早期早产临产不同干预措施的探讨

Study on the Intervention of Early Preterm Labor

目的:探讨对早期早产临产者实施干预的最佳时机和最佳方法。方法:选择2003年1月至2006年3月发生在34周前的早产临产病例73例,宫口开大5 cm以下,接受紧急宫颈环扎术和硫酸镁抑制宫缩者(39例)与接受单纯宫缩抑制剂治疗者(34例)进行对比分析。结果:紧急宫颈环扎术联合宫缩抑制剂组的保胎天数、34周后分娩率明显高于单纯镁抑制组(P<0.01)。对早产临产干预结局的影响因素为紧急宫颈环扎术。结论:单纯采用硫酸镁抑制宫缩对早产临产者进行干预可以延缓分娩,对于宫颈口扩张在5 cm以下的早产临产者,联合实施紧急宫颈环扎术和使用宫缩抑制剂,可以明显增加34孕周以上的分娩率。

Objective：The purpose of this study was to evaluate the measure of emergency cervical cerclage combined with tocolytic in preterm labour and seek for the optimal opportunity and approach for intervention of early preterm labor. Methods： Seventy three cases with preterm labor were enrolled in this study before 34 gestational weeks. 39 cases with cervical dilatation 〈 5 cm who received emergency cervical cerclage combined with tocolytic and 34 cases tocolytic alone were analized. The clinical outcomes were compared between two groups using univarlate analysis and multivariate logistic regression analysis. Results.The average prolongation of gestation and the rate of deliver after 34 weeks gestation were significantly higher in group received emergency cervical cerclage combined with tocolytic than cases in single tocolytic therapy group （ P〈 0.01 ） .Conclusions：This study showed that tocolytic prolonged pregnancy in pregnant women with symptoms of preterm labor. This delay was sufficient to allow treatment with antenatal steroids. Intervention of emergency cervical cerclage combined with tocolytic increased the delivery rate after 34 gestational weeks in preterm labor with advanced cervical dilatation 〈 5 cm.