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目的:讨论反复宫颈环扎在临床上的应用价值。方法:回顾性分析2009年1月～2011年12月中国医科大学附属盛京医院产科治疗行宫颈环扎术的患者,术后再次发生宫颈短缩或宫口开大而行反复宫颈环扎术(环扎次数≥2次)的14例患者的妊娠结局。结果:14例孕妇延长天数为12天～116天,平均为63.93天,第二次紧急宫颈环扎术至终止妊娠延长1～68天,平均24天。14例孕妇中10例患者获得活产儿12例,4例流产儿死亡,出生孕周分别为20+6周、23周、24+1周、26+5周。随访中,1例分娩周数为26+6周,新生儿于儿科住院5天后退院,退院后新生儿死亡。11例存活儿随访至今,1例神经心理发育迟缓,1例诊断为脑瘫,目前2例患儿给予药物治疗及功能锻炼。结论:反复宫颈环扎是初次宫颈环扎术后再次发生宫颈短缩或宫口开大的有效补救措施,提高胎儿存活率。
Objective: To discuss the clinical value of repeated cervical cerclage. Methods: A retrospective analysis of patients who underwent cervical cerclage surgery at the Shengjing Hospital affiliated to China Medical University from January 2009 to December 2011 was retrospectively analyzed. Cervical shortening or cervical cerclage recurrence occurred again after operation (Cerclage ≥ 2 times) in 14 patients with pregnancy outcome. Results: 14 cases of pregnant women to extend the number of days 12 days to 116 days, an average of 63.93 days, the second emergency cervical cerclage termination of pregnancy extended to 1 to 68 days, an average of 24 days. Twelve of 14 pregnant women received live births, and 4 died of abortion. The gestational weeks of pregnancy were 20 + 6 weeks, 23 weeks, 24 + 1 weeks and 26 + 5 weeks respectively. During the follow-up, 1 case of delivery week was 26 + 6 weeks, newborns were hospitalized in pediatric 5 days later, and newborns died after hospitalization. Of the 11 survivors, up to now, one patient has neuropsychological delay and one patient has been diagnosed as cerebral palsy. At present, two children are given drug therapy and functional exercise. CONCLUSION: Repeated cervical cerclage is an effective remedy for recurrent cervix shortening or large cervix opening after cervical cerclage, which can improve the fetal survival rate.