LEEP刀治疗宫颈上皮内瘤变后对妊娠分娩方式的影响研究

The impact of LEEP knife treatment of cervical intraepithelial neoplasia on pregnancy and delivery mode

目的探讨LEEP刀治疗宫颈上皮内瘤变（CIN）后对妇女妊娠结局及分娩方式的影响。方法选取我院2009年1—12月行CINLEEP手术，2011年12月前正常妊娠妇女共58例，列入研究组另随机选取2010年1月至2011年12月无LEEP治疗CIN手术史的健康妊娠妇女60例，列入对照组。回顾性分析研究患者妊娠情况、两组受试者分娩方式、妊娠结局等。结果研究组患者流产率、阴道分娩率和剖官产率与对照组比较差异均无统计学意义（P均〉0．05）。研究组患者早产率（12．07％）明显高于对照组（1．67％），数据经统计学比较差异有统计学意义（χ2=5．049，P〈0．05）；研究组胎膜早破、产生宫颈裂伤、产后出血、新生儿低体重和新生儿窒息发生率与对照组比较差异均无统计学意义（P均〉0．05）。结论LEEP刀治疗CIN后对分娩方式无明显影响，对妊娠结局影响不大，但可能增加早产发生率，对于有CIN经LEEP手术史的妊娠妇女应加强管理。

Objective A retrospective analysis was conducted to explore the impact of LEEP knife treatment of cervical intraepithelial neoplasia （CIN） on women＇s pregnancy outcomes and modes of delivery. Methods Fifty-eight women were recruited as the experimental group from our hospital. They accepted LEEP surgery for treatment of CIN during 2009 and became pregnant before December 2011. Sixty pregnant women without history of LEEP surgery were randomly selected as the control group from January 2010 to December 2011. A retrospective analysis of the study groups was conducted to investigate the pregnancy situations, two-wire receiver modes of delivery and pregnancy outcome of participants. Results There was no significant difference between the two groups on rates of abortion, vaginal delivery and cesarean section （ P 〉 0. 05）. The experimental group had significantly higher rates of preterm birth than control group （12.07% vs. 1.67%, χ2 = 5. 049, P 〈 0. 05 ）. No significant difference was observed between the two groups on rates of premature rupture of membranes, cervical laceration, postpartum hemorrhage, low birth weight and neonatal asphyxia（P 〉 0. 05 ）. Conclusion LEEP knife treatment of CIN has no significant effect on mode of delivery or pregnancy outcome, but may increase the incidence of preterm birth. Management of pregnant women with history of CIN and LEEP surgery should be strengthened.