冷刀锥切术在子宫颈上皮内瘤变后对妊娠影响的研究

Study on effect of cold knife conization on pregnancy after cervical intraepithelial neoplasia

目的：探讨冷刀锥切术在子宫颈上皮内瘤变后对妊娠的影响。方法：将2007年1月2009年7月间台州医院收治因宫颈上皮内瘤变而实施冷刀锥切术,术前无不孕症,且有生育要求的妇女50例作为观察组,并随机选取同时期内产科收住的普通妊娠妇女50例作为对照组,比较两组妇女妊娠时间、经过、孕周、妊娠结局和胎儿情况。结果：观察组50例妇女术后36个月妊娠10例,612个月妊娠21例,1230个月妊娠17例,其中早产4例,过期产2例,足月产42例;对照组50例产妇早产5例,过期产1例,足月产44例,两组数据差异无统计学意义（P〉0.05）。观察组2例产妇发生胎膜早破,随后行剖宫产,胎膜早破发生率为4.2%,对照组产妇有1例发生胎膜早破,胎膜早破发生率为2.0%,两组数据差异无统计学意义（P〉0.05）。观察组娩出胎儿均存活,体重（3 458±425）g,其中最低出生体重2 750 g,为1例早产儿,最高体重4 300 g,对照组胎儿体重（3 520±470）g,其中最低体重2 700 g,最高体重4 200 g,两组数据差异无统计学意义（P〉0.05）。结论：冷刀锥切术治疗子宫颈上皮内瘤变疗效显著,安全可靠,对患者术后妊娠无不良影响。

Objective：To explore the effect of cold knife conization on pregnancy after cervical intraepithelial neoplasia.Methods：50 women without infertility before operation and having birth demand received cold knife conization because of cervical intraepithelial neoplasia（CIN） in the hospital from January 2007 to July 2009,and they were selected as observation group,50 normal pregnant women at the same period in department of obstetrics were selected randomly as control group,the time and course of pregnancy,gestational weeks,pregnancy outcomes and fetal condition were compared between the two groups.Results：In observation group,10 women got pregnancy at 3～6 months after operation,21 women got pregnancy at 6～12 months after operation,17 women got pregnancy at 12～30 months after operation;the numbers of premature delivery,postmature delivery and mature delivery were 4,2 and 42;in control group,the numbers of premature delivery,postmature delivery and mature delivery were 5,1 and 44,there was no significant difference（P〉0.05）.In observation group,2 women had premature rupture of membranes,then cesarean section was conducted,the incidence of premature rupture of membranes was 4.2%;in control group,one woman had premature rupture of membranes,the incidence of premature rupture of membranes was 2.0%,there was no significant difference（P〉0.05）.All the fetuses in observation group were alive,the average body weight was（3 458±425） g,the lowest body weight was 2 750 g（one premature infant）,the highest body weight was 4 300g;in control group,the average body weight was（3 520±470） g,the lowest body weight was 2 700 g,the highest body weight was 4 200g,there was no significant difference（P〉0.05）.Conclusion：Cold knife conization is an effective,safe and reliable method in treatment of CIN,which has no adverse effect on pregnancy for patients after operation.