孕前“极简式”腹腔镜下宫颈环扎术的临床应用

发布时间：2018-04-25 15:51

本文选题：宫颈功能不全 + 环扎术　；参考：《国际妇产科学杂志》2016年06期

【摘要】：目的:探讨"极简式"腹腔镜下宫颈环扎术(simplified laparoscopic cervical cerclage,SLCC)预防既往经阴道宫颈环扎失败的女性中期流产、早产的效果,并评价手术安全性。方法:分析2010年12月—2015年8月首都医科大学附属复兴医院收治的153例有经阴道宫颈环扎术失败史,实施孕前SLCC的患者临床资料。患者术前孕中期流产平均次数为(2.7±1.2)次,孕周为13~27周,平均孕周(20.0±3.5)周。结果:153例SLCC患者手术顺利,平均手术时间(33.0±1.3)min,术中平均出血量(9.7±8.3)m L,无严重手术并发症。术后共117例患者妊娠,其中8例妊娠2次,总妊娠次数125次;其中包括20次早期流产,2次异位妊娠,1次葡萄胎;截至2015年8月,正在妊娠中19例,已知妊娠结局83例,活产率为96.4%(80/83),平均终止妊娠孕周为(37.2±2.2)周。结论:对于既往经阴道宫颈环扎失败的宫颈机能不全患者,SLCC是一种简单、安全、有效的治疗方法。
[Abstract]:Objective: to investigate the effect of minimized laparoscopic cervical cerclage ligation (LCC) on the prevention of miscarriage and premature delivery in women with previous vaginal cerclage failure, and to evaluate the safety of the operation. Methods: the clinical data of 153 patients with SLCC before pregnancy who were treated in Renaissance Hospital of Capital Medical University from December 2010 to August 2015 were analyzed. The average number of miscarriages in the second trimester of pregnancy before operation was 2.7 卤1.2, the gestational week was 1327 weeks, and the average gestational week was 20.0 卤3.5 weeks. Results the average operation time was 33.0 卤1.3 min and the average blood loss was 9.7 卤8.3 ml / L in 153 cases of SLCC. There were no severe operative complications. There were 117 cases of pregnancy after operation, of which 8 cases were pregnant twice, and the total number of pregnancies was 125; including 20 early miscarriages, 2 ectopic pregnancies and 1 hydatidiform mole; as of August 2015, there were 19 cases of pregnancy in progress and 83 cases of known pregnancy outcomes. The live birth rate was 96.4 / 83 and the average termination of pregnancy was 37.2 卤2.2 weeks. Conclusion: SLCC is a simple, safe and effective method for the patients with cervical dysfunction.
【作者单位】：首都医科大学附属复兴医院宫腔镜中心;
【分类号】：R714.2

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