中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2015年
2期
108-111
,共4页
子宫肌层%早产%胎膜早破%超声检查,多普勒,彩色%前瞻性研究
子宮肌層%早產%胎膜早破%超聲檢查,多普勒,綵色%前瞻性研究
자궁기층%조산%태막조파%초성검사,다보륵,채색%전첨성연구
Myometrium%Premature birth%Fetal membranes,premature rupture%Ultrasonography,Doppler,color%Prospective studies
目的通过四维彩色多普勒超声仪测量孕妇孕中期子宫前壁肌层厚度，探讨子宫前壁肌层厚度与早产发生的相关性。方法对2010年10月9日至2013年9月30日于湖南省人民医院产科门诊行产前检查的单胎妊娠孕妇进行前瞻性研究，收集孕妇的一般临床资料并追踪其妊娠结局，根据是否发生早产，将其分为早产组和足月组，于妊娠中期（孕20~27周+6）对孕妇采用四维彩色多普勒超声仪测量子宫前壁肌层厚度，分析其与早产发生的相关性。结果（1）最终有1031例孕妇纳入本研究，其中早产组147例（14.26%，147/1031），足月组884例（85.74%，884/1031）。早产组孕妇平均分娩孕周[（34.57±2.39）周]明显小于足月组[（39.23±0.92）周]，两组分娩孕周比较，差异有统计学意义（P<0.05）；两组孕妇的年龄、孕产次、早产史、剖宫产率、子宫前壁肌层厚度检测孕周等比较，差异均无统计学意义（P>0.05）。早产组胎膜早破发生率为49.0%(72/147），足月组为15.8%(140/884），两组比较，差异有统计学意义（P<0.01）。（2）足月组孕妇孕中期子宫前壁肌层厚度平均为（5.49±1.39）mm，早产组平均为（5.60±0.87）mm，两组比较，差异无统计学意义（P>0.05）。自发性早产孕妇的孕中期子宫前壁肌层厚度平均为（5.15±0.75) mm，足月胎膜未破孕妇的平均为（5.61±1.38) mm，两组比较，差异有统计学意义（P<0.01）。未足月胎膜早破早产孕妇的孕中期子宫前壁肌层厚度平均为（5.96±0.78) mm，足月胎膜早破孕妇的平均为（5.38±1.12) mm，两组比较，差异有统计学意义（P<0.01）。（3）1031例孕妇中胎膜早破共有212例，其孕中期子宫前壁肌层厚度为（5.67±1.32) mm；胎膜未破共有819例，其孕中期子宫前壁肌层厚度为（5.56±1.10) mm，两者比较，差异无统计学意义（P>0.05）。胎膜早破与子宫前壁肌层厚度无相关性（r=0.058，P>0.05），而未足月胎膜早破早产孕妇子宫前壁肌层厚度较自发性早产孕妇显著增加（P<0.01），且未足月胎膜早破与子宫前壁肌层厚度呈正相关（r=0.457，P<0.01）。结论孕中期子宫前壁肌层厚度与自发性早产和未足月胎膜早破早产存在相关性，但子宫前壁肌层厚度可能不是早产的独立影响因素。
目的通過四維綵色多普勒超聲儀測量孕婦孕中期子宮前壁肌層厚度，探討子宮前壁肌層厚度與早產髮生的相關性。方法對2010年10月9日至2013年9月30日于湖南省人民醫院產科門診行產前檢查的單胎妊娠孕婦進行前瞻性研究，收集孕婦的一般臨床資料併追蹤其妊娠結跼，根據是否髮生早產，將其分為早產組和足月組，于妊娠中期（孕20~27週+6）對孕婦採用四維綵色多普勒超聲儀測量子宮前壁肌層厚度，分析其與早產髮生的相關性。結果（1）最終有1031例孕婦納入本研究，其中早產組147例（14.26%，147/1031），足月組884例（85.74%，884/1031）。早產組孕婦平均分娩孕週[（34.57±2.39）週]明顯小于足月組[（39.23±0.92）週]，兩組分娩孕週比較，差異有統計學意義（P<0.05）；兩組孕婦的年齡、孕產次、早產史、剖宮產率、子宮前壁肌層厚度檢測孕週等比較，差異均無統計學意義（P>0.05）。早產組胎膜早破髮生率為49.0%(72/147），足月組為15.8%(140/884），兩組比較，差異有統計學意義（P<0.01）。（2）足月組孕婦孕中期子宮前壁肌層厚度平均為（5.49±1.39）mm，早產組平均為（5.60±0.87）mm，兩組比較，差異無統計學意義（P>0.05）。自髮性早產孕婦的孕中期子宮前壁肌層厚度平均為（5.15±0.75) mm，足月胎膜未破孕婦的平均為（5.61±1.38) mm，兩組比較，差異有統計學意義（P<0.01）。未足月胎膜早破早產孕婦的孕中期子宮前壁肌層厚度平均為（5.96±0.78) mm，足月胎膜早破孕婦的平均為（5.38±1.12) mm，兩組比較，差異有統計學意義（P<0.01）。（3）1031例孕婦中胎膜早破共有212例，其孕中期子宮前壁肌層厚度為（5.67±1.32) mm；胎膜未破共有819例，其孕中期子宮前壁肌層厚度為（5.56±1.10) mm，兩者比較，差異無統計學意義（P>0.05）。胎膜早破與子宮前壁肌層厚度無相關性（r=0.058，P>0.05），而未足月胎膜早破早產孕婦子宮前壁肌層厚度較自髮性早產孕婦顯著增加（P<0.01），且未足月胎膜早破與子宮前壁肌層厚度呈正相關（r=0.457，P<0.01）。結論孕中期子宮前壁肌層厚度與自髮性早產和未足月胎膜早破早產存在相關性，但子宮前壁肌層厚度可能不是早產的獨立影響因素。
목적통과사유채색다보륵초성의측량잉부잉중기자궁전벽기층후도，탐토자궁전벽기층후도여조산발생적상관성。방법대2010년10월9일지2013년9월30일우호남성인민의원산과문진행산전검사적단태임신잉부진행전첨성연구，수집잉부적일반림상자료병추종기임신결국，근거시부발생조산，장기분위조산조화족월조，우임신중기（잉20~27주+6）대잉부채용사유채색다보륵초성의측양자궁전벽기층후도，분석기여조산발생적상관성。결과（1）최종유1031례잉부납입본연구，기중조산조147례（14.26%，147/1031），족월조884례（85.74%，884/1031）。조산조잉부평균분면잉주[（34.57±2.39）주]명현소우족월조[（39.23±0.92）주]，량조분면잉주비교，차이유통계학의의（P<0.05）；량조잉부적년령、잉산차、조산사、부궁산솔、자궁전벽기층후도검측잉주등비교，차이균무통계학의의（P>0.05）。조산조태막조파발생솔위49.0%(72/147），족월조위15.8%(140/884），량조비교，차이유통계학의의（P<0.01）。（2）족월조잉부잉중기자궁전벽기층후도평균위（5.49±1.39）mm，조산조평균위（5.60±0.87）mm，량조비교，차이무통계학의의（P>0.05）。자발성조산잉부적잉중기자궁전벽기층후도평균위（5.15±0.75) mm，족월태막미파잉부적평균위（5.61±1.38) mm，량조비교，차이유통계학의의（P<0.01）。미족월태막조파조산잉부적잉중기자궁전벽기층후도평균위（5.96±0.78) mm，족월태막조파잉부적평균위（5.38±1.12) mm，량조비교，차이유통계학의의（P<0.01）。（3）1031례잉부중태막조파공유212례，기잉중기자궁전벽기층후도위（5.67±1.32) mm；태막미파공유819례，기잉중기자궁전벽기층후도위（5.56±1.10) mm，량자비교，차이무통계학의의（P>0.05）。태막조파여자궁전벽기층후도무상관성（r=0.058，P>0.05），이미족월태막조파조산잉부자궁전벽기층후도교자발성조산잉부현저증가（P<0.01），차미족월태막조파여자궁전벽기층후도정정상관（r=0.457，P<0.01）。결론잉중기자궁전벽기층후도여자발성조산화미족월태막조파조산존재상관성，단자궁전벽기층후도가능불시조산적독립영향인소。
