摘要
目的 探讨McDonald子宫颈环扎术的临床疗效及其影响因素。方法 回顾性分析2019年1月至2022年3月在我院行McDonald子宫颈环扎术的宫颈机能不全孕妇资料,并分别使用多因素logistic回归、神经网络模型以分析宫颈环扎失败的影响因素。结果 共纳入226例孕妇,其中30例(13.3%)孕妇于孕28周之前流产。多因素logistic回归分析结果:绒毛膜羊膜炎(OR=5.2;95%CI 2.013,13.428;P=0.001)、血小板淋巴细胞比(PLR)(OR=1.013;95%CI 1.005,1.021;P=0.02)和臀先露(OR=6.372;95%CI 2.017,13.428;P=0.001)是宫颈环扎失败的影响因素。神经网络模型结果:宫口扩张、绒毛膜羊膜炎、PLR、胎膜膨出、臀先露是环扎失败的影响因素。结论 McDonald宫颈环扎术是宫颈机能不全的有效治疗措施。宫口扩张、绒毛膜羊膜炎、PLR、胎膜膨出、臀先露是环扎失败的影响因素。
Objective To investigate the clinical efficacy of McDonald cervical cerclage and its influencing factors.Methods A retrospective analysis was conducted on data of pregnant women with cervical insufficiency who underwent McDonald cervical cerclage in our hospital from January 2019 to March 2022.Multivariable logistic regression and neural network model were used to analyze the factors influencing the failure of cervical cerclage.Results A total of 226 pregnant women were included,among which 30 cases(13.3%) experienced miscarriage before 28 weeks of gestation.The results of multivariable logistic regression analysis showed that chorioamnionitis(OR=5.2;95%CI 2.013,13.428;P=0.001),platelet-to-lymphocyte ratio(OR=1.013;95%CI 1.005,1.021;P=0.02),and breech presentation(OR=6.372;95%CI 2.017,13.428;P=0.001) were factors influencing the failure of cervical cerclage.The neural network model revealed that cervical dilatation,chorioamnionitis,platelet-to-lymphocyte ratio,membrane prolapse,and breech presentation were factors associated with cerclage failure.Conclusion McDonald cervical cerclage is an effective treatment for cervical insufficiency.Cervical dilatation,chorioamnionitis,platelet-to-lymphocyte ratio,membrane prolapse,and breech presentation are factors influencing the failure of cerclage.
作者
杨丹林
张钧
蒋玲玲
潘勉
YANG Danlin;ZHANG Jun;JIANG Lingling;PAN Mian(Fujian Provincial Maternal and Child Health Hospital,Fuzhou,Fujian 350005,China)
出处
《福建医药杂志》
CAS
2023年第4期4-7,共4页
Fujian Medical Journal
基金
福建省自然科学基金项目(2022J011034)。
关键词
宫颈机能不全
宫颈环扎
影响因素
cervical insufficiency
cervical cerclage
risk factors
