宫颈环形电刀锥切术后阴道分娩的临床观察

Effect of cervical electrotome cone cut method on vaginal delivery

目的:探讨宫颈环形电刀锥切术(LEEP)对分娩方式的影响,分析LEEP后自然分娩的产程特点。方法:选择既往行LEEP术、单胎、产前检查无剖宫产指征、自然进入产程的初产妇31例做为观察组,在其前及后或同时进入产程的无宫颈手术史的62例初产妇作为对照组,比较两组产程中的剖宫产率及产程的时间。结果:观察组产程中的剖宫产率为9.7%(3/31),对照组的剖宫产率为11.3%(7/62),两组比较差异无统计学意义(P>0.05);观察组总产程时间(9.2±2.1)h,对照组总产程(10.1±3.5)h,差异无统计学意义(P>0.05);观察组潜伏期(3.8±1.7)h,活跃期(4.2±2.1)h,对照组分别为(4.3±2.5)h和(4.7±1.6)h,两组差异无统计学意义(P>0.05);两组均无宫颈裂伤病例。结论:LEEP不增加产程中的剖宫产率,不影响产程进展,不能作为剖宫产指征。

Objective： To detect the effects of cervical electrotome cone cut method on the mode of delivery and stages of labor. Methods： 31 cases who had undergone cervical loop electrosurgical excision for cervical intraepithelial neoplasia （admitted from August 2008 to August 2013） were enrolled into the experimental group. 62 cases without cervical surgical operation were enrolled in control group. All the 93 cases were primiparas with singleton and cephalic presentation pregnancy and naturally entered the stages of labor. Results： The cesarean section rates were 9. 7% （3/31） and 11.1% （7/62） separately in experimental group and control group. There was no statistically significant difference in cesarean section rate （ P 〉 0. 05 ） between the two groups. The total stages of labor were （9. 2 ± 2. 1 ） h and （10. 1 ± 3.5） h respectively experimental and control groups. There was no statistically significant difference in total stages of labor （P 〉 0. 05 ） . The latent phase were （ 3.8 ±1.7 ） h in experimental group and （4. 3 ± 2. 5 ） h in control group, The active stage were （4. 2 ± 2. 1 ） h in experimental group and （4. 7±1. 6） h in control group, there were no statistically significant differences in latent phase and active stag （P 〉 0.05） . Conclusion ： Cervical electrotome cone cut method might not increase the cesarean section rate during labor with no effect on the progress of labor.