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目的:比较经腹、经阴道与经会阴三种超声途径测量宫颈长度对早产的预测价值。方法:选取我院就诊的孕妇780例,根据测量途径不同分为三组,每组260例,分别采用经腹、经阴道与经会阴方法测量宫颈长度。观察并比较三组患者的妊娠结局,以及三种测量方法的敏感度及特异性。结果:三组患者接受率相比,经腹组、经会阴组患者接受率明显高于经阴道组(P<0.05);三组患者宫颈显示率相比,经会阴组、经阴道组宫颈显示率显著高于经腹组(P<0.05)。经腹组中,宫颈长度<2.5 cm的患者早产率为48.46%,明显高于宫颈长度≥2.5 cm的患者早产率17.69%(P<0.05);经会阴组中,宫颈长度<2.5 cm的患者早产率为37.69%,明显高于宫颈长度≥2.5 cm的患者早产率13.08%(P<0.05);经阴道组中,宫颈长度<2.5 cm的患者早产率为36.92%,明显高于宫颈长度≥2.5 cm的患者早产率13.46%(P<0.05)。结论:三种超声途径测量宫颈长度对预测早产均有很大的临床价值,其中经会阴途径优势更大,值得进一步推广临床使用。
OBJECTIVE: To compare the predictive value of cervical length for preterm labor by three kinds of transabdominal, transvaginal and perineal ultrasound approaches. Methods: A total of 780 pregnant women were enrolled in our hospital. According to the different measurement methods, they were divided into three groups (260 cases in each group). The cervical length was measured by transabdominal, transvaginal and perineal methods respectively. The pregnancy outcomes of the three groups were observed and compared, as well as the sensitivity and specificity of the three measurement methods. Results: Compared with the transvaginal group (P <0.05), the acceptance rates of transabdominal group and transperineal group were significantly higher in the three groups. Compared with the cervical group, The rate was significantly higher than that of the transabdominal group (P <0.05). In the transabdominal group, the preterm birth rate was 48.46% in patients with cervical length <2.5 cm, significantly higher than that in patients with cervical length ≥ 2.5 cm (17.69%, P <0.05). In the patients with cervical length <2.5 cm The preterm delivery rate was 37.69%, significantly higher than that of the patients with cervical length≥2.5 cm (13.08%, P <0.05). The preterm birth rate was 36.92% in cervical vagina group <2.5 cm, which was significantly higher than that of cervical length≥ Preterm birth rate of 2.5 cm patients was 13.46% (P <0.05). Conclusion: The three methods of measuring the length of the cervix by ultrasound have great clinical value in predicting preterm birth. Among them, the superiority of the perineal route is greater and it is worth further promotion of clinical use.