摘要
早产严重影响子代的近远期健康,其中2/3为自发性早产(SPTB),探索其高危因素并进行有效防治可有效降低SPTB的风险。子宫颈手术尤其子宫颈锥切术被用于诊治好发于育龄妇女的子宫颈上皮内瘤变(CIN),多数文献发现其与SPTB风险增加有关,究其机制可能与手术对子宫颈的机械及免疫屏障作用的破坏有关。文献提示,子宫颈弹性可能较子宫颈长度对SPTB的风险有更好的预测价值。关于SPTB防治策略的研究认为,子宫颈环扎反而增加早产风险,但鉴于回顾性研究混杂因素未得到充分控制,有待后续高质量随机对照研究提供更明确的结论。
Premature birth seriously affects the short-and long-term outcomes of the offspring.Two thirds of them are spontaneous premature birth(SPTB).Detection of high-risk factors and effective prophylactic treatment can effectively reduce the risk of SPTB.Cervical surgery,especially cervical conization,has been used to the management of cervical intraepithelial neoplasia(CIN),which tends to occur in women of childbearing age.Most of the literature reveals its association with increased risk of SPTB.The mechanism may be related to the destruction of the mechanical and immune barrier of the cervix by the surgery.The literature suggests that cervical elasticity might have a higher predictive value than cervical length for prediction for SPTB risks.Studies on its prevention strategies suggest that cerclage might increase the risk of premature delivery,but in view of the insufficient control of the confounding factors in the retrospective study,more definite conclusions need to be made by high-quality randomized controlled trials.
作者
蒋湘
应豪
JIANG Xiang;YINC Hao(Shang-hai First Maternity and Infant Hospital,School of Medicine,Tongji University,Shanghai 201204,Chin)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2023年第6期597-601,共5页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家重点研发计划(2022YFC2704600,2022YFC2704604)
国家自然科学基金(8227060896,82071678,82171683)
促进市级医院临床技能与临床创新三年行动计划(2020-2022年)重大临床研究项目(SHDC2020CR2059B)
上海市浦东新区卫生行业专项(PW2020E-1)。
关键词
早产
子宫颈手术史
子宫颈锥切
预测
预防
premature delivery
history of cervical surgery
cervical conization
prediction
prevention
