摘要目的 探讨治疗性子宫颈环扎术在预防妊娠中期短子宫颈综合征孕妇早产中的作用.方法 收集2008年1月至2015年7月于北京大学第三医院就诊、妊娠中期B超发现子宫颈长度≤2.5 cm、内外口均闭合的短子宫颈综合征的单胎妊娠孕妇44例;其中接受治疗性子宫颈环扎术的孕妇30例(环扎组),未行治疗性子宫颈环扎术的孕妇14例(未环扎组).比较两组孕妇的保胎天数、分娩孕周、不同孕周的累积分娩率及新生儿出生体质量、早期(即出生7d内)新生儿存活率,以评估治疗性子宫颈环扎术对短子宫颈综合征的单胎妊娠孕妇的临床治疗效果.结果 环扎组与未环扎组孕妇的保胎天数[分别为103(84～141)、105(83～114)d]、分娩孕周[分别为38.0(35.5～39.4)、38.5(37.3～39.5)周]、新生儿出生体质量[分别为3120(2750～3400)、3130(2760～3545)g]及早期新生儿存活率[分别为100％(30/30)、13/14],分别比较,差异均无统计学意义(P均>0.05).两组孕妇孕≥28周的累积分娩率均为100％,≥32周、≥34周及≥37周的累积分娩率,分别比较,差异均无统计学意义(P均>0.05).结论 对于仅子宫颈缩短、内外口均闭合的短子宫颈综合征的单胎妊娠孕妇,治疗性子宫颈环扎术的临床效果并不优于保守治疗;对这类孕妇可不必急于行治疗性子宫颈环扎术,动态监测、查找病因并及时个体化处理更重要.

abstractsObjective To investigate the clinical effect of therapeutic cervical cerclage on short cervix syndrome for anti-premature birth in the second trimester. Methods Totally 44 singleton pregnant patients were diagnosed as short cervix syndrome, which was cervical length ≤2.5 cm without cervical dilatation,and received treatment from January 2008 and July 2015 in Peking University Third Hospital were collected. Among them, 30 patients who received therapeutic cervical cerclage were defined as cerclage group and another 14 cases who received conservative treatment were defined as un-cerclage group. The days of conservative treatment, delivery rate of different gestational weeks, birth weight of newborns, neonatal survival rate within 7 days of birth were analyzed between the two groups. Results There were no significant differences between the two groups in days of pregnancy conservative treatment [103(84-141)vs 105(85-114)days], delivery weeks [38.0(35.5-39.4)vs 38.5(37.3-39.5)weeks], birth weight of newborns [3120(2750-3400)vs 3130(2760-3545)g], and survival rate of newborns [100％(30/30)vs 13/14]. The fetuses of both groups were all delivered after 28 weeks. There was no significant difference in accumulated delivery rate between the two groups after 32 weeks, 34 weeks, and 37 weeks, respectively(all P>0.05). Conclusions The treatment of cervical cerclage is not superior to conservative means in single pregnancy of cervical length ≤2.5 cm without cervical dilatation. For such patients with short cervix syndrome, the treatment of cervical cerclage may not be necessary, but dynamic monitoring and search for the causing factors and prompt treatment are more important.