比较子宫颈环扎术不同手术入路治疗子宫颈机能不全的疗效

Comparison of the Efficacy of Different Surgical Approaches of Cervical Cerclage in the Treatment of Cervical Insufficiency

目的 比较子宫颈环扎术不同手术入路治疗子宫颈机能不全的疗效。方法 在2020年4月—2021年10月期间,方便选择济南市中西医结合医院收治的82例子宫颈机能不全的患者为研究对象,按照双盲法随机分为对照组与观察组,各41例,其中对照组应用经阴道子宫颈环扎术治疗,观察组患者应用经腹腔镜子宫颈环扎术治疗。比较两组患者的手术时间、术中出血量、住院时间、足月产率、早产率、流产率,统计与比较两组患者并发症发生率。结果 观察组患者术中出血量(11.32±4.95)mL以及住院时间(5.10±1.21)d显著低于对照组,差异有统计学意义(t=11.956、10.949,P<0.05);观察组患者足月产率更高,早产率更低,差异有统计学意义(P<0.05);观察组患者宫颈炎等并发症发生率2.44%显著低于对照组19.51%,差异有统计学意义(χ~2=4.493,P<0.05)。结论 经腹腔镜子宫颈环扎术治疗子宫颈机能不全的疗效更好,手术创伤更小,能够显著降低不良妊娠结局以及并发症的发生,值得应用。

Objective To compare the efficacy of different surgical approaches of cervical cerclage in the treatment of cervical insufficiency.Methods During the period from April 2020 to October 2021,82 patients with cervical insufficiency admitted to Jinan Combined Hospital of Traditional Chinese and Western Medicine were conveniently selected as the subjects of this study,and were randomly grouped by double-blind method.There were 41 cases in the control group and 41 cases in the observation group,the patients in the control group were treated with transvaginal cervical cerclage,and the patients in the observation group were treated with trans-laparoscopic cervical cerclage.Compared the operation time,intraoperative bleeding and hospitalization time,the rate of full-term delivery,preterm delivery and miscarriage rate of the two groups,and statistically compare the complication rate of the two groups.Results Intraoperative bleeding(11.32±4.95) mL and hospitalization time(5.10±1.21) d were significantly lower in the observation group than those in the control group,and the results were statistically different from those of the control group,and the difference was statistically significant(t=11.956,10.949,P<0.05).The patients in the observation group had a higher rate of full-term labor,a lower rate of preterm labor,and the difference was statistically significant(P<0.05).The complication rate of cervicitis and other complications in the observation group was 2.44%,significantly lower than that of the control group,which was 19.51%,and the difference between the two groups was statistically significant(χ~2=4.493,P<0.05).Conclusion Trans-laparoscopic cervical cerclage for the treatment of cervical insufficiency has better efficacy,less surgical trauma,can significantly reduce the adverse pregnancy outcomes and the occurrence of complications,and is worth applying.