宫颈环扎术对中期妊娠宫颈机能不全的疗效

Curative Effect of Cervical Ligation in the Treatment of Cervical Insufficiency in the Second Trimester

目的:探讨宫颈环扎术对中期妊娠宫颈机能不全的疗效。方法:选取惠州市第一妇幼保健院2018年6月至2021年5月收治的82例宫颈机能不全产妇,按随机数字表法分为对照组和观察组,各41例。给予对照组产妇地屈孕酮片保胎治疗,给予观察组产妇宫颈环扎术治疗,比较两组新生儿存活率、出生体质量、新生儿窒息率等新生儿预后情况以及分娩孕龄、足月产、流产、早产情况,将观察组产妇按手术不同时期分为A组(21例,孕14~16周手术)和B组(20例,16~24周手术),比较不同手术时期产妇新生儿预后及妊娠结局。结果:观察组新生儿存活率和出生体质量高于对照组,新生儿窒息率低于对照组,差异具有统计学意义(P<0.05)。观察组产妇分娩孕龄、足月产率高于对照组,流产率、早产率低于对照组,差异具有统计学意义(P<0.05)。A组、B组产妇流产率比较,差异无统计学意义(P>0.05);A组足月产率、新生儿存活率高于B组,早产率低于B组,差异具有统计学意义(P<0.05)。结论:宫颈环扎术可延长宫颈机能不全产妇的孕龄,改善新生儿预后及妊娠结局,且在孕14~16周进行宫颈环扎术是手术的最佳时机。

Objective To investigate the curative effect of cervical ligation in the treatment of cervical insufficiency in the second trimester.Methods A total of 82 parturitions with cervical insufficiency admitted to Huizhou First Maternal and Child Health Hospital from June 2018 to May 2021 were selected and divided into control group and observation group according to random number table method,with 41 cases in each group.Control group received dydrogesterone tablets treatment,and observation group received cervical ligation treatment.The neonatal survival rate,body quality,newborn asphyxia rate,other neonatal prognosis and gestational age,term birth,abortion,premature delivery were compared between the two groups.The parturients in the observation group were divided into group A(21 cases,operation at 14-16 weeks of gestation)and group B(20 cases,operation at 16-24 weeks gestation)according to different operation periods.The pregnancy outcome were compared in different operation periods.Results The survival rate and birth weight of neonates in the observation group were higher than those in the control group,and the neonatal asphyxia rate was lower than that in the control group,the differences were statistically significant(P<0.05).The gestational age and full term birth rate in the observation group were higher than those in the control group,and the abortion rate and premature birth rate were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in maternal abortion rate between group A and group B(P>0.05).The full-term birth rate and neonatal survival rate in group A were higher than those in group B,and the preterm birth rate was lower than that in group B,the differences were statistically significant(P<0.05).Conclusion Cervical ligation can prolong the gestational age of parturient women with cervical insufficiency,improve the neonatal prognosis and pregnancy outcome,and cervical ligation at 14 to 16 weeks of gestation is the best time for operation.