摘要
目的 对比紧急性宫颈环扎术与预防性宫颈环扎术治疗宫颈机能不全的临床疗效。方法 以回顾性分析为法,观察对象为2021年1月至2022年6月入海南医学院第一附属医院的100例宫颈机能不全患者,参考手术时机分为研究组(n=50)与对照组(n=50),研究组行预防性宫颈环扎术治疗,对照组行紧急性宫颈环扎术治疗。比较两组患者的手术相关指标(术中出血量、手术时间、住院时间)、分娩情况(妊娠32周宫颈长度、分娩孕周、妊娠延长时间)、分娩结局(剖宫产、自然分娩)、妊娠结局(足月产率、早产率、流产率)及并发症(胎膜早破、产后出血、宫颈裂伤)发生情况。结果 两组患者手术时间比较差异无统计学意义(P>0.05);研究组患者术中出血量为(30.18±5.33) mL,明显低于对照组[(42.17±5.71) mL],住院时间为(6.81±2.74) d,明显短于对照组[(9.04±2.63) d],差异均有统计学意义(P<0.05)。研究组患者妊娠32周宫颈长度、分娩孕周、妊娠延长时间分别为(2.98±0.32) cm、(37.49±3.97)周、(9.82±2.47)周,均明显长于对照组[(2.49±0.28) cm、(34.68±4.08)周、(4.71±2.48)周],差异均有统计学意义(P<0.05)。研究组患者的剖宫产率为14.00%,明显低于对照组(34.00%),差异有统计学意义(P<0.05)。研究组患者的足月产率为58.00%,明显高于对照组(14.00%),早产率、流产率分别为38.00%、4.00%,明显低于对照组(60.00%、26.00%),差异均有统计学意义(P<0.05)。研究组患者的总并发症发生率为8.00%,明显低于对照组(26.00%),差异有统计学意义(P<0.05)。结论 预防性宫颈环扎术治疗宫颈机能不全的临床疗效优于紧急性宫颈环扎术,可明显减少患者术中出血量,缩短住院时间,还可进一步改善患者分娩情况及妊娠结局,减少并发症,安全性更高。
Objective To compare the clinical efficacy of emergency cervical cerclage and preventive cervical cerclage in the treatment of cervical incompetence.Methods By retrospective analysis,100 patients with cervical incompetence admitted to the First Affiliated Hospital of Hainan Medical College from January 2021 to June 2022 were divided into study group(n=50)and control group(n=50)according to the operation opportunity.The study group was treated with preventive cervical cerclage,while the control group was treated with emergency cervical cerclage.The operation-related indexes(intraoperative blood loss,operation time and hospitalization time),delivery situation(cervical length at 32 weeks of pregnancy,delivery week and prolonged pregnancy time),delivery outcome(cesarean section and natural delivery),pregnancy outcome(full-term rate,premature delivery rate and abortion rate)and complications(premature rupture of membranes,postpartum hemorrhage and cervical laceration)were compared between the two groups.Results There was no statistically significant difference in operation time between the two groups(P>0.05);the amount of intraoperative bleeding in the study group was(30.18±5.33)mL,which was significantly lower than that in the control group[(42.17±5.71)mL],and the hospitalization time was(6.81±2.74)d,which was significantly shorter than that in the control group[(9.04±2.63)d],the differences were statistically significant(P<0.05).The length of cervix at 32 weeks'gestation,the gestational age of delivery and the time of prolonged pregnancy in the study group were(2.98±0.32)cm,(37.49±3.97)weeks,and(9.82±2.47)weeks,respectively,which were significantly longer than those in the control group[(2.49±0.28)cm,(34.68±4.08)weeks,and(4.71±2.48)weeks],the differences were statistically significant(P<0.05).The cesarean section rate of patients in the study group was 14.00%,which was significantly lower than that in the control group(34.00%),the difference was statistically significant(P<0.05).The full-term delivery rate
作者
周玉华
符梅沙
吴小妹
薛春颜
ZHOU Yu-hua;FU Mei-sha;WU Xiao-mei(Department of Obstetrics,the First Affiliated Hospital of Hainan Medical College,Haikou Hainan 570000,China)
出处
《临床和实验医学杂志》
2023年第14期1537-1540,共4页
Journal of Clinical and Experimental Medicine
基金
海南省医药卫生科研项目(编号:1901032031A2002)。
关键词
宫颈机能不全
预防性宫颈环扎术
紧急性宫颈环扎术
分娩结局
妊娠结局
并发症
Cervical incompetence
Preventive cervical cerclage
Emergency cervical cerclage
Delivery outcome
Pregnancy outcome
Complication
