摘要
目的探讨宫颈高频环形电刀切除术(LEEP)对宫颈鳞状上皮内病变患者宫颈长度及妊娠的影响。方法回顾性分析2017年1月至2020年12月中国人民武装警察部队安徽省总队医院收治因宫颈高级别鳞状上皮内病变(HSIL)行LEEP治疗的、有生育需求且处于育龄期的43例患者为LEEP组,选取同阶段处于育龄期且既往无LEEP术史的65例健康妇女为对照组,两组均对妊娠结局、妊娠率、宫颈长度及分娩方式进行统计学分析。结果两组孕前宫颈长度LEEP组[(28.43±0.47)mm]短于对照组[(29.07±0.40)mm],两组差异有统计学意义(t=-7.623,P<0.001);LEEP组47例患者中成功妊娠43例,均完成随访并获得妊娠结局,妊娠率达91.5%,其中7例发生早期流产(16.3%),3例晚期流产(7.0%),分娩33例,其中平产分娩27例(81.8%),剖宫产分娩6例(18.2%),早产3例(9.1%),胎膜早破3例(9.1%),低出生体质量儿4例(12.1%),新生儿窒息1例(3.0%)。两组的一般资料、妊娠率、晚期流产率、胎膜早破率、早产率、剖宫产率、低出生体质量儿率、新生儿窒息率比较,差异无统计学意义(P>0.05);LEEP组早期流产率为16.3%,对照组为1.5%,差异有统计学意义(χ^(2)=8.199,P<0.05)。结论对于有生育需求的育龄期患者应规范操作LEEP手术,术中应注意控制宫颈锥切的深度和范围,尽可能保留宫颈的形态和宫颈的正常生理功能,以降低手术对女性妊娠及分娩产生的不良影响。
Objective To investigate the effect of loop electrosurgical excision procedure(LEEP)on the cervical length and pregnancy outcome in patients with high-grade cervical intraepithelial lesions.Methods The patients with high-grade squamous intraepithelial lesions treated by LEEP from January 2017 to December 2020 in Hospital of Anhui Corps of the Armed Police Force were followed and the healthy pregnant women were selected as the control group.The pregnancy rate,pregnancy outcome(early abortion,late abortion,premature birth,premature rupture of membranes,low birth weight infants,neonatal asphyxia),and delivery mode were analyzed and SPSS 22.0 statistical software was used for data analysis.Results Before pregnancy,the cervical length of the LEEP group[(28.43±0.47)mm]was shorter than that of the control group[(29.07±0.40)mm],and the difference between the two groups was statistically significant(t=-7.623,P<0.001).43 of 47 patients were successfully pregnant after LEEP.The pregnancy rate was 91.5%.In 43 pregnant women,there were 7 cases of early abortion(16.3%),3 cases of late abortion(7.0%),3 cases of premature birth(9.1%),3 cases of premature rupture of membranes(9.1%),4 cases of low birth weight infants(12.1%),and 1 case of neonatal asphyxia(3.0%).Among the 33 patients who had delivered,27(81.8%)had a natural delivery and 6(18.2%)had a cesarean section.There was no significance in general information,pregnancy rate,late abortion rate,premature birth rate,premature rupture of membranes rate,low birth weight rate,neonatal asphyxia rate,and cesarean section rate between the two groups(P>0.05);the early abortion rate of the observation group was 16.3%,and that of the control group was 1.5%,the difference was significant(χ^(2)=8.199,P<0.05).Conclusions For patients of reproductive age who have fertility requirements,LEEP surgical operation should be standardized,the depth and range of cervical coning should be controlled during the operation,and the cervical morphology and normal physiological function should be prese
作者
王青云
陈咏梅
吴胜东
张琴
汪树静
Wang Qingyun;Chen Yongmei;Wu Shengdong;Zhang Qin;Wang Shujing(Department of Obstetrics and Gynecology,Hospital of Anhui Corps of the Armed Police Force,PLA,Hefei 230001,China)
出处
《中国临床保健杂志》
CAS
2021年第4期554-558,共5页
Chinese Journal of Clinical Healthcare
关键词
宫颈鳞状上皮内病变
锥形切除术
宫颈长度
妊娠
流产
Squamous intraepithelial lesions of the ervix
Conization
Cervical length
Pregnancy
Abortion
