经阴道宫颈环扎术治疗宫颈机能不全的临床价值

Clinical value of transvaginal cervical cerclage in the treatment of cervical incompetence

目的探讨经阴道宫颈环扎术治疗宫颈机能不全的临床价值。方法98例行经阴道宫颈环扎术的宫颈机能不全患者,根据符合的诊断标准不同分为对照组和观察组,每组49例。对照组患者接受紧急性宫颈环扎术,观察组患者接受预防性宫颈环扎术。对比两组孕妇分娩孕周、新生儿体质量及妊娠结局(早产、足月产、流产、新生儿存活)。结果观察组孕妇分娩孕周长于对照组,新生儿体质量高于对照组,差异具有统计学意义(P<0.05)。观察组新生儿存活率93.88%、足月产率61.22%均高于对照组79.59%、24.49%,早产率32.65%、流产率6.12%低于对照组的55.10%、20.41%,差异具有统计学意义(P<0.05)。结论采用经阴道宫颈环扎术治疗宫颈机能不全为一类行之有效的方法,同时,预防性宫颈环扎术的预后效果优于紧急性宫颈环扎术,能够显著延长孕周,提升新生儿存活率,降低流产、早产等发生率。

Objective To discuss the clinical value of transvaginal cervical cerclage in the treatment of cervical incompetence.Methods A total of 98 patients with cervical incompetence undergoing transvaginal cervical cerclage were divided into control group and observation group according to different diagnostic criteria,with 49 cases in each group.Patients in the control group received emergency cervical cerclage,and patients in the observation group received preventive cervical cerclage.The gestational weeks of delivery,neonatal body mass and pregnancy outcomes(premature delivery,full-term delivery,abortion,and neonatal survival)were compared between the two groups.Results The gestational weeks of delivery of the observation group was longer than that of the control group,and the neonatal body mass was higher than that of the control group.All the difference was statistically significant(P<0.05).The neonatal survival rate 93.88%and full-term delivery rate 61.22%of the observation group were higher than 79.59%and 24.49%of the control group,and premature delivery rate 32.65%and abortion rate 6.12%were lower than those of the control group.All the difference was statistically significant(P<0.05).Conclusion Transvaginal cervical cerclage is an effective method to treat cervical insufficiency.At the same time,preventive cervical cerclage has better prognostic effect than emergency cerclage,which can significantly extend the gestational weeks of delivery and improve the survival rate of newborns,reduce the incidence of miscarriage and premature delivery.