Objective To investigate the relationship between preterm delivery and anterior myometrial (MA) thickness measured by ultrasound in the second trimester. Methods The general information and pregnancy outcome of singleton pregnant women who had antenatal visit in the Hunan Provincial People′s Hospital between Oct 2010 and Sep 2013 were collected prospectively. The MA thickness was measured at 20-27+6 gestational weeks. The cases were divided into preterm delivery group and term delivery group. Results (1)A total of 1 031 pregnant women were recruited in this study. 147 pregnant women were in the preterm delivery group(14.26%,147/1 031) and 884 women were in the term delivery group(85.74%,884/1 031). The gestation age at delivery of the preterm delivery group was significantly earlier than the term delivery group [(34.57 ± 2.39) vs (39.23 ± 0.92) weeks,P<0.05]. No significant difference was observed in the age, gravidity, parity, history of preterm delivery, cesarean delivery rate and gestational age at the time of MA measurement between the two groups(P>0.05). The incidence of premature rupture of membrane(PROM) in the preterm delivery group and in the term delivery group were 49.0%(72/147) and 15.8%(140/884),respectively, with statistically significant diffrence(P<0.01). (2) The mean value of MA thickness in the term delivery group was (5.49±1.39) mm, while in the preterm delivery group it was (5.60 ± 0.87) mm. There was no statistically significant difference between the two groups(P>0.05). The mean value of MA thickness in the spontaneous preterm delivery group was(5.15±0.75) mm, and was (5.61±1.38 ) mm in the term delivery group, with statistically significant difference(P<0.01). The mean value of MA thickness in the preterm premature rupture of membrane (PPROM) cases was( 5.96±0.78 ) mm, and in term delivery group with PROM it was(5.38±1.12) mm. The difference between the two groups were statistically significant (P< 0.01). (3) Among the 1 031 pregnant women, 212 women had PROM, with the mean value of MA thickness of (5.67±1.32) mm. For those who did not have PROM, the mean value of MA thickness was (5.56±1.10) mm. There was no statistically significant difference between the two groups(P>0.05). No correlation was found among PROM and MA thickness(r=0.058,P>0.05). However, in the preterm delivery group, the mean value of MA in PPROM was significantly thicker than the spontaneous preterm delivery cases(P<0.01). There was a positive correlation between the MA thickness and PPROM (r=0.457,P<0.01). Conclusion The MA thickness had some correlation with spontaneous preterm delivery and PPROM, while the MA thickness should not be considered as an independent factor of preterm delivery.
