双胎妊娠宫颈机能不全行阴道宫颈环扎对妊娠结局的影响

Effect of vaginal cervical ring ligation on pregnancy outcome in twin pregnancy with cervical insufficiency

目的研究阴道宫颈环扎治疗双胎妊娠宫颈机能不全的效果及对妊娠结局的影响。方法采用回顾性研究方法,选择2015年1月至2020年1月秦皇岛市妇幼保健院收治的50例单胎妊娠宫颈机能不全患者与50例双胎妊娠宫颈机能不全患者,分别设定为对照组与研究组,两组均选用经阴道宫颈环扎术治疗,比较两组患者的手术指标、妊娠情况及妊娠结局。结果研究组术中出血量、手术时间、住院时间、术后延长妊娠孕周、终止妊娠孕周、5 min新生儿Apgar评分、新生儿存活率、新生儿体重、足月产率、早产率及流产率依次为(19.32±3.17) ml、(36.71±2.15) min、(3.74±0.57) d、(18.53±1.92)周、(36.84±1.83)周、(7.73±0.38)分、86.00%、(3.02±0.67) kg、58.00%、26.00%、16.00%,对照组依次为(20.08±2.96) ml、(36.95±1.97) min、(3.58±0.55) d、(21.47±1.83)周、(38.39±1.81)周、(9.15±0.42)分、98.00%、(3.51±0.73) kg、78.00%、14.00%、4.00%。两组手术指标(术中出血量、手术及住院时间)、早产率比较,差异无统计学意义(P>0.05);研究组较对照组术后延长妊娠孕周、终止妊娠孕周更短,新生儿Apgar评分、新生儿存活率、新生儿体重及足月产率更低,流产率更高,差异均具有统计学意义(P <0.05)。结论双胎妊娠宫颈机能不全行阴道宫颈环扎术治疗的效果良好,但较单胎妊娠宫颈机能不全疗效较差,临床治疗应根据患者实际情况谨慎使用阴道宫颈环扎术。

Objective To study the effect of vaginal cervical puncture in the treatment of cervical dysfunction in twin pregnancy and its effect on pregnancy outcome.Methods Retrospective research method was used.50 patients with cervical dysfunction in single pregnancy and 50patients with cervical dysfunction in twin pregnancy who were admitted to Qinhuangdao Maternal and Child Health Hospital from January 2015 to January 2020 were selected respectively as the control group and the study group.Both groups were treated with transvaginal cervical cerclage,and the surgical indicators,pregnancy status and pregnancy outcomes of the two groups were compared.Results Team intraoperative blood loss,operative time,length of hospital stay,postoperative prolong pregnancy gestational age,gestational age,termination of pregnancy and neonatal 5 min Apgar score,newborn,neonatal weight term production rate,the rate of preterm birth and abortion rate of (19.32±3.17) ml,(36.71±2.15)min and (3.74±0.57) d,(18.53±1.92) weeks,(36.84±1.83) weeks,(7.73±0.38) points,86.00%,(3.02±0.67) kg,58.00%,26.00%,16.00%.The control group was (20.08±2.96) ml,(36.95±1.97) min,(3.58±0.55) d,(21.47±1.83) weeks,(38.39±1.81) weeks,(9.15±0.42) points,98.00%,(3.51±0.73) kg,78.00%,14.00%,and 4.00%,respectively.There was no difference between the two groups in surgical indicators (intraoperative blood loss,operation and hospital stay) and premature delivery rate (P>0.05).Compared with the control group,the length of gestational week and the length of gestational week were shorter,the Apgar score,neonatal survival rate,neonatal weight and full-term delivery rate were lower,and the abortion rate was higher (P<0.05).Conclusion The effect of vaginal cervical circumcision in twin pregnancy is good,but the curative effect is worse than that in single pregnancy.Therefore,vaginal cervical circumcision should be used carefully according to the actual situation of patients.