孕前腹腔镜子宫峡部环扎术治疗宫颈机能不全临床探究.docVIP

孕前腹腔镜子宫峡部环扎术治疗宫颈机能不全的临床研究 　　[摘要] 目的 为临床治疗宫颈机能不全及经宫颈环扎术失败致晚期流产患者找到一种更安全、可行、有效的治疗方法。 方法 将我院 2013年12月～2016年6月收治的宫颈机能不全患者共42例，分为两组，孕前腹腔镜子宫峡部环扎术治疗者为研究组，共18例（其中5例曾孕期宫颈环扎失败流产），自愿接受孕期经阴道宫颈内口环扎术治疗者为对照组，共24例，观察两组治疗后的临床效果、再次复发流产情况、并发症等。 结果 研究组孕前腹腔镜子宫峡部环扎术18例，手术均成功，其中15例怀孕分娩，足月分娩率93.3%，明显高于对照组的58.3%，研究组再次复发流产率为0，早产率及并发症均低于对照组。 结论 腹腔镜孕前子宫峡部环扎术微创易行，术后足月分娩率高，可作为有妊娠中期流产病史及经阴道环扎失败的宫颈机能不全患者有效替代治疗方法 [关键词] 腹腔镜；宫颈机能不全；宫颈环扎；晚期流产 [中图分类号] R713.4 [文献标识码] B [文章编号] 1673-9701（2016）23-0043-03 [Abstract] Objective To research on a safe， feasible， and effective treatment method for late abortion due to cervical incompetence and cervical cerclage failure. Methods A total of 42 patients with cervical incompetence treated in our hospital from December 2013 to June 2016 were selected and divided into two groups： patients with pre-pregnant laparoscopic uterine isthmus cerclage were divided into study group（n=18）， of which 5 patients previously experienced aborthion due to cervical cerclage failure during pregnancy， and patients with transvaginal cervical cerclage during pregnancy were divided into control group（n=24）. The clinical effects in both groups were observed and rates of recurrent abortion， complications， etc were compared. Results In the study group， pre-pregnant laparoscopic uterine isthmus cerclages in 18 patients were all successfully conducted； 15 patients were pregnant and delivered； the rate of mature delivery was 93.3%， which was significantly higher than the 58.3% in the control group. The recurrent abortion rate of study group was 0， and rates of premature delivery and complications were both lower than those in the control group. Conclusion Laparoscopic uterine isthmus cerclage is micro-invasive and easy to conduct， with high mature delivery rate， which can be used as an effective supplementary therapy for patients with tranvaginal cerclage failure and cervical incompetence. [Key words] Laparoscope； Cervical incompetence； Cervical cerclage； Late abortion 宫颈机能不全多为宫颈发育不