摘要
目的:探讨不同宫颈病变治疗方案对妊娠结局及分娩方式影响。方法:回顾性分析2012年3月—2018年3月本院行宫颈病变治疗后受孕的870例临床资料(病例组),根据治疗方案不同分为环形电刀锥切术(LEEP)(n=207)、宫颈冷刀锥切术(CKC)(n=105)、聚集超声术(IFU)(n=302)、物理激光(n=256),选择同期本院82例健康孕妇临床资料为对照组。对比各组分娩方式、妊娠结局、分娩并发症、总产程、孕22~24周宫颈平均长度、宫颈狭窄度、新生儿体重、身长及Apgar评分。结果:剖宫产率CKC组>LEEP组>IFU、物理激光组>对照组(P<0.05);病例组早产、胎膜早破发生率高于对照组(P<0.05);CKC组宫颈裂伤、子宫破裂、产后出血、产后感染发生率最高(P<0.05);各组新生儿体重、身长、Apgar评分有差异(P<0.05);总产程、宫颈狭窄度CKC组>LEEP组>IFU、物理激光组>对照组(P<0.05),孕22~24周宫颈平均长度CKC组<LEEP组<IFU、物理激光组<对照组(P<0.05)。结论:宫颈病变治疗可增加妊娠剖宫产率和早产、胎膜早破、感染发生率,提示临床在治疗宫颈病变过程中应加强注意抗感染治疗,且应根据患者自身情况制定适宜分娩方式,减少剖宫产率。
Objective:To investigate the effect different treatments of cervical lesions of pregnant women on their pregnancy outcomes and delivery mode.Methods:The clinical data of 870 pregnant women after treatment of cervical lesions from March 2012 to March 2018 were retrospectively analyzed.According to the different treatment of cervical lesions,these women were divided into Group A(207 women had received the loop electrosurgical excision procedure(LEEP),group B(105 women had received the cold knife conization(CKC),group C(302 women had received intensity focused ultrasound(IFU),and group D(256 women had received physical laser).Meanwhile,82 healthy pregnant women were randomly selected in control group during the same period.The delivery mode,pregnancy outcomes,rate of complications during delivery,time of the total stage of labor,the cervical length in 22-24 gestational weeks,and the degree of cervical stenosis of women,and neonatal weight,length,Apgar score were compared among these groups.Results:The cesarean section rate of women in the control group,group D,group C,group A,and group B had increased in turn(P<0.05).The incidences of premature delivery and premature rupture of membranes of women in group A,B,C,and D were significant higher than those of women in the control group(P<0.05).The incidence of cervical laceration,uterine rupture,postpartum hemorrhage,or postpartum infection of women in group B was the highest(P<0.05).There were significant different in the neonatal weight,length,and Apgar score among these groups(P<0.05).The total stage of labor time and cervical stenosis degree of women in the control group,group D.group C,group A,and group B had increased in turn(P<<0.05).The cervical length of women in 22-24 gestational weeks in the control group,group D,groupC,group A,and group B had shorted in turn(P<0.05).Conclusion:The treatment of the cervical lesions can maybe increase the rate of cesarean section,premature delivery,premature rupture of membranes,and infection of women after pregnancy,which sugg
作者
徐燕
朱丽芳
王丹
卢春
陈成
任玉香
冯顺
张晓林
梁志清
阎萍
XU Yan;ZHU Fang;WANG Dan;LU Chun;CHEN Cheng;REN Yuxiang;FENG Shun;ZHANG Xiaolin;LIANG Zhiqing;YAN Ping(The First Affiliated Hospital of Army Military Medical University,Chongqing,400037;Outpatient Department of Provincial Military Area Command,Central Theater General Hospital of the Chinese People’s Liberation Army)
出处
《中国计划生育学杂志》
2020年第7期1108-1113,共6页
Chinese Journal of Family Planning
基金
国家自然科学基金(81673011)。
关键词
宫颈病变
治疗方案
妊娠结局
分娩方式
Cervical lesions
Treatment approach
Pregnancy outcomes
Delivery mode
