不同手术时机对宫颈机能不全的双胎妊娠患者分娩结局、并发症的观察

Observation on delivery outcomes and complications of twin pregnancy patients with cervical incompetence at different surgical timing

目的观察预防性宫颈环扎与紧急性宫颈环扎治疗双胎妊娠宫颈机能不全患者的临床效果及对分娩结局与并发症的影响。方法选取68例宫颈机能不全的双胎妊娠患者,依据术式分组,对照组8例孕期检查见胎膜处于宫颈口外行紧急性宫颈环扎术,研究组60例孕期检查确诊后于孕13~18周行预防性宫颈环扎术。比较两组分娩结局及并发症发生率。结果研究组延长妊娠时间、分娩孕周及32周宫颈长度均比对照组长,新生儿体质量均高于对照组,且新生儿Apgar评分高于对照组(P<0.05)。与对照组相比,研究组<35周早产率更低、≥35周分娩率与新生儿存活率更高(P<0.05),两组晚期流产率比较,差异无统计学意义(P>0.05)。研究组并发症发生率为8.33%,低于对照组的25.00%,但比较差异无统计学意义(P>0.05)。结论与紧急性宫颈环扎术相比,预防性宫颈环扎术更能改善宫颈机能不全双胎妊娠患者分娩结局且减少并发症发生风险,更具推广价值。

Objective To observe the clinical effect of prophylactic cervical cligation and emergency cervical cligation in the treatment of twin pregnancy with cervical insufficiency and its influence on delivery outcomes and complications.Methods 68 cases of patients with cervical insufficiency of twin pregnancy,according to the operation group,control group in 8 cases of pregnancy check see membranes in the opening of the cervix dilettante urgent cervical cerclage,group of 60 cases of pregnancy after pregnancy confirmed by 13~18 go preventive cervical cerclage.The birth outcome and complication rate of the two groups were compared.Results The prolonged gestation time,gestational weeks and 32 weeks of cervical length in the study group were longer than those in the control group.The body weight of newborns was higher than that in the control group,and the Apgar score of newborns was higher than that in the control group(P<0.05).Compared with the control group,the study group had a lower rate of<35 week preterm delivery,a higher rate of≥35 week delivery and a higher survival rate of newborns(P<0.05),and there was no statistical significance in the rate of late abortion between the two groups(P>0.05).The incidence of complications in the study group was 8.33%,lower than that in the control group(25.00%),but there was no statistical significance(P>0.05).Conclusion Compared with emergency cervical cerclage,preventive cervical cerclage is more effective in improving delivery outcomes and reducing the risk of complications in patients with cervical insufficiency twin pregnancies,and has more promotional value.