CAJ | 학술논문

目的：探讨不同孕期测量宫颈长度（ CL）预测早产的价值。方法：对定期产前检查的单胎初产孕妇368例，分别于孕24～28周、30～34周经阴道超声测量宫颈长度，观察妊娠不同阶段宫颈长度变化及对早产的预测价值。结果：①宫颈长度变化。孕24～28周测量368例，CL平均37.87±3.10 mm；30～34周测量363例，CL平均为34.23±4.41 mm。二者比较有极显著性差异（ P＜0.01）。②不同孕期宫颈长度与早产的关系。孕24～28周368例中，足月分娩340例（占92.39％），早产28例（占7.61％）。与CL≥30 mm的孕妇比较，CL 25～29 mm、＜25 mm的孕妇早产发生的风险分别为4.35倍、7.97倍，且具有显著性差异（ P＜0.05）。孕30～34周363例中，足月分娩338例（占93.12％），早产25例（占6.88％）。与CL≥30 mm的孕妇比较，CL 25～29 mm、＜25 mm的孕妇早产发生的风险分别为8.4倍、16.04倍，且具有显著性差异（ P＜0.05）。③不同孕期宫颈长度预测早产的价值。以宫颈长度＜25 mm为早产预测值，孕24～28周、30～34周在敏感性、特异性、阳性预测值、阴性预测值之间无显著性差异（ P＞0.05）。结论：孕晚期与孕中期比较，宫颈显著缩短；宫颈长度与早产的发生存在关联，且长度越短风险越大；但是不同孕周宫颈长度在预测早产结果准确性上没有什么区别。
목적：탐토불동잉기측량궁경장도（ CL）예측조산적개치。방법：대정기산전검사적단태초산잉부368례，분별우잉24～28주、30～34주경음도초성측량궁경장도，관찰임신불동계단궁경장도변화급대조산적예측개치。결과：①궁경장도변화。잉24～28주측량368례，CL평균37.87±3.10 mm；30～34주측량363례，CL평균위34.23±4.41 mm。이자비교유겁현저성차이（ P＜0.01）。②불동잉기궁경장도여조산적관계。잉24～28주368례중，족월분면340례（점92.39％），조산28례（점7.61％）。여CL≥30 mm적잉부비교，CL 25～29 mm、＜25 mm적잉부조산발생적풍험분별위4.35배、7.97배，차구유현저성차이（ P＜0.05）。잉30～34주363례중，족월분면338례（점93.12％），조산25례（점6.88％）。여CL≥30 mm적잉부비교，CL 25～29 mm、＜25 mm적잉부조산발생적풍험분별위8.4배、16.04배，차구유현저성차이（ P＜0.05）。③불동잉기궁경장도예측조산적개치。이궁경장도＜25 mm위조산예측치，잉24～28주、30～34주재민감성、특이성、양성예측치、음성예측치지간무현저성차이（ P＞0.05）。결론：잉만기여잉중기비교，궁경현저축단；궁경장도여조산적발생존재관련，차장도월단풍험월대；단시불동잉주궁경장도재예측조산결과준학성상몰유십요구별。
Objective:To investigate the value of cervical length ( CL ) measurement for prediction of premature birth in different gestation .Methods:Recorded the cervical length of 368 cases of primiparas with single embryo during regular antenatal examination with transvaginal measurement , respectively in 24 ~28 weeks of pregnancy and 30~34 weeks of pregnancy , and observed the predictive value of preterm birth with cervical length change in different stages of pregnancy .Results:①Cervical length changes:in 368 cases of 24~28 weeks pregnancy the CL was 37.87 ±3.10 mm, in 363 cases of 30~34 weeks of pregnancy the CL was 34.23 ±4.41 mm, and the difference was statistically significant ( P <0.01 ) .②The relationship between cervical length and preterm birth in different gestation:368 cases of 24~28 weeks pregnancy , in which there were 340 cases of full -term birth ( 92.39%) , 28 cases of premature birth ( 7.61%) .Compared with in pregnant women with CL≥30 mm, the risk of preterm birth occurred 4.35, 7.97 times respectively in pregnant women with a CL 25~29 mm or <25 mm, the difference was statistically significant ( P<0.05 ) . 363 cases of 30 ~34 weeks pregnancy , in which there were 338 cases of full -term birth ( 93.12%) , 25 cases of premature birth ( 6.88%) .Compared with that in pregnant women with CL≥30 mm, the risk of preterm birth occurred 8.4, 16.04 times respectively in pregnant women with a CL 25~29 mm or <25 mm, the difference was statistically significant ( P <0.05 ) .③The value of cervical length measurement for prediction of premature birth in different gestation:Adopted the predictive value of cervical length <25 mm for premature birth, the differences insensitivity, specificity, positive predictive value, negative predictive valuewere not statistical significance (P >0.05) at 24 ~28 weeks and 30 ~34 weeks pregnancy.Conclusion:Compared with in mid -trimester,the cervical length is significantly shortened in late trimester ; the cervicallength is associated with the occurrence of premature birth , the shorter of cervical length the greater of risk;but there is no difference in different cervical lengths with in different gestation for prediction of prematurebirth.