宫颈电环切术对宫颈上皮内瘤变患者妊娠及其结局的影响

Effect of cervical loop electrical excision procedure on pregnancy and pregnancy outcomes of cases with cervical intraepithelial neoplasia

目的：探讨宫颈电环切术（LEEP）对宫颈上皮内瘤变（CIN）患者妊娠及其结局的影响。方法：对佛山市妇幼保健院2006-2009年1 000例因CINⅠ或CINⅠ伴HPV感染实施宫颈电环切术（LEEP）的患者进行随访,术前无原发不孕、年龄≤40岁、未生育过、有生育要求的380例患者纳入该研究。对380例患者的妊娠时间、妊娠周数、妊娠结局和终止妊娠方式进行回顾性分析。结果：①380例患者中有280例获得300次妊娠,妊娠率为78.95%（300/380）,与该280例患者宫颈电环切术前的妊娠率72.00%比较差异无统计学意义（P〉0.05）。②280例妊娠患者中12例异位妊娠,45例自然流产。其中已分娩145例患者中12例早产行剖宫产术,早产率为8.28%（12/145）;胎膜早破22例,胎膜早破发生率为15.17%（22/145）;无低出生体重儿发生;110例行剖宫产术,剖宫产率为75.86%（110/145）。③已分娩的145例患者中,宫颈电环切深度平均1.0 cm（0.5-1.5 cm）,宽度平均为1.25 cm（0.5-2.0 cm）。结论：宫颈电环切术对CIN患者的妊娠及其结局无明显影响,也不增加早产和低体重儿发生率。

Objective：To explore the effect of cervical loop electrical excision procedure（LEEP） on pregnancy and pregnancy outcomes of cases with cervical intraepithelial neoplasia（CIN）.Methods：1 000 cases receiving LEEP because of CIN Ⅰ or CIN Ⅰ combined with HPV infection in the hospital from 2006 to 2009 were followed up,380 nonparous cases without primary infertility before operation,≤40 years old and having birth demand were included in the study;the pregnancy time,gestational weeks,pregnancy outcomes and the pattern of terminating pregnancy were analyzed retrospectively.Results：Among 380 cases,280 cases got pregnancy for 300 times,the pregnancy rate was 78.95%（300/380）,the pregnancy rate of 280 cases before operation was 72.00%,there was no significant difference in pregnancy rate before and after operation（P0.05）;among 280 cases,12 cases got ectopic pregnancy,45 cases got spontaneous abortion;among 145 cases after delivery,12 cases underwent cesarean section because of premature delivery,the rate of premature delivery was 8.28%（12/145）;the incidence of premature rupture of membrane was 15.17%（22/145）;no low birth weight infants was born;110 cases underwent cesarean section,the rate of cesarean section was 75.86%（110/145）;among 145 cases after delivery,the average depth of LEEP was 1.0 cm（0.5~1.5 cm）,the average width was 1.25 cm（0.5~2.0 cm）.Conclusion：LEEP has no obvious effect on pregnancy and pregnancy outcomes of cases with CIN,which does not increase the incidences of premature delivery and low birth weight infants.