| 徐叶红,米 阳,肖景华,李亚妮,熊贤翠.择期经阴道宫颈环扎术与期待疗法治疗宫颈机能不全的效果比较[J].,2021,(1):146-149 |
| 择期经阴道宫颈环扎术与期待疗法治疗宫颈机能不全的效果比较 |
| Comparison of the Effect of Selective Transvaginal Cerclage and Expectant Therapy on the Cervical Insufficiency |
| 投稿时间：2020-03-07 修订日期：2020-03-31 |
| DOI：10.13241/j.cnki.pmb.2021.01.032 |
| 中文关键词: 经阴道宫颈环扎术 期待疗法 宫颈机能不全 |
| 英文关键词: Transvaginal cervical cerclage Expectation therapy Cervical incompetence |
| 基金项目:国家重点研发计划项目(2016YFC1000101) |
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| 中文摘要: |
| 摘要 目的：比较择期经阴道宫颈环扎术以及期待疗法治疗宫颈机能不全的效果。方法：选择2017年10月～2019年10月我院收治的201例宫颈机能不全患者，将其随机分为两组。对照组100例患者采取期待疗法，即卧床休息，口服地屈孕酮，每次服用的剂量为10 mg，每日2 次，一直服药到30孕周；观察组101例患者择期经阴道宫颈环扎术，比较两组的早产率、成功妊娠率、新生儿出生体重以及分娩孕周。结果：对照组100例宫颈机能不全患者中，22例患者流产(占22.00 %)，78例患者获得活婴(占78.00 % )，78例成功分娩的患者中，47例患者≥37周分娩，31例患者＜37周分娩，早产率为39.74 %(31/78)。观察组的101例患者中，8例患者流产(占7.92 %)，93例患者获得活婴(占 92.08 % )。93例成功分娩的患者中，81例患者≥37周分娩，12例患者＜37周分娩，早产率为12.90 %(12/93)；12例早产的患者中，4例患者由于胎膜早破和胎儿窘迫，而在孕32~33周采取剖宫产手术，2例患者由于胎膜早破臀位，而在孕 35~36周时采取剖宫产手术，6例患者在孕35~36周早产。观察组宫颈机能不全患者的早产率明显低于对照组(P<0.05)，且成功妊娠率、新生儿出生体重以及分娩孕周明显高于或长于对照组(P<0.05)。结论：与期待疗法相比较，择期经阴道宫颈环扎术不但可以明显延长宫颈机能不全患者的分娩孕周，提高成功妊娠率，还能改善新生儿的预后、降低早产的风险。 |
| 英文摘要: |
| ABSTRACT Objective: To compare of the effect of selective transvaginal cervical cerclage and expectant therapy in the treatment on the cervical incompetence. Methods: Selected 201 patients with cervical incompetence admitted in our hospital from October 2017 to October 2019 and randomly divide them into two groups. The 100 patients in the control group received expectant therapy, that is, the patient rests in bed, and takes oral desdrogesterone, each dose is 10 mg, twice daily, and the medicine is taken until 30 weeks of gestation. The 101 patients in the observation group received selective transvaginal cervical cerclage. Compare the preterm birth rate, successful pregnancy rate, birth weight of the newborn, and the gestational age of childbirth between the two groups. Results: Among the 100 patients with cervical incompetency in the control group, 22 patients had abortion (22.00 %), 78 cases had live infants (78.00 %), and among 78 patients who successfully delivered, 47 patients gave birth ≥37 weeks, 31 patients gave birth less than 37 weeks, and the premature delivery rate was 39.74 % (31/78). Of the 101 patients with cervical incompetency in the observation group, 8 (7.92 %) had abortion and 93 (92.08 %) had live infants. Among 93 patients who delivered successfully, 81 patients gave birth≥37 weeks. Of the 12 patients gave birth <37 weeks, and the premature delivery rate was 12.90 % (12/93), 4 patients of them had a caesarean section at 32 to 33 weeks of pregnancy due to premature rupture of membranes and fetal distress, and 2 patients underwent cesarean section at 35 to 36 weeks of pregnancy due to premature rupture of the fetal membranes, and 6 patients were born prematurely at 35 to 36 weeks of pregnancy. The preterm birth rate of the patients with cervical dysfunction in the observation group was significantly lower than that in the control group (P<0.05), and the successful pregnancy rate, birth weight and gestational age of the newborn in the observation group were significantly higher or longer than those in the control group (P<0.05). Conclusion: Compared with anticipated therapy, elective transvaginal cervical cerclage can not only significantly prolong the gestational weeks of delivery in patients with cervical insufficiency, improve the success rate of pregnancy, but also improve the prognosis of newborns and reduce the risk of premature delivery. |
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