宫颈环扎术治疗宫颈机能不全临床疗效观察

刘秀平

【摘 要】目的：比较MeDonald环扎术和Shirodkar环扎术的临床疗效。方法： 63例宫颈机能不全患者随机分为A组和B组，A组32例为MeDonald环扎术式，B组31例为Shirodkar环扎术式，比较两组手术成功率，足月儿分娩率，早产儿发生率，先兆早产保胎二次住院率及并发症发生率。结果： A组、B组手术成功率分别为81%、90%，B组高于A组，差异无统计学意义（P>0.05）；B组足月儿分娩率为74.2%，均高于A组（50%），差异具有统计学意义（P<0.05）； B组因先兆早产二次住院率为16.1%，均低于A组40.6%，差异具有统计学意义（P<0.05）。B组并发症为6.5%，高于A组6.3%差异无统计学意义（P>0.05）。结论：治疗宫颈机能不全，Shirodkar环扎术式足月儿分娩率高于MeDonald环扎术，Shirodkar环扎术式早产儿分娩率、二次住院率低于MeDonald环扎术式。

【关键词】MeDonald环扎术式；Shirodkar环扎术式；宫颈机能不全；妊娠结局

【中图分类号】R196 【文献标识码】A 【文章编号】1004-7484（2019）02-0099-02

【Abstract】Objective： To compare the clinical effects of MeDonald and Shirodkar. Methods： 63 patients with cervical insufficiency were randomly divided into group A and group B， 32 cases in group A were Medonald ring-ligation， and 31 cases in group B were Shirodkar ring-ligation. The success rate of the two groups was compared. The rate of childbirth and premature infant incidence， Secondary hospitalization rate and complication rate of preterm preterm birth retention. Results： The surgical success rate of group A and group B was 81 % and 90 % respectively， and the B group was higher than group A， and the difference was not statistically significant（P & GT； 0.05）； The rate of fulltime delivery in Group B was 74.2 %， which was higher than Group A（50 %）， and the difference was statistically significant（P & lt； 0.05）； The secondary hospitalization rate of preterm preterm in group B was 16.1 %， which was lower than 40.6 % in group A， and the difference was statistically significant（P & lt； 0.05）. Complications in group B were 6.5 %， which was higher than the 6.3 % difference in group A（P & GT； 0.05）. Conclusion： In the treatment of cervical insufficiency， the rate of delivery in Shirodkar ring-zapping was higher than that in Medonald ring-zapping， and the rate of delivery and secondary hospitalization in Shirodkar ring-zapping premature infants were lower than that in Medonald ring-zing.

【Keywords】MeDonald ring type； Shirodkar ring type； Cervical insufficiency； Pregnancy outcome

宮颈机能不全是引起复发性流产和早产的主要因素之一，发病率为0.1-2.0%，据统计中孕期复发性流产中约15%的为宫颈机能不全 [1].治疗宫颈机能不全常用方法是宫颈环扎术，宫颈机能不全的处理已纳入早产预防的范畴[2]。手术方式的优略存在争议，本文回顾分析因宫颈机能不全在我院行宫颈环扎术患者临床资料，对比MeDonald环扎术和Shirodkar环扎术的临床疗效。

1 临床资料

1.1 一般资料 选择本院2012年1月至2018年5月收治的63例宫颈机能不全患者，随机分为A组32例，年龄（30.09+3.78）岁，孕次（2.53+1.27），产次（0.28+0.52），环扎孕周（19.02+4.46）周；B组31例，年龄（30.26+5.57）岁，孕次（2.32+0.94），产次（0.35+0.55），环扎孕周（19.90+4.21）周；。两组年龄、流产次数、环扎孕周等一般资料比较差异无统计学意义（P>0.05），具有可比性。

1.2 诊断标准 国内外尚无明确标准，手术指征不能完全统一。（1）既往有宫颈机能不全丢失史.（2）非孕期宫颈检查宫颈管可无阻力通过8号宫颈扩张器并直达宫腔。（3……