子宫肌层厚度联合宫颈管长度在预测早产及母婴结局的作用

Role of uterine muscle layer thickness combined cervical tube length in predicting premature birth and maternal and neonatal outcomes

目的探讨子宫肌层厚度联合宫颈管长度在诊断早产中的作用及其对母婴结局的影响。方法选取2015年1月至2016年2月于北京美华妇儿医院早产的84例孕妇为观察组,同时选择79例正常孕妇为对照组,比较两组孕妇不同部位子宫肌层厚度、宫颈管长度、母婴结局。结果观察组分娩孕周显著低于对照组(t=2.164,P<0.05)。观察组宫底部肌层厚、子宫体部肌层厚度均显著高于对照组(t值分别为2.787、2.463,均P<0.05),而子宫下段肌层厚度、宫颈长度均显著低于对照组(t值分别为2.344、3.324,均P<0.05)。观察组胎膜早破、羊水污染、新生儿肺炎发生率均显著高于对照组(χ~2值分别为5.658、6.583、4.357,均P<0.05),新生儿体重、新生儿Apgar评分均显著低于对照组(t值分别为2.670、2.908,均P<0.05),两组分娩方式无显著性差异(χ~2=0.002,P>0.05),产后出血量无显著性差异(t=1.124,P>0.05)。结论子宫肌层厚度联合宫颈管长度对早产有一定的预测价值,可作为临床参考。

Objective To explore the role of uterine muscle layer thickness combining cervical tube length in predicting premature birth and its effects on maternal and neonatal outcomes. Methods Totally 84 women with premature birth in Women and Children Hospital of Beijing Meihua Hospital were selected as observation group from January 2015 to February 2016,and 79 normal pregnant women were selected as control group. The thickness of uterine muscle layer,the length of cervical canal and the outcomes of mother and neonates were compared between two groups. Results Pregnancy week at delivery in the observation group was significantly lower than the control group（ t = 2. 164,P〈0. 05）. The muscle layer thickness of palace at the bottom and uterine body muscle layer thickness were significantly higher in the observation group than the control group（ t value was 2. 787 and 2. 463,respectively,both P〈0. 05）,while the muscle layer thickness of lower uterine segment and cervical tube length were significantly lower than the control group（ t value was 2. 344 and 3. 324,respectively,both P〈0. 05）. The incidence of premature rupture of membranes,amniotic fluid contamination and neonatal pneumonia were significantly higher in the observation group than the control group（ χ^2value was 5. 658,6. 583 and 4. 357,respectively,all P〈0. 05）,but neonatal birth weight and Apgar score were significantly lower than the control group（ t value was 2. 670 and 2. 908,respectively,both P〈0. 05）.There was no significant difference in delivery way between two groups（ χ^2= 0. 002,P〈0. 05）. The difference in postpartum blood loss between two groups was not significant（ t = 1. 124,P〈0. 05）. Conclusion The uterine muscle layer thickness combined with cervical tube length has some predictive value for premature labor,which can be used as a clinical reference.