孕中期宫颈机能不全行宫颈环扎术的临床疗效及手术时机探究

CLINICAL EFFICACY OF CERVICAL CERCLAGE IN PATIENTS WITH MIDTRIMESTER CERVICAL INCOMPETENCE AND ITS TIMING OF SURGERY INQUIRY

目的：探究宫颈环扎术治疗孕中期宫颈机能不全的最佳手术时机及其临床疗效。方法回顾性分析2009年1月—2012年1月在我院接受宫颈环扎术治疗的100例孕中期合并宫颈机能不全患者的临床资料，其中孕14～16周的孕妇60例，＞16孕周的孕妇40例。所有孕妇均实施宫颈环扎术治疗，其中行急诊手术者36例，行择期手术者64例，分别将其作为A、B二组。观察孕妇的妊娠结局及手术成功率。结果孕14～16周的孕妇行宫颈环扎术后胎儿存活率稍高于＞16孕周的患者，组间比较差异无统计学意义（ P＞0．05）。B组患者手术成功率为90．6％，明显高于A组（61．1％），组间比较差异有统计学意义（ P＜0．01）。结论宫颈环扎术对孕中期合并宫颈机能不全的治疗效果显著，可有效预防习惯性流产的发生，提高胎儿的成活率，在孕14～16周行宫颈环扎术最为安全有效，是手术的最佳时机。

Objective To explore the cervical cerclage optimal timing of surgery and clinical efficacy of the treatment in the second trimester cervical incompetence .Methods Clinical data of 100 cases of patients with second trimester cervical insufficiency treated by cervical cerclage in January 2008 - January 2012 in author＇s hospital were analyzed retrospectively ,in which 40 cases were over 16 weeks gestation ,60 cases in 14 to 16 weeks gestation .All pregnant women were implemented a cervical cerclage ,36 patients underwent an emergency surgery（group A） ,64 cases in elective surgery （group B） .The success rate of cervical cer‐clage and pregnancy outcomes were observed and compared between the two groups .Results The fetal vi‐ability in 14 to 16 weeks pregnant women after cervical cerclage were slightly higher than in patients over 16 weeks of gestation ,there was no significant difference between the two groups , P〉0 .05 .Successful surgery patients in group B was 90 .6 % ,significantly higher than group A （ 61 .1% ） ,there was signifi‐cant differences between the two groups , P〈0 .05 .Conclusion The treatment of cervical cerclage com‐bined second trimester cervical incompetence is significant ,can effectively prevent the occurrence of habit- 〈br〉 ual abortion ,improve the survival rate of the fetus .Cervical cerclage is the best surgery time with safe and effective at 14 to 16 weeks pregnant .