CAJ | 학술논문

目的：探讨生物蛋白胶宫颈封堵术治疗未足月胎膜早破的有效性。方法将在我院治疗的28例未足月胎膜早破孕产妇随机分为三组，A组10例采用B超监测下经宫颈插管生物蛋白胶封堵法治疗，B组8例行腔镜介导下宫颈插管推注生物蛋白胶封堵术，C组10例行羊膜镜介导下宫颈插管推注生物蛋白胶封堵胎膜破口术，三组再给予相同的抑制宫缩治疗和护理，比较三组孕产妇的手术效果和分娩差异。结果 A组孕产妇治愈0例(0.0%)，有效2例(20.0%)，无效8例(80.0%)，其中自然分娩2例，人工助产3例，剖宫产5例，胎儿存活率为60.0%；B组孕产妇治愈2例(25.0%)，有效4例(50.0%)，无效2例(25.0%)，其中自然分娩4例，人工助产1例，剖宫产3例，胎儿存活率为83.3%；C组孕产妇治愈8例(80.0%)，有效1例(10.0%)，无效1例(10.0%)，其中自然分娩8例，人工助产1例，剖宫产1例，胎儿存活率为100.0%，治疗效果和术后分娩情况显著优于其他两组，其差异均具有统计学意义(P<0.05)。结论羊膜镜介导下生物蛋白胶封堵胎膜破口法结合了传统方法的优点，封堵成功率高，操作相对简单，而且不需要注水，不影响生物蛋白胶的凝固，值得推广。
목적：탐토생물단백효궁경봉도술치료미족월태막조파적유효성。방법장재아원치료적28례미족월태막조파잉산부수궤분위삼조，A조10례채용B초감측하경궁경삽관생물단백효봉도법치료，B조8례행강경개도하궁경삽관추주생물단백효봉도술，C조10례행양막경개도하궁경삽관추주생물단백효봉도태막파구술，삼조재급여상동적억제궁축치료화호리，비교삼조잉산부적수술효과화분면차이。결과 A조잉산부치유0례(0.0%)，유효2례(20.0%)，무효8례(80.0%)，기중자연분면2례，인공조산3례，부궁산5례，태인존활솔위60.0%；B조잉산부치유2례(25.0%)，유효4례(50.0%)，무효2례(25.0%)，기중자연분면4례，인공조산1례，부궁산3례，태인존활솔위83.3%；C조잉산부치유8례(80.0%)，유효1례(10.0%)，무효1례(10.0%)，기중자연분면8례，인공조산1례，부궁산1례，태인존활솔위100.0%，치료효과화술후분면정황현저우우기타량조，기차이균구유통계학의의(P<0.05)。결론양막경개도하생물단백효봉도태막파구법결합료전통방법적우점，봉도성공솔고，조작상대간단，이차불수요주수，불영향생물단백효적응고，치득추엄。
Objective To investigate the effectiveness of biological fibrin glue closure in pregnant women with preterm premature rupture of membrane. Methods Twenty-eight cases of pregnant women with preterm prema-ture rupture of membrane from March 2012 to December 2013 in our hospital were selected and divided into three groups randomly. All three groups were treated with biological fibrin glue closure via the cervical intubation with the monitoring of ultrasound (Group A, 10 cases), endoscopy (Group B, 8 cases) and amnioscopy (Group C, 10 cases). To-colytics were applied as following in all groups. And then the effectiveness and differences in delivery were compared. Results In Group A, the cure rate, effective rate and inefficiency rate were 0.0%(0 case), 20.0%(2 cases) and 80.0%(8 cases) respectively, with 2 cases of natural childbirth, 3 cases of operative vaginal delivery and 5 cases of cesarean section, and the fetal survival rate was 60.0%. In Group B, the cure rate, effective rate and inefficiency rate were 25.0%(2 cases), 50.0%(4 cases) and 25.0%(2 cases) respectively, with 1 case of natural childbirth, 1 case of opera-tive vaginal delivery and 3 cases of cesarean section, and the fetal survival rate was 83.3%. And in Group C, the cure rate, effective rate and inefficiency rate were 80.0%(8 cases), 10.0%(1 case) and 10.0%(1 case), with 8 cases of natu-ral childbirth, 1 case of operative vaginal delivery, 1 case of cesarean section, and the fetal survival rate was 100.0%. The total effective rate in group C was higher than those in group A and B (P<0.05). Meanwhile, compared with other groups, Group C had a longer pregnant period, lower neonatal death rate and less perinatal compilations (P<0.05). Conclusion Biological fibrin glue closure via the cervical intubation with the monitoring of amnioscopy is effective and easy to be manipulated, which can avoid the influence of water injection on the coagulation of biological fibrin glue. Therefore, it's worthy to be recommended.