子宫颈环扎术的规范化应用与思考OA

Cervical insufficiency is a major cause of sec-ond-trimester miscarriage and early preterm birth,and cer-vical cerclage is currently a surgical intervention proven to be effective.In recent years,with the widespread adoption of transvaginal ultrasound cervical length measurement and increased clinical awareness,the use of cervical cerclage has shown a tendency toward broadening indications and arbitrary selection of surgical techniques,making standard-ization of the entire clinical process an urgent issue in ob-stetrics.Based on the latest national and international guidelines,expert consensus,and evidence-based data,this article systematically elaborates on the key points of standardized implementation of cervical cerclage,focusing on critical aspects such as identification of high-risk fac-tors,screening and diagnosis,stratification of surgical indi-cations,timing of surgery,choice of surgical technique and suture material,perioperative management,management of special populations,and suture removal and follow-up.It emphasizes the establishment of a stratified indication sys-tem grounded in evidence grading,aiming to advance the construction of a standardized diagnosis and treatment pro-tocol for cervical insufficiency that adheres to the principle of"cerclage only when indicated,and standardized whenev-er performed".