国际妇产科学杂志

国际妇产科学杂志 ›› 2016, Vol. 43 ›› Issue (6): 638-642.

• 论著 • 上一篇    下一篇

孕早期使用杯状举宫器行腹腔镜下宫颈环扎手术20例分析

马宁，夏恩兰，黄晓武，李天照   

  1. 100038 北京，首都医科大学附属复兴医院宫腔镜中心（马宁，夏恩兰，黄晓武）；香港中文大学妇产科（李天照）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-12-15 发布日期:2016-12-15
  • 通讯作者: 夏恩兰

Laparoscopic Cervical Cerclage during Pregnancy by Using an Elevate-cup at First Trimester: 20 Cases Analysis

MA Ning，XIA En-lan，HUANG Xiao-wu，LI Tin-Chiu   

  1. Hysteroscopic Center，Fuxing Hospital，Capital Medical University，Beijing 100038，China（MA Ning，XIA En-lan，HUANG Xiao-wu）；Department of Obstetrics and Gynecology，Chinese University of HongKong，Hongkong 999077，China（LI Tin-Chiu）
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-12-15 Online:2016-12-15
  • Contact: XIA En-lan

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摘要： 目的：使用杯状举宫器在孕早期行腹腔镜下宫颈环扎的极简手术方法，追踪妊娠结局。方法：回顾性研究2013年7月—2016年1月于首都医科大学附属复兴医院宫腔镜中心因宫颈机能不全伴有孕中期流产史，使用杯状举宫器在孕早期进行腹腔镜下宫颈环扎术的妇女20例，介绍手术方法，记录手术并发症，随访妊娠结局。结果：20例患者平均手术时间（59.2±21.7）min（24～110 min），出血量10（10，15） mL（5～100 mL）。1例因暴露困难中转开腹手术，术后病率为0。2例术后胎儿停止发育。18例于孕35～39周均剖宫产分娩，活产率90%（18/20），获活婴19例，平均分娩孕周（37.5±1.3）周，新生儿体质量平均（3 348.8±407.4）g。结论：对宫颈机能不全患者使用杯状举宫器进行腹腔镜下宫颈环扎术的方法微创、有效、易于掌握，妊娠结局良好。

Abstract: Objective: Report a simplified procedure by using an elevate-cup in Laparoscopy for Transabdominal Cervical Cerclage （ＬＴＣＣ） during pregnancy and follow-up the obstetrical outcomes. Methods: Retrospective study was carried out in Fuxing Hosptial, Captial Medical University, hysteroscopic center. From July 2013 to January 2016, 20 cases pregnancy women with cervical incompetence underwent LTCC by using an elevate-cup at first trimester. We described the surgical techniques along with the obstetrical outcomes including the success and complication rate. Results: Among the 20 cases of LTCC, the surgical time was （59.2±21.7） min （24-110 min） and blood loss was 10（10，15） mL（5-100 mL）. 1 case was converted to laparotomy because of poor operation field. Postopertative morbidity rate was 0%. There were 2 cases of miscarriage after the operation. 18 women had delivered 19 live babies by cesarean section in the third trimester,live birth rate was 90%（18/20）. 1 of them conceived twins. The mean gestational age at delivery was（37.5±1.3） weeks. Neonatal weight was （3 348.8±407.4） g. Conclusions: The present study reports a series of cervical incompetence cases treated by LTCC using an elevate-cup simplified surgical procedure which is easy-operating, minimal invasive and highly effective. The obstetrical outcomes are acceptable.