经阴道紧急宫颈环扎术治疗妊娠中期宫颈机能不全的临床效果探讨

Discussion on the clinical effect of transvaginal emergency cervical cerclage in the treatment of cervical insufficiency in the second trimester

目的 评价经阴道紧急宫颈环扎术治疗妊娠中期宫颈机能不全的临床效果。方法 96例妊娠中期宫颈机能不全患者,根据治疗方法不同分为手术组(51例)与保守组(45例)。手术组采用经阴道紧急宫颈环扎术治疗,保守组采用常规保守治疗。比较两组分娩孕周、延长孕期、新生儿存活情况。结果 手术组分娩孕周(33.42±3.14)周、延长孕期(93.25±27.01)d均长于保守组的(26.43±2.16)周、(5.11±4.37)d,差异有统计学意义(P<0.05)。手术组新生儿存活率60.78%高于保守组的6.67%,体重(2320.40±300.15)g重于保守组的(680.55±190.77)g, Apgar评分(8.76±0.22)分高于保守组的(0.75±1.15)分,差异有统计学意义(P<0.05)。结论 相对于保守治疗,对妊娠中期宫颈机能不全患者行经阴道紧急宫颈环扎术可明显延长妊娠时间,为促胎成熟治疗获得宝贵时间,可提高新生儿体重值及Apgar评分,降低胎儿死亡率,改善母婴结局。

Objective To evaluate the clinical effect of transvaginal emergency cervical cerclage in the treatment of cervical insufficiency in the second trimester. Methods A total of 96 patients with cervical insufficiency in the second trimester were divided into surgical group(51 cases) and conservative group(45 cases) according to different treatment methods. The surgical group was treated with transvaginal emergency cervical cerclage, and the conservative group was treated with conventional conservative treatment. The gestational weeks of delivery, prolongation of gestational age and neonatal survival were compared between the two groups. Results The gestational age of delivery and prolongation of gestational age in the surgical group were(33.42±3.14) weeks and(93.25±27.01) d, which were longer than(26.43±2.16) weeks and(5.11±4.37) d in the conservative group, and the differences were statistically significant(P<0.05). The newborn survival rate of the surgical group was 60.78%, which was higher than 6.67% of the conservative group;the weight of the surgical group was(2320.40±300.15) g, which was heavier than(680.55±190.77) g of the conservative group;the Apgar score of the surgical group was(8.76±0.22) points, which was higher than(0.75±1.15) points of the conservative group;the differences were statistically significant(P<0.05). Conclusion Compared with conservative treatment,transvaginal emergency cervical cerclage for the treatment of cervical insufficiency in the second trimester can significantly prolong the duration of pregnancy, provide valuable time for maturation therapy, increase neonatal weight and Apgar score, reduce fetal stillbirth rate, and improve maternal and infant outcomes.