摘要
目的探讨经阴道择期宫颈环扎术和紧急宫颈环扎术的治疗效果。方法回顾性分析2016年1月—2020年12月于广州市妇女儿童医疗中心确诊为宫颈机能不全患者,78例患者分别实施了经阴道择期宫颈环扎术(n=43)和经阴道紧急宫颈环扎术(n=35),比较两组术前宫颈管长度、手术时长、出血量、手术孕周、术后延长孕周、新生儿出生体质量、足月产率、早产率、活产率等指标。结果择期环扎组和紧急环扎组在手术孕周[(18.4±4.0)w VS(23.1±2.2)w]、术前宫颈长度[(22.0±7.1)mm VS(1.6±4.0)mm]、分娩孕周[(36.7±3.6)w VS(33.8±4.1)w]、术后延长孕周[(18.3±6.1)w VS(10.7±4.8)w]、新生儿出生体质量[(2641.4±662.9)g VS(2197.7±839.7)g]等方面均差异存在统计学意义(P<0.05)。择期环扎组足月产率(65.1%)高于紧急环扎组(25.7%),择期环扎组早产率(30.2%)明显低于紧急环扎组(62.9%),两组差异存在显著统计学意义(P<0.05)。结论相比于紧急宫颈环扎术,择期宫颈环扎术能显著延长孕周,增加新生儿活产率,降低早产率,改善新生儿结局,故择期宫颈环扎术的疗效优于紧急宫颈环扎术。
Objective To explore the efficacy of selective cervical cerclage and emergency cervical cerclage via vagina.Methods From January 2016 to December 2020,78 patients who were diagnosed with cervical insufficiency in Guangzhou Women and Children’s Medical Center were retrospectively analyzed,and they were administered selective cervical cerclage(n=43)and emergency cervical cerclage(n=35),respectively.The preoperative length of cervical canal,surgical time,blood loss,operation gestational age,postoperative prolonged gestational age,birth weight of newborn,full-term delivery rate,premature birth rate,live birth rate and other indicators were compared between the two groups.Results Between the selective cerclage group and emergency cervical cerclage group,statistically significant differences existed in the operation gestational age[(18.4±4.0)w vs.(23.1±2.2)w],preoperative cervical length[(22.0±7.1)mm VS(1.6±4.0)mm],delivery gestational age[(36.7±3.6)w vs.(33.8±4.1)w],postoperative prolonged gestational age[(18.3±6.1)w vs.(10.7±4.8)w]and the birth weight of newborn[(2641.4±662.9)g vs.(2197.7±839.7)g].The full-term delivery rate in the selective cerclage group was significantly higher than that in the emergency cerclage group(65.1%vs.25.7%,P<0.05),and the premature birth rate in the selective cerclage group was significantly lower than that in the emergency cerclage group(30.2%vs.62.9%,P<0.05).Conclusion Compared with emergency cervical cerclage,elective cervical cerclage can significantly prolong the gestational age,increase the live birth rate,reduce the premature delivery rate and improve the neonatal outcome,so the curative effect of elective cervical cerclage is better than emergency cervical cerclage.
作者
金小龙
易莉莎
苏向辉
唐翔
JIN Xiaolong;YI Lisha;SU Xianghui;TANG Xiang(Guangzhou Women and Children’s Medical Center,Guangzhou 510623,China)
出处
《现代医院》
2022年第8期1309-1312,共4页
Modern Hospitals
基金
广东省医学科学技术研究基金项目(A2021341)。
关键词
择期宫颈环扎术
紧急宫颈环扎术
宫颈环扎术
宫颈机能不全
Selective cervical cerclage
Emergency cervical cerclage
Cervical cerclage
Cervical insufficiency
