改良倒“U”型缝合对宫颈机能不全患者及妊娠结局的影响

Effect of modified inverted U-shaped ligation on patients with cervical incompetence and pregnancy outcome

目的评估改良倒“U”型缝合对宫颈机能不全患者及妊娠结局的影响。方法选择2018年1月至2020年1月收治的宫颈机能不全的患者120例作为研究对象,根据治疗方法将患者分为观察组(n=59)和对照组(n=61)。观察组给予改良式倒“U”字缝扎,对照组给予Mcdonald手术方法。观察2组术中出血量的多少、手术时间的长短,术后阴道炎、便秘、膀胱刺激征的发生率及妊娠结局。结果观察组与对照组在术中出血量、术后阴道炎、便秘、胎膜早破发生率方面差异无统计学意义(P>0.05);观察组足月产率显著高于对照组(57.62%vs.34.42%,P=0.019);早产率低于(37.28%vs.59.01%,P=0.031);膀胱刺激症发生率显著低于对照组(0.00%vs.13.11%,P=0.029);手术时间短于对照组[(25.16±3.23)min vs.(37.15±3.65)min,P=0.039]。术后复查B超测量宫颈长度(经会阴)观察组宫颈长度显著高于对照组[(3.84±2.18)cmvs.(2.21±1.98)cm,P<0.05]。结论改良倒“U”型缝合可明显降低膀胱刺激症发生率、缩短手术时间、增加术后宫颈管长度,提高足月产率,减少早产率,有效促进妊娠结局向良好结局方向发展,手术时间短,操作简便,值得推广。

Objective To evaluate the effect of modified inverted U-shaped ligation on pregnancy outcome in patients with cervical incompetence.Methods From January 2018 to January 2020,patients(n=120)with cervical incompetence were enrolled,they were allocated to an observation group(n=59)and a control group(n=61).The observation group was given modified inverted U-shaped ligation,while the control group was given Mcdonald operation.Intraoperative blood loss,operating duration,postoperative vaginitis,constipation,bladder irritation and pregnancy outcome were include as comparators.Results There were no significant differences in intraoperative bleeding loss,postoperative vaginitis,constipation and premature rupture of membranes between groups(P>0.05).The percentage of full term gestation in the observation group was significantly higher than that in the control group(57.62%vs.34.42%,P=0.019),the preterm birth rate was significantly lower than that in the control group(37.28%vs.59.01%,P=0.031),the incidence of bladder irritation was significantly lower than that in the control group(0.00%vs.13.11%,P=0.029),the operating duration was shorter than that in the control group([25.16±3.23]min vs.[37.15±3.65]min,P=0.039).The cervical length(transperineal)measured by ultrasound in the observation group was significantly higher than that in the control group([3.84±2.18]cm vs.[2.21±1.98]cm,P<0.05).Conclusion The modified inverted U-shaped ligation can significantly reduce the incidence of bladder irritation,shorten operating duration,increase postoperative cervical length,improve full term gestation and reduce premature rate,which can effectively promote the development of pregnancy outcome to a good outcome,the operation time is short and the operation is simple,it is worth popularizing.