子宫颈环扎术后未足月胎膜早破拆除环扎线的时机研究

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Doi：10.3969/j.issn.1673—5293.2025.12.011

[中图分类号]R173 [文献标识码]A [文章编号]1673—5293（2025）12—0073-05

Optimal timing of cerclage suture removal following preterm premature rupture of membranesafter cervical cerclage

LUO Yao，WANG Qian，WU Chenhua （Department of Obstetrics and Gynecology，Ningde Municipal Hospital Affiliated to NingdeNormal University，FujianNingde 352OoO，China）

[Abstract]ObjectiveToinvestigatetheoptimal timingofcerclagesutureremovalinpatients with prematureruptureofmembranes （PPROM） after cervical cerclage（CC）.Methods A totalof 86 pregnant women with PPROM afterCC who were admited to the affiliated NingdeMunicipalHospitalofNingdeNormalUniversityfromApril2O22toApril2O24wereselectedastheresearch subjects.They were divided into the early group （ ⋅<24 hours）and the delayed group （ >24 hours）based on the timing of the removalof thecerclage suture after membranerupture，with43cases ineach group.Pregnancyoutcomes，inflammatorymarkers [procalcitonin（PCT），interleukin-6（IL-6），white bloodcellcount（WBC），Creactive protein（CRP）]levels，neonatalApgarsore and infectiouscomplications werecompared between thetwo groups.Results The intervalfrom membranerupture todelivery was significantly shorter in the early removal group compared to the delayed removal group （t=9.507，P<0.05） .Priortodelivery，both groups showed elevated serum levels of PCT，IL-6，and CRP compared to levels at membrane rupture （ t -values ranging from 2.338 to 19.971，P<0.05） ，while no significant difference was observed in WBC levels （ P>0.05 ）.At delivery，the early removal group demonstrated significantly lower PCT and IL-6 levels than the delayed removal group （ χ=2.304 and 2.156，respectively， P<0.05 ， with no significant intergroup differences in WBC or CRP levels（ P>0.05） .Neonatal Apgar scores were significantly higher in the early removal group （t=7.329，P<0.05） .No significant differences were found between groups regarding postpartum hemorrhage， total incidence of infectious complications，or neonatal birth weight（all P>0.05 .Conclusion In patients with PPROM after CC， earlycerclagesutureremovalcanshortentheintervalfrommembranerupturetodeliveryandreduceinflammatoryresponses，but has no significant effect on adverse perinatal outcomes.

[Keywords]pregnantwoman;pretermprematureruptureofmembranes;cervicalcerclagecerclagesutureremoval;timing;clinical outcome

子宫颈机能不全（cervical insufficiency，CI）是指子宫颈在妊娠中期扩张和消失而没有宫缩或分娩的情况，可导致流产或早产[1]。（剩余7274字）