宫颈环扎术治疗前置胎盘疗效的Meta分析

周敏; 聂宇翔; 陈慧君

doi:10.14188/j.1671-8852.2024.0066

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宫颈环扎术治疗前置胎盘疗效的Meta分析

综述与Meta分析 | 更新时间：2026-11-05

- 宫颈环扎术治疗前置胎盘疗效的Meta分析
- A meta analysis on the efficacy of cervical cerclage in the treatment of placenta previa
- 武汉大学学报（医学版） 2025年46卷第6期页码：822-828
- 作者机构：
  
  武汉大学中南医院产科湖北武汉 430071
- 作者简介：
  
  周敏，女，1999—，医学硕士，主要从事围产医学研究，E⁃mail: 13971025975@163.com
  陈慧君，女，1981—，医学博士，主任医师，博士生导师，主要从事围产医学研究、发育源性疾病研究，E⁃mail: karrel@sina.com
- 基金信息：
- DOI：10.14188/j.1671-8852.2024.0066
  中图分类号： R714
- 收稿：2024-01-24，
  
  纸质出版：2025-06-25
- 稿件说明：
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周敏,聂宇翔,陈慧君.宫颈环扎术治疗前置胎盘疗效的Meta分析[J].武汉大学学报（医学版）,2025,46(06):822-828.

ZHOU Min,NIE Yuxiang,CHEN Huijun.A meta analysis on the efficacy of cervical cerclage in the treatment of placenta previa[J].Medical Journal of Wuhan University,2025,46(06):822-828.
周敏,聂宇翔,陈慧君.宫颈环扎术治疗前置胎盘疗效的Meta分析[J].武汉大学学报（医学版）,2025,46(06):822-828. DOI： 10.14188/j.1671-8852.2024.0066.

ZHOU Min,NIE Yuxiang,CHEN Huijun.A meta analysis on the efficacy of cervical cerclage in the treatment of placenta previa[J].Medical Journal of Wuhan University,2025,46(06):822-828. DOI： 10.14188/j.1671-8852.2024.0066.

摘要

目的

采用Meta分析的方法评价宫颈环扎术治疗前置胎盘的临床治疗效果。

方法

综合检索PubMed、Embase、Cochrane Library、万方（Wanfang）、知网（CNKI）、维普（VIP）、中国生物医学（CBM）数据库，纳入国内外报道宫颈环扎治疗前置胎盘的文献，检索年限从1990年1月至2023年12月，采用RevMan 5.3软件进行Meta分析，以相对危险度（

）和加权均数差（

）的95%可信区间（

）表示结局指标的效应量

分别采用

检验和

值进行异质性检验。

结果

本研究共纳入了13篇研究（共739例），其中环扎组387例，对照组352例。Meta分析结果显示，相比于期待治疗，宫颈环扎组延长分娩的孕周（

=2.60，95%

：1.86~3.35，

0.000 01），延长妊娠的孕周（

=2.83，95%

：2.93~3.28，

0.000 01)，增加新生儿出生平均体质量（

=639.47，95%

：340.92~938.02，

0.000 1），减少产前出血量（

=-172.54，95%

：-341.21~-3.86，

=0.04），减少产时输血的次数（

=0.29，95%

：0.12~0.70，

=0.006），减少围产儿死亡数（

=0.13，95%

：0.06~0.30，

0.000 01），差异均具有统计学意义。

结论

宫颈环扎术治疗前置胎盘优于期待治疗策略，宫颈环扎术治疗前置胎盘相对安全有效。

Abstract

Objective

To conduct a meta⁃analysis to evaluate the clinical treatment effects of cervical cerclage in managing placenta previa.

Methods

This study conducted a comprehensive search of PubMed

Embase

Cochrane Library

Wanfang

CNKI

VIP

and CBM databases. Literature on cervical cerclage for treating placenta previa was i

ncluded

with the search period from January 1990 to December 2023. Meta⁃analysis was performed using RevMan 5.3 software

and the effect sizes of outcome indicators were expressed as relative risks (

) and weighted mean differences (

) with 95% confidence intervals (

⁃test and

values were used for heterogeneity testing.

Results

The study included a total of 13 studies (739 cases)

with 387 cases in the cervical cerclage group and 352 cases in the control group. The meta⁃analysis results showed that

as compared with the expectant management group

the cervical cerclage group had a prolonged gestational age at delivery (

=2.60

95%

: 1.86⁃3.35，

0.000 01)

extended duration of pregnancy (

=2.83

95%

: 2.93‑3.28

0.000 01)

increased average birth weight of newborns (

=639.47

95%

: 340.92⁃938.02

0.000 1)

reduced antepartum bleeding (

=-172.54

95%

: -341.21⁃-3.86

=0.04)

decreased number of blood transfusions during labor （

=0.29

95%

: 0.12⁃0.70

=0.006)

and reduced perinatal mortality (

=0.13

95%

: 0.06⁃0.30

0.000 01）. These differences were statistically significant.

Conclusion

This meta⁃analysis found that cervical cerclage treatment for placenta previa bleeding is superior to expectant management

and cervical cerclage treatment is relatively safe and effective.

关键词

Keywords

references

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