[1]杨丹林,张钧,蒋玲玲,等.单胎宫颈环扎术的临床疗效及基于人工智能的影响因素分析[J].福建医药杂志,2023,45(04):4-7.
 YANG Danlin,ZHANG Jun,JIANG Lingling,et al.Analysis of clinical effect of McDonald cervical cerclage in singleton pregnancies and the related risk factors[J].FUJIAN MEDICAL JOURNAL,2023,45(04):4-7.
点击复制

单胎宫颈环扎术的临床疗效及基于人工智能的影响因素分析()
分享到:

《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
45
期数:
2023年04期
页码:
4-7
栏目:
临床研究
出版日期:
2023-08-15

文章信息/Info

Title:
Analysis of clinical effect of McDonald cervical cerclage in singleton pregnancies and the related risk factors
文章编号:
1002-2600(2023)04-0004-04
作者:
杨丹林张钧蒋玲玲潘勉1
福建省妇幼保健院(福州 350005)
Author(s):
YANG Danlin ZHANG Jun JIANG Lingling PAN Mian
Fujian Provincial Maternal and Child Health Hospital, Fuzhou, Fujian 350005, China
关键词:
宫颈机能不全 宫颈环扎 影响因素
Keywords:
cervical insufficiency cervical cerclage risk factors
分类号:
R714.21
文献标志码:
B
摘要:
目的 探讨McDonald子宫颈环扎术的临床疗效及其影响因素。方法 回顾性分析2019年1月至2022年3月在我院行McDonald子宫颈环扎术的宫颈机能不全孕妇资料,并分别使用多因素logistic回归、神经网络模型以分析宫颈环扎失败的影响因素。结果 共纳入226例孕妇,其中30例(13.3%)孕妇于孕28周之前流产。多因素logistic回归分析结果:绒毛膜羊膜炎(OR=5.2; 95%CI 2.013,13.428; P=0.001)、血小板淋巴细胞比(PLR)(OR=1.013; 95%CI 1.005,1.021; P=0.02)和臀先露(OR= 6.372; 95%CI 2.017,13.428; P=0.001)是宫颈环扎失败的影响因素。神经网络模型结果:宫口扩张、绒毛膜羊膜炎、PLR、胎膜膨出、臀先露是环扎失败的影响因素。结论 McDonald宫颈环扎术是宫颈机能不全的有效治疗措施。宫口扩张、绒毛膜羊膜炎、PLR、胎膜膨出、臀先露是环扎失败的影响因素。
Abstract:
Objective To investigate the clinical efficacy of McDonald cervical cerclage and its influencing factors. Methods A retrospective analysis was conducted on data of pregnant women with cervical insufficiency who underwent McDonald cervical cerclage in our hospital from January 2019 to March 2022. Multivariable logistic regression and neural network model were used to analyze the factors influencing the failure of cervical cerclage. Results A total of 226 pregnant women were included, among which 30 cases(13.3%)experienced miscarriage before 28 weeks of gestation. The results of multivariable logistic regression analysis showed that chorioamnionitis(OR=5.2; 95%CI 2.013,13.428; P=0.001), platelet-to-lymphocyte ratio(OR=1.013; 95%CI 1.005,1.021; P=0.02), and breech presentation(OR=6.372; 95%CI 2.017,13.428; P=0.001)were factors influencing the failure of cervical cerclage. The neural network model revealed that cervical dilatation, chorioamnionitis, platelet-to-lymphocyte ratio, membrane prolapse, and breech presentation were factors associated with cerclage failure. Conclusion McDonald cervical cerclage is an effective treatment for cervical insufficiency. Cervical dilatation, chorioamnionitis, platelet-to-lymphocyte ratio, membrane prolapse, and breech presentation are factors influencing the failure of cerclage.

参考文献/References:

[1] 孙笑,丁秀萍,时春艳,等.McDonald子宫颈环扎术的临床疗效及其影响因素分析[J].中华妇产科杂志,2016,51(2):87-91.
[2] 常喜梅,李辞妹,李国芸,等.McDonald子宫颈环扎术的临床疗效及其影响因素分析[J].临床医学,2017,37(5):97-98.
[3] 肖汀,张新玲.超声检查预测早产研究进展[J].中国实用妇科与产科杂志,2017,33(2):229-232.
[4] Crane J M,Hutchens D.Transvaginal sonographic measure-ment of cervical length to predict preterm birth in asymptomatic women at increased risk:a systematic review[J].Ultrasound Obstet Gynecol,2008,31(5):579-587.
[5] Boelig R C,Orzechowski K M,Berghella V.Cervical length,risk factors,and delivery outcomes among women with spontaneous preterm birth[J].Matern Fetal Neonatal Med,2016,29(17):2840-2844.
[6] Sperling J D,Dahlke J D,Gonzalez J M.Cerclage use:a review of 3 national guidelines[J].Obstet Gynecol Surv,2017,72(4):235-241.
[7] Alfirevic Z,Stampalija T,Medley N.Cervical stitch(cerclage)for preventing preterm birth in singleton pregnancy[J].Cochrane Database Syst Rev,2017,6(6):CD008991.
[8] Brown R,Gagnon R,Delisle M F.No.373-Cervical insuffi-ciency and cervical cerclage[J].J Obstet Gynaecol Can,2019,41(2):233-247.
[9] Lee S E,Romero R,Park C W,et al.The frequency and significance of intraamniotic inflammation in patients with cervical insufficiency[J].Am J Obstet Gynecol,2008,198(6):633.
[10] Toprak E,Bozkurt M,Dinçgez Ç B,et al.Platelet-to-lymphocyte ratio:a new inflammatory marker for the diagnosis of preterm premature rupture of membranes[J].J Turk Ger Gynecol Assoc,2017,18(3):122-126.
[11] Cunningham F G,Leveno K J,Bloom S L,et al.Williams Obstetrics,24th edition[M].New York:McGraw-Hill Education,2014:558.
[12] 黄春晖.生殖道感染和胎位异常与早产妇女胎膜早破的相关性及对妊娠结局的影响[J].中国妇幼保健,2022,37(12):2161-2163.
[13] Fortner K B,Fitzpatrick C B,Grotegut C A,et al.Cervical dilation as a predictor of pregnancy outcome following emergency cerclage[J].J Matern Fetal Neonatal Med,2012,25(10):1884-1888.
[14] 刘思诗,崔红,李秋玲,等.紧急宫颈环扎术对妊娠结局的影响及相关因素分析[J].中国妇幼保健,2012,27(31):4999-5001.

备注/Memo

备注/Memo:
基金项目:福建省自然科学基金项目(2022J011034)
1 通信作者,Email:panmian1973@126.com
更新日期/Last Update: 2023-08-15