擇期宮頸環(huán)扎術(shù)聯(lián)合間苯三酚治療宮頸機能不全對孕婦妊娠結(jié)局和新生兒的影響

吳國熒 魯順瓊 王斌

[摘要]目的 探討擇期宮頸環(huán)扎術(shù)聯(lián)合間苯三酚治療宮頸機能不全（CIC）對孕婦妊娠結(jié)局和新生兒的影響。方法 選取2015年1月～2018年6月我科收治的45例CIC孕婦作為研究對象，根據(jù)隨機數(shù)字表法分為對照組（22例）與觀察組（23例）。對照組采用期待療法，觀察組采用擇期宮頸環(huán)扎術(shù)聯(lián)合間苯三酚，兩組孕婦均隨訪至妊娠結(jié)束。比較兩組的新生兒預(yù)后、妊娠結(jié)局。將觀察組孕婦根據(jù)手術(shù)時期分為A組（孕12～16周手術(shù)，13例）與B組（孕>16～24周手術(shù)，10例），比較兩組的新生兒預(yù)后及妊娠結(jié)局。結(jié)果 觀察組新生兒存活率、出生體重、出生5 min Apgar評分高于對照組，新生兒窒息率低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）;觀察組分娩孕齡、足月產(chǎn)率高于對照組，流產(chǎn)率、早產(chǎn)率低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）;A組足月產(chǎn)率高于B組，早產(chǎn)率低于B組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 擇期宮頸環(huán)扎術(shù)聯(lián)合間苯三酚治療CIC患者可延長孕齡，有效地改善新生兒預(yù)后及妊娠結(jié)局，孕早期手術(shù)療效更好。

[關(guān)鍵詞]宮頸環(huán)扎術(shù);間苯三酚;宮頸機能不全;新生兒預(yù)后;妊娠結(jié)局

[Abstract] Objective To investigate the effect of selective cervical cerclage combined with Phloroglucinol on pregnancy outcome and neonatal outcome of pregnant women with cervical insufficiency （CIC）. Methods A total of 45 pregnant women with CIC admitted to our department from January 2015 to June 2018 were selected as the subjects， and divided into control group （n=22） and observation group （n=23） by random number table method. The control group used expectant therapy， and the observation group were given selective cervical cerclage combined with Phloroglucinol， the two groups were all followed up until the end of pregnancy. The neonatal prognosis and pregnancy outcomes were compared between the two groups. According to the period of operation， the pregnant women of observation group were divided into group A （12-16 weeks of gestation， 13 cases） and group B （more than 16 to 24 weeks of gestation， 10 cases）. The neonatal prognosis and pregnancy outcomes were compared between the two groups. Results The neonatal survival rate， birth weight and 5 min Apgar score in the observation group were higher than those in the control group， and the asphyxia rate was lower than that in the control group， the differences were statistically significant （P<0.05）. The gestational week and full-term rate of delivery in the observation group were higher than those in the control group， and the abortion rate and premature delivery rate were lower than those in the control group， the differences were statistically significant （P<0.05）. The full-term rate of group A was higher than that of group B， while the premature rate was lower than that of group B， the differences were statistically significant （P<0.05）. Conclusion Selective cervical cerclage combined with Phloroglucinol can prolong the gestational age of CIC patients， effectively improve the prognosis and pregnancy outcomes of neonates， and the effect of early pregnancy surgery is better.

[Key words] Cervical cerclage; Phloroglucinol; Cervical insufficiency; Neonatal prognosis; Pregnancy outcome

綜上所述，擇期宮頸環(huán)扎術(shù)聯(lián)合間苯三酚治療CIC可延長孕齡，有效改善新生兒預(yù)后以及妊娠結(jié)局，孕早期行宮頸環(huán)扎術(shù)的療效可能更好。

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（收稿日期：2019-09-11? 本文編輯：閆? 佩）