宫颈环扎术在妊娠期宫颈机能不全中的临床价值

Clinical significance of cervical cerclage in treatment of cervical incompetence in pregnancy

目的评价宫颈环扎术在治疗妊娠期宫颈机能不全中的临床应用价值，并探讨影响妊娠结局的因素。方法对2005年1月至2011年5月在南京大学医学院附属鼓楼医院妇产科治疗的40例因宫颈机能不全于孕中期行宫颈环扎术的患者进行回顾性分析。结果40例手术患者中8例晚期流产，8例早产，24例足月分娩。手术时宫颈长度与妊娠结局呈显著性正相关（P=0．015），手术时孕周、宫颈形态等因素均对妊娠结局无显著性影响。结论宫颈环扎术是治疗妊娠期宫颈机能不全的有效手段，可用于预防反复晚期流产和早产，改善围产结局。宫颈环扎时的孕周、宫颈形态对妊娠结局无显著性影响，宫颈长度对于妊娠结局有显著性影响。

Objective To evaluate the clinical significance of cervical cerclage in management of cervical incompetence in pregnancy and to explore the influencing factors of pregnancy outcomes. Methods From January 2005 to May 2011,40 patients with cervical incompetence received cervical cerclage in department of obstetrics and gynecology of Drum Tower Hospital Affiliated to Medical Institute of Nanjing University. A retrospective study was conducted to analyze their data. Results Among 40 cases,8 patients had late abortion, 8 patients had premature birth and the other 24 cases experienced term labor. The cervical length was positively related with the results of pregnancy significantly （P =0.015）, but the cervical shape and operating gestational weeks were not significantly related with pregnancy outcomes. Conclusion Cervical cerclage is effective in the management of cervical incompetence and can be used to prevent recurrent late abortion and premature birth and improve perinatal outcomes. The cervical length is related with the results of pregnancy significantly, but the cervical shape and operating gestational weeks are not significantly related with pregnancy outcomes.