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目的:探讨影响宫颈环扎术成功率的因素及防治措施,评价宫颈环扎术对治疗妊娠期宫颈机能不全的意义。方法:将海南医学院附属医院2002年1月～2010年5月收治的33例宫颈机能不全的孕妇在卧床休息及保胎治疗的基础上于妊娠14～25周行U形宫颈环扎术。结果:33例患者手术过程顺利,术中均无胎膜破裂,大出血等术中并发证。足月分娩23例,占69.7%(23/33);早产4例,占12.1%(4/33),其中有2例新生儿存活;存活胎儿25例,占75.8%(25/33);术后继发阴道炎9例,发生率27.3%(9/33)。手术最后成功25例,失败8例,失败组术后阴道炎的发生率高于成功组(P<0.05)。结论:宫颈环扎术后继发阴道炎是影响环扎成功率的主要因素,监控感染有利于提高宫颈环扎术的成功率,减轻患者的负担。
Objective: To explore the factors influencing the success rate of cervical cerclage and its prevention and treatment measures, to evaluate the significance of cervical cerclage in treating cervical incompetence during pregnancy. Methods: 33 cases of cervix insufficiency from January 2002 to May 2010 in Affiliated Hospital of Hainan Medical College were treated with U-shaped cerclage at 14 to 25 weeks of pregnancy on the basis of bed rest and miscarriage. Results: The operation procedure of 33 patients was successful. No intraoperative rupture of membranes and bleeding were observed in the operation. There were 23 cases of full-term delivery, accounting for 69.7% (23/33), 4 cases of premature delivery (12.1%, 4/33), 2 newborns surviving, 25 surviving fetuses accounting for 75.8% (25/33) Postoperative vaginitis in 9 cases, the incidence was 27.3% (9/33). The operation was successful in 25 cases and failed in 8 cases. The incidence of postoperative vaginitis in the failed group was higher than that in the successful group (P <0.05). Conclusion: Secondary vaginitis is the main factor that affects the success rate of cerclage after cervical cerclage. Surveillance of infection can improve the success rate of cervical cerclage and reduce the burden of patients.