子宫颈功能不全的不同手术干预及临床结局分析

发布时间：2018-03-11 18:37

本文选题：妊娠　切入点：复发性流产　出处：《滨州医学院》2014年硕士论文　论文类型：学位论文

【摘要】：目的通过对子宫颈功能不全患者资料进行回顾性分析,探讨McDonald环扎术与子宫颈“U”形缝合术对患者妊娠结局的影响。方法选择2009年11月一2014年1月于滨州医学院附属医院就诊的66例子宫颈功能不全患者,其中再入院分娩者51例,电话随访15例。随访过程中,1例患者因孕27(+1)周胎儿畸形拆除缝线后引产,予以剔除,余65例患者无心脏病、多胎妊娠、糖尿病或妊娠期高血压疾病等内科疾病及妊娠并发症,均纳入本研究。65例患者中,30例行McDonald环扎术,35例患者行“U”形缝合术,随访分析两组间临床资料及妊娠结局。采用SPSS13.0软件包进行统计分析,统计方法包括t检验、X2检验等。结果 1. McDonald环扎术组与“U”形缝合术组一般情况比较：年龄、体重指数、中晚期妊娠流产史、孕次、手术孕周及术中颈管长度之间差异没有明显统计学意义。2. McDonald环扎术组与“U”形缝合术组妊娠结局的比较：两组间妊娠延长天数(132.53±5.44 vs 113.09±48.94)、分娩孕周(37.57±3.55 vs 32.46±1.15)及分娩孕周分布均具有统计学差异(P0.05)。3. McDonald环扎术组与“U”形缝合术组新生儿结局比较：新生儿体重(2728.25±197.61 vs 2270.70±203.20)、新生儿住院情况具有统计学差异(P0.05),新生儿存活情况无明显统计学差异。结论宫颈环扎术是治疗子宫颈功能不全的一种有效手术方式。本次试验研究表明,McDonald手术患者出生新生儿体重较子宫颈“U”形缝合术者大；与子宫颈“U”形缝合术相比,McDonald环扎术可以明显延长子宫颈功能不全患者孕周、降低新生儿住院率,值得在临床推广应用。
[Abstract]:Objective to analyze retrospectively the data of patients with cervical insufficiency. To investigate the effect of McDonald ring ligation and cervical "U" suture on pregnancy outcome. Methods 66 patients with cervical dysfunction were selected from affiliated Hospital of Binzhou Medical College on November 1st 2009. 15 cases were followed up by telephone. During the follow-up, 1 patient with fetal malformation at 27 (1) weeks of pregnancy removed the suture and induced labor, and the remaining 65 patients had no medical diseases, such as heart disease, multiple pregnancy, diabetes mellitus or hypertension complicating pregnancy, and pregnancy complications, and the other 65 patients had no heart disease, multiple pregnancy, diabetes mellitus or hypertensive disorder complicating pregnancy, etc. All the 65 patients were included in this study. 30 patients underwent McDonald ring ligation and 35 patients underwent "U" suture. The clinical data and pregnancy outcome of the two groups were followed up and analyzed by SPSS13.0 software package. Results 1.Compared with "U" suture group and McDonald ring ligation group: age, body mass index (BMI), history of miscarriage in middle and late pregnancy, pregnancy times, and so on. There was no significant difference between the gestational weeks and the length of cervical canal during operation. 2. Comparison of pregnancy outcome between McDonald ring ligation group and "U" suture group: pregnancy prolongation days (132.53 卤5.44 vs 113.09 卤48.94), gestational weeks (37.57 卤3.55 vs 32.46 卤1.15) and gestational weeks were compared between the two groups. The neonatal outcome of McDonald group and "U" suture group were compared: neonatal weight was 2728.25 卤197.61 vs 2270.70 卤203.20, neonatal hospitalization had statistical difference (P0.05N), and there was no significant difference in neonatal survival. Cervix ring ligation is an effective surgical method for treating cervical dysfunction. The experimental study shows that the newborn born weight of the patients undergoing McDonald's operation is larger than that of the cervical "U" suture. Compared with "U" suture of cervix, McDonald ring ligation can significantly prolong the gestational age and reduce the rate of neonatal hospitalization in patients with cervical insufficiency, which is worth popularizing in clinic.
【学位授予单位】：滨州医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713.4

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