孕期不同指征经阴道宫颈环扎术的效果评价

Evaluation of Different Indications for Pregnancy by Transvaginal Cervical Cerclage Results

目的:回顾性分析孕期3种不同指征经阴道宫颈环扎术的妊娠结局和新生儿预后。方法:收集66例采用Mc Donald方法进行宫颈环扎术患者的临床资料。结果:病史指征性环扎组与超声指征性环扎组,在平均分娩孕周、活产率及新生儿平均出生体质量方面差异均无统计学意义(P>0.05)。紧急性环扎组的分娩孕周(29.17±6.44)周均低于病史指征性环扎组的(34.06±6.66)周和超声指征性环扎组的(35.42±4.75)周,差异有统计学意义(P<0.05)。紧急环扎组中手术失败孕妇在宫口开大程度、术后白细胞计数及C反应蛋白(CRP)最高值较手术成功孕妇高。结论:病史指征性环扎术和超声指征性环扎术均可获得良好的相似妊娠结局。术后加强抗炎可提高紧急性环扎手术的成功率。剖宫产再孕者有一定的发生宫颈机能不全的概率,孕期应B超监测宫颈的变化。

Objective：To retrospectively analyze the pregnancy outcome and neonatal prognosis of transvaginal cervical cerclage during pregnancy based on three different indications.Methods：Records of 66 patients with transvaginal cervical cerclage were retrospectively analyzed.Results：There were no statistically significant differences between elective cerclage group and ultrasound-indicated cerclage group in gestational age,live-birth rate and neonatal birth weight（P〉0.05）.The gestational age was（29.17±6.44） weeks in the emergency cerclage cervical group was lower than（34.06±6.66） weeks in the elective cerclage group and（35.42 ±4.75） weeks in the ultrasound-indicated cerclage group,the difference was statistically significant（P〈0.05）.In the emergency cerclage cervical group,the mean cervical dilation before operation,postoperative white blood cell count,highest level of C-reactive protein of the failure group were higher than the successful group.Conclusions：Pregnancy women with elective cervical cerclage and pregnancy women with ultrasound-indicated cerclage all achieve good and similar pregnancy outcome.Through effective strengthen anti-inflammatory,emergency cerclage cervical success rate can be improved.Caesarean re-pregnancy women those who have a certain probability of occurrence of cervical incompetence during pregnancy should check changes in the cervix by B-ultrasound.