中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2014年
4期
508-510
,共3页
子宫颈/超声检查%宫颈长度测量%早产%预测
子宮頸/超聲檢查%宮頸長度測量%早產%預測
자궁경/초성검사%궁경장도측량%조산%예측
Cervix uteri/ultrasonography%Cervical length measurement%Premature birth%Forecasting
目的:探讨超声测宫颈长度预测早产的临床意义,并对经腹、经阴道与经会阴三种超声途径测宫颈长度预测早产进行比较。方法对2012年1月至2013年12月有先兆早产征象来本院就诊的孕妇(840例)行超声测宫颈长度预测早产,按不同测量宫颈长度途径分为3组,每组280例,经腹测量宫颈长度(Ⅰ组)、经阴道测量宫颈长度(Ⅱ组)、经会阴测量宫颈长度(Ⅲ组),记录宫颈长度( CL ),追踪妊娠结局,并对三种测量方法进行比较。结果Ⅰ组孕妇接受率为100%(280/280),宫颈实现率为85.0%(238/280),CL<3 cm组早产率为48.6%(18/37),CL≥3 cm组早产率为17.9%(36/201),CL<3 cm预测早产敏感性为33.3%(18/54);Ⅱ组孕妇接受率为81.8%(229/280),宫颈实现率为98.7%(226/229),CL<3 cm组早产率为37.8%(28/74),CL≥3 cm组早产率为13.2%(20/152),CL<3 cm预测早产敏感性为58.3%(28/48);Ⅲ组孕妇接受率为99.3%(278/280),宫颈实现率为98.2%(273/278),CL<3 cm组早产率为37.1%(33/89),CL≥3 cm组早产率为13.6%(25/184),CL<3 cm预测早产敏感性为56.9%(33/58)。三组CL<3 cm组早产率(48.6%,37.8%,37.1%)均明显高于CL≥3 cm组早产率(17.9%,13.2%,13.6%),差异有统计学意义( P <0.05)。Ⅱ组孕妇接受率(81.8%)明显低于Ⅰ组(100%)和Ⅲ组(99.3%),差异有统计学意义( P <0.05)。Ⅰ组宫颈实现率85%明显低于Ⅱ组98.7%和Ⅲ组98.2%,差异有统计学意义( P <0.05);Ⅰ组CL<3 cm预测早产敏感性33.3%,明显低于Ⅱ组(58.3%)和Ⅲ组(56.9%),差异有统计学意义( P <0.05)。结论超声测宫颈长度预测早产有较大临床意义,相比之下经会阴途径更具优势,值得推广。
目的:探討超聲測宮頸長度預測早產的臨床意義,併對經腹、經陰道與經會陰三種超聲途徑測宮頸長度預測早產進行比較。方法對2012年1月至2013年12月有先兆早產徵象來本院就診的孕婦(840例)行超聲測宮頸長度預測早產,按不同測量宮頸長度途徑分為3組,每組280例,經腹測量宮頸長度(Ⅰ組)、經陰道測量宮頸長度(Ⅱ組)、經會陰測量宮頸長度(Ⅲ組),記錄宮頸長度( CL ),追蹤妊娠結跼,併對三種測量方法進行比較。結果Ⅰ組孕婦接受率為100%(280/280),宮頸實現率為85.0%(238/280),CL<3 cm組早產率為48.6%(18/37),CL≥3 cm組早產率為17.9%(36/201),CL<3 cm預測早產敏感性為33.3%(18/54);Ⅱ組孕婦接受率為81.8%(229/280),宮頸實現率為98.7%(226/229),CL<3 cm組早產率為37.8%(28/74),CL≥3 cm組早產率為13.2%(20/152),CL<3 cm預測早產敏感性為58.3%(28/48);Ⅲ組孕婦接受率為99.3%(278/280),宮頸實現率為98.2%(273/278),CL<3 cm組早產率為37.1%(33/89),CL≥3 cm組早產率為13.6%(25/184),CL<3 cm預測早產敏感性為56.9%(33/58)。三組CL<3 cm組早產率(48.6%,37.8%,37.1%)均明顯高于CL≥3 cm組早產率(17.9%,13.2%,13.6%),差異有統計學意義( P <0.05)。Ⅱ組孕婦接受率(81.8%)明顯低于Ⅰ組(100%)和Ⅲ組(99.3%),差異有統計學意義( P <0.05)。Ⅰ組宮頸實現率85%明顯低于Ⅱ組98.7%和Ⅲ組98.2%,差異有統計學意義( P <0.05);Ⅰ組CL<3 cm預測早產敏感性33.3%,明顯低于Ⅱ組(58.3%)和Ⅲ組(56.9%),差異有統計學意義( P <0.05)。結論超聲測宮頸長度預測早產有較大臨床意義,相比之下經會陰途徑更具優勢,值得推廣。
