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目的讨论宫颈内口的功能检查在防治早产和流产中的临床效果。方法收集30例曾有过不孕或流产史,后经过治疗后妊娠的患者,在未妊娠期宫颈内口可通过8号扩张器而无阻力者,可以认为宫颈机能不全。如果宫颈内口不能容8号扩张器,在其妊娠的早,中,晚三个阶段结合阴道超声检查,测量出宫颈的各个经线,如发现患者宫颈机能不全,即行宫颈环扎术。结果宫颈机能不全的发现率为60%,明显随流产的次数增多而增高,经诊断为宫颈机能不全的孕产妇及时进行宫颈逢扎,术后仍然发生早产的发生率为6.7%,明显小于未经过宫颈缝扎的患者发生早产或流产的几率(42.9%),P<0.05。而宫颈机能良好或者轻微机能不全的孕产妇但进行了宫颈缝扎术后,无一人发生流产,P<0.05。结论未妊娠期使用宫颈扩张器对宫颈机能进行早期评价,妊娠的早,中,晚三个阶段结合阴道超声检查,测量出宫颈的各个经线,如发现患者宫颈机能不全,即行宫颈环扎术。做出早期诊断和治疗,可显著降低宫颈机能不全患者的流产或早产发生率。
Objective To discuss the clinical effect of cervical intravaginal function test in the prevention and treatment of premature delivery and abortion. Methods A total of 30 patients who had history of infertility or miscarriage before and after treatment were enrolled in this study. In the non-pregnant cervix, the cervix can pass through the No.8 dilator with no resistance, and cervical incompetence can be considered. If the cervix can not accommodate expansion of No. 8 dilator, pregnancy in the early, middle and late stages combined with vaginal ultrasound examination, the measurement of the various menstrual line, if found in patients with cervical incompetence, that is, cervical cerclage. Results The detection rate of cervical incompetence was 60%, which was obviously increased with the increase of abortion. The pregnant women with cervical incompetence diagnosed as cervical punctured in time, the incidence of preterm birth after operation was 6.7% The incidence of premature delivery or miscarriage in patients with cervical suture (42.9%), P <0.05. None of the women who had a good cervix or mild dysfunction but had a cervical suture had no miscarriage (P <0.05). Conclusions Uterine cervix dilator was used in early pregnancy to evaluate early stage of cervical function. The early, middle and late stages of pregnancy combined with vaginal ultrasonography to measure each warp of the cervix. If cervical incompetence was found, cervical cerclage was performed. Making early diagnosis and treatment can significantly reduce the incidence of miscarriage or premature birth in patients with cervical insufficiency.