紧急宫颈环扎术联合网片补丁缝合治疗宫颈机能不全32例临床分析

Emergency Cervical Cerclage Combined Mesh Patch Suture in the Treatment Caused by Cervical Incompetence Clinical Analysis of 32 Cases

目的:探讨紧急宫颈环扎术联合网片补丁缝合治疗宫颈机能不全的临床价值。方法:选取2011年1月至2016年8月我院宫颈机能不全孕妇65例,32例施行紧急宫颈环扎联合网片补丁缝合术(A组),33例仅实施紧急宫颈环扎术(B组),对两组延长妊娠的时间、分娩孕周、新生儿结局、分娩方式及术后相关并发症进行比较。结果:A组手术时间长于B组,手术并发症宫颈裂伤A组少于B组,差异均有统计学意义(P<0.05);术后两组绒毛膜羊膜炎的发生率差异无统计学意义(P>0.05);A组延长孕周84.45±35.77天,B组延长孕周51.86±29.93天,两组比较差异有统计学意义(P<0.05);A组≥28周分娩23例(71.88%),B组≥28周分娩17例(51.52%),两组比较差异有统计学意义(P<0.05);两组分娩方式比较,差异无统计学意义(P>0.05);B组的新生儿出生体质量、出生时Apgar 1分钟评分均低于A组,差异均有统计学意义(P<0.05)。结论:紧急宫颈环扎术联合网片补丁缝合能有效延长宫颈机能不全患者的孕周,明显改善新生儿结局,安全性较好,有一定临床应用价值。

Objective：To investigate the clinical value of emergency cervical cerclage combined mesh patch suture in the treatment of cervical incompetence, Methods：From January 2011 to August 2016 in our hospital 65 cases of pregnant women with inevitable abortion,32 cases of they had carried out emergency cervical cerclage combined mesh patch suture（group A） ,33 cases of they had carried out cervical cerclage only（ group B）, The prolongation of gestation time, delivery gestational age, neonatal outcome, delivery mode and postoperative com- plications were compared between the two groups, Results：The operation time of A group was higher than that of group B,surgical complications of cervical laceration in group A was less than B group,the difference was statisti- cally significant（ P 〈 0.05） ; there was no significant difference in the incidence of chorioamnionitis between the two groups（ P 〉 0.05） ;the gestational age of group A was extended to 84.45 ± 35.77 days, and the gestational age of B group was extended to 51.86±29.93 days,there was statistically significant difference between the two groups（ P 〈 0. 05 ） ; there was more than 28 weeks delivery in 23 cases （71.88%）in group A, and 17 cases （51.52%） in group B,the difference was statistically significant（ P 〈 0.05） ;there were no statistically significant differences in the delivery mode between the two groups（ P 〉 0.05） ;neonatal birth weight, birth Apgar 1 minutes score of group B were significantly lower than those of group A, the difference was statistically significant （ P 〈 0. 05）. Conclusions： Emergency cervical cerclage combined mesh patch suture can effectively prolong the gesta- tional age,improve neonatal outcome, no obvious complication and has certain clinical applicative value.