목적:탐토초성측궁경장도예측조산적림상의의,병대경복、경음도여경회음삼충초성도경측궁경장도예측조산진행비교。방법대2012년1월지2013년12월유선조조산정상래본원취진적잉부(840례)행초성측궁경장도예측조산,안불동측량궁경장도도경분위3조,매조280례,경복측량궁경장도(Ⅰ조)、경음도측량궁경장도(Ⅱ조)、경회음측량궁경장도(Ⅲ조),기록궁경장도( CL ),추종임신결국,병대삼충측량방법진행비교。결과Ⅰ조잉부접수솔위100%(280/280),궁경실현솔위85.0%(238/280),CL<3 cm조조산솔위48.6%(18/37),CL≥3 cm조조산솔위17.9%(36/201),CL<3 cm예측조산민감성위33.3%(18/54);Ⅱ조잉부접수솔위81.8%(229/280),궁경실현솔위98.7%(226/229),CL<3 cm조조산솔위37.8%(28/74),CL≥3 cm조조산솔위13.2%(20/152),CL<3 cm예측조산민감성위58.3%(28/48);Ⅲ조잉부접수솔위99.3%(278/280),궁경실현솔위98.2%(273/278),CL<3 cm조조산솔위37.1%(33/89),CL≥3 cm조조산솔위13.6%(25/184),CL<3 cm예측조산민감성위56.9%(33/58)。삼조CL<3 cm조조산솔(48.6%,37.8%,37.1%)균명현고우CL≥3 cm조조산솔(17.9%,13.2%,13.6%),차이유통계학의의( P <0.05)。Ⅱ조잉부접수솔(81.8%)명현저우Ⅰ조(100%)화Ⅲ조(99.3%),차이유통계학의의( P <0.05)。Ⅰ조궁경실현솔85%명현저우Ⅱ조98.7%화Ⅲ조98.2%,차이유통계학의의( P <0.05);Ⅰ조CL<3 cm예측조산민감성33.3%,명현저우Ⅱ조(58.3%)화Ⅲ조(56.9%),차이유통계학의의( P <0.05)。결론초성측궁경장도예측조산유교대림상의의,상비지하경회음도경경구우세,치득추엄。
Objective To compare three ultrasonic methods of transabdominal , transvaginal , and transperineal ultrasonogra-phy for the cervical length ( CL) in predicting the preterm birth .Methods The pregnancy women with threatened preterm labor in Hunan Provincial Hospital of Maternal and Child Health from January , 2012 to December, 2013 were chosen to measure the cervical length by sonography , and were randomly divided into three guoups ( 280 pregnancy women in each group ) , including Group Ⅰ( transabdominal ) , groupⅡ( transvaginal ) , and group Ⅲ ( transperineal ) .The cervical length and the pregnancy outcome were fol-lowed up.Results The acceptance rate of group Ⅱ(81.8%=229/280) was significantly lower than that of groupⅠ(100%=280/280)and group Ⅲ(99.3%=278/280)( P <0.05).The realization ratio of the cervix in group Ⅰ(85.0%=238/280) was signifi-cantly lower than that of group Ⅱ(98.7%=226/229) and group Ⅲ (98.2%=273/278) ( P <0.05).The preterm birth rate of 48.6%(18/37) in groupⅠ, 37.8%(28/74) in groupⅡ, and 37.1%(33/89) in groupⅢin the pregnancy women with CL <3 cm was significantly higher than the corresponding preterm birth rate of 17.9%(36/201) in groupⅠ, 13.2%(20/152)in groupⅡ, and 13.6% (25/184) in groupⅢin the pregnancy women with CL≥3 cm.The sensitivity of groupⅠ(33.3%=18/54) was significantly lower than that of group Ⅱ(58.3%=28/48) and group Ⅲ(56.9%=33/58).Conclusions The cervical length measured by ultra-sound is valuable in predicting preterm birth among the pregnancy women with threatened preterm birth .The transperineal ultrasonogra-phy is superior to transabdominal and transvaginal ultrasonography in predicting preterm birth , and is worth being popularized .