摘要
目的比较不同干预策略(单纯息肉切除、宫颈环扎术)对妊娠合并宫颈管蜕膜息肉患者妊娠结局的影响,为临床决策提供循证依据。方法采用单中心、回顾性队列研究,选取2022年6月—2025年6月吉林省妇幼保健院收治的96例妊娠合并宫颈管蜕膜息肉患者为研究对象,根据干预策略分为单纯息肉切除术组(45例)和宫颈环扎术组(51例)。收集患者基线资料、手术方案及母婴结局,比较两组流产、早产、胎膜早破及足月产等妊娠结局,分娩孕周、新生儿Apgar评分及术后并发症发生率。结果宫颈环扎术组早产率(5.88%vs.20.00%)和胎膜早破率(3.92%vs.17.78%)均显著低于单纯息肉切除术组,足月产率(84.31%vs.66.67%)高于单纯息肉切除术组,差异均有统计学意义(χ^(2)=4.356、4.919及4.087,均P<0.05);两组流产率(9.80%vs.13.33%)比较,差异无统计学意义(χ^(2)=0.294,P>0.05)。宫颈环扎术组分娩孕周[(36.21±3.87)周vs.(34.29±2.86)周]长于单纯息肉切除术组,实际妊娠延长天数[(37.28±3.84)d vs.(35.26±4.59)d]高于单纯息肉切除术组,差异均有统计学意义(t=2.733、2.347,均P<0.05)。宫颈环扎术组新生儿Apgar评分[(8.67±0.76)分vs.(8.26±0.56)分]高于单纯息肉切除术组,呼吸窘迫综合征发生率(1.96%vs.13.33%)和缺血缺氧性脑病发生率(0.00%vs.8.89%)显著低于单纯息肉切除术组,差异均有统计学意义(t=2.975,χ^(2)=4.437、4.730,均P<0.05)。两组新生儿出生体重[(2827.58±581.36)g vs.(2930.27±663.64)g]比较,差异无统计学意义(t=0.808,P>0.05)。两组术后并发症总发生率(5.88%vs.13.33%)比较,差异无统计学意义(χ^(2)=1.562,P>0.05)。结论宫颈环扎术可显著降低妊娠合并宫颈管蜕膜息肉患者早产和胎膜早破风险,延长妊娠时间,改善新生儿预后,且不增加术后并发症,临床效果优于单纯息肉切除术。
Objective To compare the effects of different intervention strategies(simple polypectomy and cervical cerclage)on pregnancy outcomes of patients with cervical canal decidual polyps during pregnancy,and to provide evidence-based basis for clinical decisionmaking.Methods A single-center,retrospective cohort study was conducted.A total of 96 patients with pregnancy complicated by cervical decidual polyps admitted to Jilin Women and Children Health Hospital from June 2022 to June 2025 were selected as the study subjects.According to the intervention strategies,they were divided into the simple polyp excision group(45 cases)and the cervical cerclage group(51 cases).Baseline data of patients,surgical plans,and maternal-infant outcomes were collected.Pregnancy outcomes such as abortion,preterm birth,premature rupture of membranes,and full-term delivery,as well as the gestational age at delivery,neonatal Apgar score,and the incidence of postoperative complications were compared between the two groups.Results The preterm birth rate(5.88%vs.20.00%)and the premature rupture of membranes rate(3.92%vs.17.78%)in the cervical cerclage group were significantly lower than those in the simple polyp excision group,while the full-term delivery rate(84.31%vs.66.67%)was higher than that in the simple polyp excision group,with all differences being statistically significant(χ^(2)=4.356,4.919,and 4.087,respectively,all P<0.05).There was no statistically significant difference in the abortion rate(9.80%vs.13.33%)between the two groups(χ^(2)=0.294,P>0.05).The gestational age at delivery in the cervical cerclage group[(36.21±3.87)weeks vs.(34.29±2.86)weeks]was longer than that in the simple polyp excision group,and the actual number of days of pregnancy extension[(37.28±3.84)days vs.(35.26±4.59)days]was higher than that in the simple polyp excision group,with both differences being statistically significant(t=2.733,2.347,respectively,al P<0.05).The neonatal Apgar score in the cervical cerclage group[(8.67±0.76)points vs.(8.26±0.56)points]was higher than that in the simple polyp excision group,and the incidences of respiratory distress syndrome(1.96%vs.13.33%)and hypoxic-ischemic encephalopathy(0.00%vs.8.89%)were significantly lower than those in the simple polyp excision group,with all differences being statistically significant(t=2.975,χ^(2)=4.437,4.730,respectively,all P<0.05).There was no statistically significant difference in the neonatal birth weight[(2827.58±581.36)g vs.(2930.27±663.64)g]between the two groups(t=0.808,P>0.05).There was no statistically significant difference in the total incidence of postoperative complications(5.88%vs.13.33%)between the two groups(χ^(2)=1.562,P>0.05).Conclusion Cervical cerclage can significantly reduce the risks of preterm birth and premature rupture of membranes in patients with pregnancy complicated by cervical decidual polyps,prolong the duration of pregnancy,and improve neonatal prognosis without increasing the incidence of postoperative complications.Its clinical effect was superior to that of simple polyp excision.
作者
于艳秋
冷宗祥
张兴威
刘春雷
伊咏
YU Yan-qiu;LENG Zong-xiang;ZHANG Xing-wei;LIU Chun-lei;YI Yong(Jilin Women and Children Health Hospital(Jilin Provincial Obstetric Quality Control Center),Changchun,Jilin 130061,China)
出处
《中国妇幼保健》
2026年第2期234-238,共5页
Maternal and Child Health Care of China
基金
吉林省卫生健康科技能力提升项目(2023LC085)。
关键词
妊娠期
宫颈蜕膜息肉
宫颈环扎术
流产
早产
Pregnancy
Cervical decidual polyps
Cervical cerclage
Miscarriage
Premature delivery
