紧急宫颈环扎术治疗宫颈机能不全致宫颈扩张临床分析

Clinical analysis of emergency cervical cerclage in treatment of cervical dilatation caused by cervical incompetence

目的探讨对宫颈机能不全导致宫颈扩张的孕产妇行紧急宫颈环扎术对分娩结局及胎儿存活率的临床疗效与意义。方法选择我院产科宫颈机能不全导致宫颈扩张产妇124例随机分为A、B两组。A组患者使用宫缩抑制药物进行保守治疗;B组在A组基础上联合紧急宫颈环扎术治疗。比较两组患者不同方法治疗后分娩时间、分娩方式及胎儿阿氏评分等相关指标。结果联合紧急宫颈环扎术手术B组患者足月生产人数显著多于保守治疗A组,分娩时未到足月患者人数显著少于A组(P<0.05),B组术后自然分娩人数51例,胎儿阿氏评分(8.6±0.41)分均显著高于保守治疗A组32例,(6.3±0.40)分(P<0.05)。结论对由于宫颈机能不全导致宫颈扩张的产妇行紧急宫颈环扎术能够可显著减少宫缩次数,延长胎龄,帮助胎儿在母体内进行更好的生长发育;对改善分娩结局,提高新生儿存活率具有重要意义。

Objective To explore the clinical efficacy and significance of emergency cervical cerclage in treatment of maternal with cervical dilatation caused by cervical incompetence for birth outcomes and fetal survival. Methods 124 cases of cervical dilatation caused by cervical incompetence in Department of Obstetrics of our hospital were selected and randomly divided into group A and group B. Patients in group A were treated with conservative treatment of uterine contractions, and patients in group B were treated with emergency cervical cerclage on the basis of group A. The delivery time, delivery mode and fetal thyroid score of the two groups after treatment were compared. Results The number of term production of emergency cervical cerclage group B was significantly higher than that of conservative treatment group A. and the number of patients not delivered to full term was significantly lower than that in group A （P 〈 0.05）. The number of natural childbirth was 51 in group B. And fetal thyroid score of group B was （8.6 ± 0.41）, which were all higher than the number of nature childbirth with 32 and the fetal thyroid score of （6.3± 0.40） （P 〈 0.05）. Conclusion Emergency cervical cerclage in treatment of cervical dilatation caused by cervical incompetence can significantly reduce the number of contractions, extend the gestational age, and help the fetus in the mother for better growth and development. It is of great significance to improve the delivery outcome and neonatal survival rate.