宫颈机能不全的临床诊治进展

Clinical Diagnosis and Treatment Progress of Cervical Insufficiency

宫颈机能不全的发病率约占所有孕妇的0.1%～2.0%,近年来呈上升趋势。宫颈机能不全导致的早产率比非宫颈机能不全者高,而早产可导致残疾儿的出生或者新生儿死亡,给家庭、社会带来一系列问题。但目前宫颈机能不全的病因尚不完全明确,其中主要有先天性、后天性和药物因素等等。其诊断缺乏客观诊断金标准,主要根据病史、超声检查和典型临床表现来诊断。治疗包括非手术治疗和手术治疗,其中最有效的方法为宫颈环扎术。通过对宫颈机能不全的预防、早期诊断,采取适合孕妇的个性化治疗方案,从而延长宫颈机能不全患者的妊娠孕周,改善妊娠结局,减少早产儿出生,提高新生儿健康质量。故宫颈机能不全的诊治对于预防流产、早产,改善围产儿结局有重要意义。现将对宫颈机能不全的病因、诊断、治疗进展等做如下报道。

The incidence of cervical insufficiency is about 0.1%~2.0%of all pregnant women,and it is on the rise in recent years.The rate of preterm birth caused by cervical insufficiency is significantly higher than that of non-cervical insufficiency,and preterm birth can lead to the birth or neonatal death of disabled children,bringing a series of problems to families and society.But at present the cause of cervical insufficiency is not completely clear,which mainly have congenital,acquired and drug factors and so on.Its diagnosis lacks the objective gold standard,mainly according to the medical history,the ultrasonic examination and the typical clinical manifestation to diagnose.The treatment includes non-surgical and surgical treatment,and the most effective method is cervix ligation.Through the prevention and early diagnosis of cervical insufficiency,individualized treatment programs suitable for pregnant women are adopted,so as to extend the pregnancy week of patients with cervical insufficiency,improve the pregnancy outcome,reduce the birth of premature babies and improve the health quality of newborns.The diagnosis and treatment of cervical insufficiency is of great significance for the prevention of miscarriage,preterm birth and improvement of perinatal outcome.This article reviews the etiology,diagnosis and treatment progress of cervical insufficiency.