颈环扎术的母婴预后。结果3组患者年龄、孕产史、大月份流产史、宫颈管长度、宽度、漏斗形成及羊膜囊膨出等情况比较差异无统计学意义(P>0.05)。C组的分娩孕周、延长孕周天数、延长妊娠时间超过28 d的比例均小于A、B组,差异有统计学意义(P<0.05)。A、B两组新生儿体质量大于C组;A、B两组新生儿体质量大于1000 g比例、Apgar评分、新生儿重症监护病房转入率均优于C组,差异有统计学意义(P<0.05)。3组患者宫颈环扎术后发生胎膜早破(24 h内)、抗生素使用超过6 d、环扎失败、重复环扎、早产胎膜早破、绒毛膜羊膜炎的比例比较,差异无统计学意义(P>0.05)。结论与孕22周后比较,孕22周前实施紧急宫颈环扎术能有效延长孕周及改善新生儿预后。
Objective To investigate the clinical prognosis of emergency cervical ligation at different gestational ages in women with cervical insufficiency during middle pregnancy.Methods A total of 68 patients who underwent emergency cervical ligation due to cervical insufficiency during middle pregnancy in the hospital were selected as study subjects.According to gestational weeks,68 patients were divided into group A(≤22 weeks),group B(22+1-24 weeks)and group C(24+1-27 weeks).The maternal age,history of pregnancy and delivery,history of abortion in large month,length and width of cervical canal,funnel formation and amniotic sac bulge were statistically analyzed to compare the prognosis undergoing cervical ligation at different gestational weeks.Results There were no statistically significant differences among the 3 groups in maternal age,history of pregnancy and delivery,history of abortion in large month,length and width of cervical canal,funnel formation and amniotic sac bulge.In group C,the gestational week of delivery,the days of extended gestation,and the proportion of extended pregnancy than 28 days were all smaller than those of group B and group A,with statistically significant differences(P<0.05).Neonatal weight of group A and group B was greater than that of group C.The proportion of newborn weight greater than 1000 g,Apgar score and transfer rate of neonatal intensive care unit were all better than group C,and the differences were statistically significant(P<0.05).There was no statistical difference in the proportions of premature rupture of membranes occurred after ligation(within 24 hours),antibiotics used for more than 6 days,failure of ligation,repeated ligation,premature rupture of membranes and chorioamnionitis(P>0.05).Conclusion Emergency cervical ligation before gestational age 22 weeks is more effective in prolongating the gestational age and improving the prognosis.
作者
邱江南
陈黎
张国英
范明松
QIU Jiangnan;CHEN Li;ZHANG Guoying;FAN Mingsong(Department of Gynecology,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210036,China;Department of Obstetrics,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210036,China)
出处
《重庆医学》
CAS
2021年第1期22-26,共5页
Chongqing medicine
基金
国家自然科学基金项目(81300507)。
关键词
宫颈机能不全
紧急宫颈环扎术
母婴预后
孕周
新生儿
cervical incompetent
emergency cervical cerclage
maternal and fetal prognosis
gestational age
newborn
