摘要
目的分析不同治疗方式治疗宫颈机能不全患者疗效及其影响因素。方法回顾性选择宣城市人民医院自2018年1月至2022年7月接诊的70例宫颈机能不全患者作为研究对象,分为A组(39例)和B组(31例)。A组予以McDonald子宫颈环扎术治疗,B组予以保守期待治疗。比较两组妊娠结局、并发症发生情况;根据治疗是否成功,分为成功组与失败组,使用多因素Logistic回归分析治疗失败的影响因素。结果A组足月分娩率、顺产率为56.41%、66.67%,均高于B组(29.03%、32.26%),早产率、晚期流产率为7.69%、5.13%,均低于B组(25.81%、22.58%),分娩孕周为(36.16±1.25)周,大于B组[(33.28±1.07)周],差异均有统计学意义(P<0.05)。A组并发症发生率为28.21%,低于B组的54.84%,差异有统计学意义(P<0.05)。在70例宫颈机能不全患者中,治疗成功39例,治疗失败31例;成功组与失败组年龄、子宫颈长度、宫口扩张程度和生殖道感染发生率比较,差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,年龄、子宫颈长度、宫口扩张程度和生殖道感染均是宫颈机能不全患者治疗失败的独立影响因素(OR=7.456,95.0%CI:2.654~25.813;OR=2.653,95.0%CI:1.058~9.584;OR=8.518,95.0%CI:2.685~13.695;OR=4.521,95.0%CI:0.568~12.478;P<0.05)。结论McDonald子宫颈环扎术治疗宫颈机能不全患者的疗效优于保守期待疗法,前者在改善妊娠结局和减少并发症发生上具有优势,但疗效受年龄、子宫颈长度、宫口扩张程度和生殖道感染的影响,均是导致治疗失败的独立影响因素。
Objective To analyze the curative effect and influencing factors of different treatment methods in patients with cervical insufficiency.Methods Seventy cervical insufficiency patients treated in Xuancheng People's Hospital from January 2018 to July 2022 were retrospectively selected as the study subjects,and divided into group A(39 cases)and group B(31 cases).Group A was treated with McDonald cervical cerclage,and group B was treated with conservative expectation.Pregnancy outcomes and complications were compared between the two groups.According to whether the treatment was successful or not,the patients were divided into success group and failure group.Multivariate Logistic regression was used to analyze the influencing factors of treatment failure.Results The full-term delivery rate and spontaneous delivery rate in group A were 56.41%and 66.67%,which were higher than those in group B(29.03%and 32.26%),the premature delivery rate and late abortion rate were 7.69%and 5.13%,which were lower than those in group B(25.81%and 22.58%),and the gestational weeks of delivery were(36.16±1.25)weeks,which were higher than those in group B[(33.28±1.07)weeks],the differences were statistically significant(P<0.05).The complication rate of group A was 28.21%,which was less than that of the group B(54.84%),the difference was statistically significant(P<0.05).Among 70 patients with cervical insufficiency,39 cases were treated successfully and 31 cases failed.There were statistically significant differences in age,cervical length,dilatation degree and incidence of reproductive tract infection between successful group and failure group(P<0.05).Multivariate Logistic regression analysis showed that age,cervical length,dilatation degree and reproductive tract infection were independent influencing factors of treatment failure in patients with cervical insufficiency(OR=7.456,95.0%CI:2.654-25.813;OR=2.653,95.0%CI:1.058-9.584;OR=8.518,95.0%CI:2.685-13.695;OR=4.521,95.0%CI:0.568-12.478;P<0.05).Conclusion McDonald cervical cerclage is superior to conservative expectant therapy in the treatment of patients with cervical insufficiency,the former has advantages in improving pregnancy outcomes and reducing complications,but the efficacy is affected by age,cervical length,dilatation degree and reproductive tract infection,which are independent influencing factors for treatment failure.
作者
刘伟
孙云霞
姚栋琴
LIU Wei;SUN Yun-xia;YAO Dong-qin(Department of Obstetrics and Gynecology,Xuancheng People's Hospital,Xuancheng Anhui 242000,China)
出处
《临床和实验医学杂志》
2023年第5期521-525,共5页
Journal of Clinical and Experimental Medicine
基金
安徽省卫健委科研项目(编号:AHWJ2021b133)。
关键词
宫颈机能不全
子宫颈环扎
地屈孕酮
疗效
影响因素
Cervical insufficiency
Cervical cerclage
Dydrogesterone
Curative effect
Factors affecting
