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目的对比预防性McDonald子宫颈环扎术与治疗性子宫颈环扎术患者的妊娠结局。方法选取2009年5月—2015年5月宫颈功能不全患者60例,依据手术指征将患者分为观察组25例与对照组35例。观察组给予预防性McDonald子宫颈环扎术,对照组给予治疗性Mc Donald子宫颈环扎术。对比两组手术时间、术中出血量、手术成功率、妊娠结局、并发症发生率。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果两组手术时间、术中出血量、手术成功率、活产率、并发症发生率比较差异无统计学意义(均P>0.05)。两组足月分娩率(76.00%、48.57%)、新生儿转儿科率(12.00%、37.14%)比较差异有统计学意义(χ~2=4.571、4.714,均P<0.05)。结论预防性Mc Donald子宫颈环扎术与治疗性子宫颈环扎术疗效相当,并发症均较少,但预防性Mc Donald子宫颈环扎术可明显降低新生儿转儿科比例,提高足月分娩率,具有一定的临床应用价值。
Objective To compare the pregnancy outcome of patients with prophylactic McDonald cervical cerclage and curative cervical cerclage. Methods From May 2009 to May 2015, 60 patients with cervical insufficiency were divided into observation group (25 cases) and control group (35 cases). The observation group received prophylactic McDonald cervical cerclage and the control group received therapeutic McDonald cervical cerclage. The operation time, intraoperative blood loss, operation success rate, pregnancy outcome and complication rate were compared between the two groups. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results There was no significant difference in operative time, intraoperative blood loss, operative success rate, live birth rate and complication rate between the two groups (all P> 0.05). The rates of full-term delivery (76.00%, 48.57%) and pediatric neonates (12.00%, 37.14%) were significantly different between the two groups (χ ~ 2 = 4.571, 4.714, all P <0.05). Conclusions The prophylactic McDonald cervical cerclage and curative cervical cerclage have the same curative effect and fewer complications. However, prophylactic McDonald cervical cerclage can significantly reduce the neonatal transfer rate and improve the full-term delivery rate , Has a certain clinical value.