本文選題：妊娠　切入點(diǎn)：復(fù)發(fā)性流產(chǎn)　出處：《濱州醫(yī)學(xué)院》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 通過對子宮頸功能不全患者資料進(jìn)行回顧性分析,探討McDonald環(huán)扎術(shù)與子宮頸“U”形縫合術(shù)對患者妊娠結(jié)局的影響。方法 選擇2009年11月一2014年1月于濱州醫(yī)學(xué)院附屬醫(yī)院就診的66例子宮頸功能不全患者,其中再入院分娩者51例,電話隨訪15例。隨訪過程中,1例患者因孕27(+1)周胎兒畸形拆除縫線后引產(chǎn),予以剔除,余65例患者無心臟病、多胎妊娠、糖尿病或妊娠期高血壓疾病等內(nèi)科疾病及妊娠并發(fā)癥,均納入本研究。65例患者中,30例行McDonald環(huán)扎術(shù),35例患者行“U”形縫合術(shù),隨訪分析兩組間臨床資料及妊娠結(jié)局。采用SPSS13.0軟件包進(jìn)行統(tǒng)計(jì)分析,統(tǒng)計(jì)方法包括t檢驗(yàn)、X2檢驗(yàn)等。結(jié)果 1. McDonald環(huán)扎術(shù)組與“U”形縫合術(shù)組一般情況比較：年齡、體重指數(shù)、中晚期妊娠流產(chǎn)史、孕次、手術(shù)孕周及術(shù)中頸管長度之間差異沒有明顯統(tǒng)計(jì)學(xué)意義。2. McDonald環(huán)扎術(shù)組與“U”形縫合術(shù)組妊娠結(jié)局的比較：兩組間妊娠延長天數(shù)(132.53±5.44 vs 113.09±48.94)、分娩孕周(37.57±3.55 vs 32.46±1.15)及分娩孕周分布均具有統(tǒng)計(jì)學(xué)差異(P0.05)。3. McDonald環(huán)扎術(shù)組與“U”形縫合術(shù)組新生兒結(jié)局比較：新生兒體重(2728.25±197.61 vs 2270.70±203.20)、新生兒住院情況具有統(tǒng)計(jì)學(xué)差異(P0.05),新生兒存活情況無明顯統(tǒng)計(jì)學(xué)差異。結(jié)論 宮頸環(huán)扎術(shù)是治療子宮頸功能不全的一種有效手術(shù)方式。本次試驗(yàn)研究表明,McDonald手術(shù)患者出生新生兒體重較子宮頸“U”形縫合術(shù)者大；與子宮頸“U”形縫合術(shù)相比,McDonald環(huán)扎術(shù)可以明顯延長子宮頸功能不全患者孕周、降低新生兒住院率,值得在臨床推廣應(yīng)用。
[Abstract]:Objective to analyze retrospectively the data of patients with cervical insufficiency. To investigate the effect of McDonald ring ligation and cervical "U" suture on pregnancy outcome. Methods 66 patients with cervical dysfunction were selected from affiliated Hospital of Binzhou Medical College on November 1st 2009. 15 cases were followed up by telephone. During the follow-up, 1 patient with fetal malformation at 27 (1) weeks of pregnancy removed the suture and induced labor, and the remaining 65 patients had no medical diseases, such as heart disease, multiple pregnancy, diabetes mellitus or hypertension complicating pregnancy, and pregnancy complications, and the other 65 patients had no heart disease, multiple pregnancy, diabetes mellitus or hypertensive disorder complicating pregnancy, etc. All the 65 patients were included in this study. 30 patients underwent McDonald ring ligation and 35 patients underwent "U" suture. The clinical data and pregnancy outcome of the two groups were followed up and analyzed by SPSS13.0 software package. Results 1.Compared with "U" suture group and McDonald ring ligation group: age, body mass index (BMI), history of miscarriage in middle and late pregnancy, pregnancy times, and so on. There was no significant difference between the gestational weeks and the length of cervical canal during operation. 2. Comparison of pregnancy outcome between McDonald ring ligation group and "U" suture group: pregnancy prolongation days (132.53 鹵5.44 vs 113.09 鹵48.94), gestational weeks (37.57 鹵3.55 vs 32.46 鹵1.15) and gestational weeks were compared between the two groups. The neonatal outcome of McDonald group and "U" suture group were compared: neonatal weight was 2728.25 鹵197.61 vs 2270.70 鹵203.20, neonatal hospitalization had statistical difference (P0.05N), and there was no significant difference in neonatal survival. Cervix ring ligation is an effective surgical method for treating cervical dysfunction. The experimental study shows that the newborn born weight of the patients undergoing McDonald's operation is larger than that of the cervical "U" suture. Compared with "U" suture of cervix, McDonald ring ligation can significantly prolong the gestational age and reduce the rate of neonatal hospitalization in patients with cervical insufficiency, which is worth popularizing in clinic.
【學(xué)位授予單位】：濱州醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R713.4

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