腹部B超联合宫颈环扎在复发性晚期流产防治中的应用

Application of abdominal B ultrasound combined with cervical cerclage in prevention and control of recurrent abortion

目的：研究腹部B超联合宫颈环扎在复发性晚期流产防治中的应用价值。方法：将2010年6月-2013年5月期间在我院接受腹部B超联合宫颈环扎治疗的患者纳入观察组,进行前瞻性研究;2007年1月~2010年5月期间在我院接受紧急宫颈环扎术的合适病例纳入对照组,进行回顾性研究,比较两组患者的炎症反应、应激反应和分娩结局。结果：（1）观察组产妇流产率（3.6%）、早产率（21.4%）,均少于对照组（21.4%、50.0%）,足月分娩率（75.0%）高于对照组（28.6%）;观察组胎儿的早产存活率（100.0%）、足月存活率（95.0%）均高于对照组（57.1%、50.0%）,差异有统计学意义（P均〈0.05）。（2）观察组患者肾上腺素、去甲肾上腺素、肾素、血管紧张素Ⅱ水平以及肿瘤坏死因子-a（TNF-a）、白介素1、6（IL-1、IL-6）水平均低于对照组,差异有统计学意义（P均〈0.05）。结论：腹部B超联合宫颈环扎能够延长妊娠时间,提高足月分娩率和胎儿存活率,且孕14~18周是治疗的最佳时机。

Objective： To study the application value of abdominal B ultrasound combined with cervical cerclage in the prevention and control of recurrent abortion. Methods： Patients received abdominal B ultrasound combined with cervical cerelage in our hospital from 2011 June to 2013 May were enrolled in observation group; while patients received emergency cervical cerclage from 2007 January -2010 May were enrolled in control group. Then inflammation reaction, stress reaction and delivery outcome were compared. Results. （1） Abortion rate was 3.6%, premature delivery rate was 21.4% in observation group,while abortion rate was 21.4%, premature delivery rate was 50.0% in control group. Term delivery rate in observation group was higher than that of control group; fetal premature survival rate, term survival rate of observation group were higher than those of control group. TNF-a, IL-1, IL-6 levels and adrenaline, noradrenaline, renin, angiotensin II levels of observation group were lower than those of control group. Conclusions： Abdominal B ultrasound combined with cervical cerclagecan can prolong the time of pregnancy, increase term delivery rate and fetal survival rate. 14-18 weeks pregnant is the best time for treatment.