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目的:观察生物蛋白胶封堵合并宫颈环扎术治疗胎膜早破,对孕妇、胎儿及新生儿的影响,明确该技术治疗胎膜早破的疗效。方法:我院产科共收治妊娠<30周胎膜早破患者48例,采用生物蛋白胶封堵合并宫颈环扎术治疗胎膜早破,观察治疗后孕妇羊水指数,胎儿双顶径,新生儿出生时体重,及孕妇的副反应。结果:在本次封堵治疗过程中均一次封堵成功,没有不良反应发生,所有孕妇术后阴道流水情况均明显改善,其中有2例孕妇术后1周阴道流水停止。所有孕妇术后羊水漏出量均明显减少,B超检查显示羊水指数均在(6±2)cm,胎儿每周双顶径增长均达到(0.15±0.02)cm,延长孕周最短(5±2)w,10例早产,38例继续妊娠至37 w。新生儿出生时体重为(2000±260)g,无1例发生NRDS。同期没有进行宫颈内封堵仅行药物保胎治疗的10例孕妇,胎龄延长最长达到10 d,最短者24 h内出现早产分娩,早产儿平均体重1400 g,均发生NRDS,有2例放弃治疗,4例在NICU行治疗,最终因各种并发症死亡。48例行封堵治疗孕妇未发生过敏反应,无阴道出血及产后出血和感染等。结论:应用生物蛋白胶结合宫颈环扎术治疗胎膜早破,手术操作简单,可延长了孕周,提高了新生儿成活率,无不良反应,具有广泛的应用前景。
OBJECTIVE: To observe the effects of biofilm closure and cervical cerclage on premature rupture of membranes, effects on pregnant women, fetus and newborn, and to clarify the curative effect of this technique on premature rupture of membranes. Methods: Obstetrics and Gynecology in our hospital received a total of 48 cases of premature rupture of membranes in pregnancy <30 weeks, using biological protein glue closure and cervical cerclage treatment of premature rupture of membranes, observation of pregnant women after amniotic fluid index, fetal biparietal diameter, neonatal Birth weight, and pregnant women’s side effects. Results: During the procedure of blocking therapy, all the patients were successfully blocked without any adverse reactions, and vaginal fluid flow in all pregnant women were significantly improved. Among them, 2 cases of vaginal fluid flow stopped one week after operation. The amount of amniotic fluid leakage in all pregnant women was significantly reduced, B-ultrasound showed that the amniotic fluid index was at (6 ± 2) cm, fetal bimodal diameter increased by 0.15 ± 0.02 cm, and the shortest gestational age was prolonged (5 ± 2 ) w, 10 cases of premature delivery, 38 cases of pregnancy continue to 37 w. Neonatal birth weight (2000 ± 260) g, no case of NRDS occurred. In the same period, 10 pregnant women who did not undergo intrauterine sealing only with drug miscarriage survived for a maximum of 10 days. The shortest occurred within 24 hours and the average weight of preterm infants was 1400 g, with NRDS occurring in 2 cases Give up treatment, 4 cases of NICU line of treatment, eventually died of various complications. 48 routine treatment of pregnant women without blocking the occurrence of allergic reactions, no vaginal bleeding and postpartum hemorrhage and infection. Conclusion: The application of biological protein glue and cervical cerclage in the treatment of premature rupture of membranes has the advantages of simple operation, prolonged gestational age, improved neonatal survival rate and no adverse reactions, and has broad application prospects.