CAJ | 학술논문

目的：探讨孕期监测宫颈长度与先兆早产的相关性，预测孕妇发生早产的临床价值，为今后临床诊治提供参考和借鉴。方法本研究随机选取我院2012年10月～2013年10月期间收治的无任何合并症及并发症孕妇177例，孕期内行常规超声监测宫颈长度，按分娩时间分为两组：先兆早产（A）组138例，早产（B）组39例，分析孕期监测宫颈长度与先兆早产的相关性。结果A组平均宫颈长度为（3.29±0.62）cm明显长于B组的（2.67±0.64）cm，差异有统计学意义（t=3.5083，P=0.0132）；宫颈长度改变是孕妇先兆早产的主要特征。以宫颈长度3.0cm为界，宫颈长度预测孕妇发生早产的敏感度为92.31%（36/39），特异度为93.47%（129/138），阳性预测值为80.00%（36/45），阴性预测值为97.73%（129/132）。结论宫颈长度改变是孕妇先兆早产的主要特征，对宫颈长度＜3.0cm的孕妇应高度警惕其发生早产，对于宫颈长度＞3.0cm的孕妇，应根据其具体的临床表现对症用药，保证母婴安全。采用超声监测孕期宫颈长度能客观、准确地预测早产，是一种安全、有效、可靠的监测方法，值得在临床实践中广泛的应用和推广。
목적：탐토잉기감측궁경장도여선조조산적상관성，예측잉부발생조산적림상개치，위금후림상진치제공삼고화차감。방법본연구수궤선취아원2012년10월～2013년10월기간수치적무임하합병증급병발증잉부177례，잉기내행상규초성감측궁경장도，안분면시간분위량조：선조조산（A）조138례，조산（B）조39례，분석잉기감측궁경장도여선조조산적상관성。결과A조평균궁경장도위（3.29±0.62）cm명현장우B조적（2.67±0.64）cm，차이유통계학의의（t=3.5083，P=0.0132）；궁경장도개변시잉부선조조산적주요특정。이궁경장도3.0cm위계，궁경장도예측잉부발생조산적민감도위92.31%（36/39），특이도위93.47%（129/138），양성예측치위80.00%（36/45），음성예측치위97.73%（129/132）。결론궁경장도개변시잉부선조조산적주요특정，대궁경장도＜3.0cm적잉부응고도경척기발생조산，대우궁경장도＞3.0cm적잉부，응근거기구체적림상표현대증용약，보증모영안전。채용초성감측잉기궁경장도능객관、준학지예측조산，시일충안전、유효、가고적감측방법，치득재림상실천중엄범적응용화추엄。
Objective To investigate the correlation between pregnancy monitoring of cervical length and threatened premature labor and the clinical value of predicting premature labor in order to provide reference for future clinical diagnosis and treatment. Methods 177 pregnant women without complications or combinations admitted to our hospital from October 2012 to October 2013 were selected to receive the conventional ultrasound monitoring of cervical length during pregnancy and divided into two groups according to the labor time:the threatened premature labor group(A) with 138 patients and the premature labor group(B) with 39 patients.The correlation between pregnancy monitoring of cervical length and threatened premature labor was analyzed. Results The average cervical length of group A was(3.29±0.62)cm,which was significantly longer than the(2.67±0.64)cm of group B(t=3.5083,P=0.0132),with statistically significant difference. The change of cervical length was the main feature of threatened premature labor in pregnant women. With 3.0 cm as the boundary of cervical length, the sensitivity of cervical length in predicting premature labor was 92.31%(36/39),the specificity was 93.47%(129/138),the positive predictive value was 80.00%(36/45),and the negative predictive value was 97.73%(129/132). Conclusion The change of cervical length is the main feature of threatened premature labor in pregnant women.For pregnant women with cervical length < 3.0cm,high attention should be paid to avoid premature labor. For pregnant women with cervical length > 3.0cm,medication should be conducted based on the specific clinical manifestations to ensure maternal and child safety.The application of ultrasound monitoring of cervical length can predict premature labor objectively and accurately,thus is a safe, effective and reliable monitoring method and worthy of wide application and promotion in clinical practice.