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目的通过分析2001年1月至2011年12月我院收治的53例/次行宫颈环扎术患者的手术及分娩情况,评价宫颈环扎术的疗效及其影响因素。方法将患者分为治疗性环扎组和预防性环扎组,分析两组患者的手术情况、术后并发症及分娩情况(包括分娩孕周、分娩方式、新生儿体重及NICU住院率等)。结果所有患者均于13+3～26+6之间行宫颈环扎术,治疗性环扎组环扎高度不满意及早产率分别为54.5%和36.4%,而预防性环扎组仅为4.2%和21.4%,同时治疗性环扎组患者所分娩的新生儿新生儿重症监护病房(neonatal intensive care unit,NICU)入院率较高(36.4%VS 14.3%)。感染是较为常见的术后并发症,尤以治疗性环扎组感染率较高(27.3%VS 9.5%)。结论宫颈环扎术对于治疗宫颈机能不全是一种行之有效且相对安全的治疗方法。预防性环扎相对于治疗性环扎术后感染率较低,活产率和足月产率较高,NICU入院率低,所以对于反复发生晚期流产/早产的患者,在排除其他因素后应考虑行预防性环扎。对于已经发生宫颈管缩短,内口扩张、而胎膜未膨出的患者,经过治疗性宫颈环扎,活产率也可达到81.8%,平均延长孕周8w。对于这些病例,治疗性环扎不失为一种很好的选择。
Objective To evaluate the efficacy and influencing factors of cervical cerclage by analyzing the operation and delivery of 53 patients with cervical cerclage treated in our hospital from January 2001 to December 2011. Methods The patients were divided into two groups: therapeutic cerclage group and prophylactic cerclage group. The operative conditions, postoperative complications and delivery (including gestational period, mode of delivery, neonatal weight and NICU hospitalization rate) were analyzed. . Results All patients underwent cervical cerclage between 13 + 3 and 26 + 6. The height of cerclage was not satisfied and the preterm delivery rate was 54.5% and 36.4% respectively in the cerclage group, but only 4.2 in the preventive cerclage group % And 21.4%, respectively. In addition, neonatal intensive care unit (NICU) neonates had a higher admission rate (36.4% vs 14.3%) in the patients in the cerclage group. Infection is a more common postoperative complication, especially in the treatment group (27.3% VS 9.5%). Conclusion Cervical cerclage is an effective and relatively safe treatment for cervical incompetence. Preventive cerclage is associated with a lower incidence of infection after cerclage, a higher live birth rate and full-term birth rate, and a lower rate of NICU admission, so for patients with recurrent late abortion / prematurity, after excluding other factors Consider the line of preventive cerclage. For cervical canal contraction has occurred, the expansion of the mouth, and the membranes are not bulging patients, after curative cervical cerclage, the live birth rate can reach 81.8%, an average of 8 weeks gestational weeks extended. For these cases, therapeutic cerclage is a good choice.