宫颈锥切术对宫颈上皮内瘤变患者妊娠结局影响的Meta分析

Effect of cervical conization on pregnancy outcomes in patients with cervical intraepithelial neoplasia: a Meta analysis

目的 探讨宫颈锥切术对宫颈上皮瘤病变（CIN）患者术后妊娠结局的影响. 方法 计算机检索 PubMed、SCI、Cochrance Database、中国生物医学文献数据库、中国知网全文数据库、万方等数据库,查找有关宫颈锥切术对CIN患者妊娠结局影响的随机对照试验（RCT）. 应用纽卡斯尔-渥太华量表进行文献质量评价,采用RevMan5.2软件进行Meta分析. 结果本研究纳入9篇文献,共7 650例患者. Meta分析显示与未行宫颈锥切术的正常人群相比,宫颈上皮内瘤变的患者行宫颈锥切术后流产率无明显差异（OR=1.15,95%CI：0.83-1.59,P〉0.05）,早产率增加（OR=2.17,95%CI：1.59-2.59,P〈0.01）,胎膜早破率增加（OR=3.83,95%CI：2.38-6.18,P〈0.01）,新生儿出生低体重发生率增加（OR=2.84,95%CI：1.88-4.29,P〈0.01）.结论 宫颈锥切术可增加术后早产率、胎膜早破率、新生儿低体重儿发生率,对流产率无影响。

Objective To explore the effect of cervical conization on postoperative pregnancy outcomes in patients with cervical intraepithelial neoplasia（ CIN） .Methods A computer retrieve was performed in the databases including PubMed,SCI,Cochrance Database, CBM Database,CNKI Database and Wanfang Database.And randomized controlled trials（RCTs） about the effect of cervical conization on pregnancy outcomes in patients with CIN were collected.The quality assessment was performed based on Newcastle-Ottawa Scale,and a Meta analysis was conducted using RevMan 5.2 software.Results Nine RCTs were involved,which consisted of 7650 patients.Meta analysis revealed that the incidence of abortion presented few differences（OR=1.15,95%CI：0.83 -1.59,P〉0.05）,while the incidences of preterm birth（OR=2.17,95%CI：1.59-2.59,P〈0.01）,premature rupture of membranes（OR=3.83,95%CI：2.38-6.18,P〈0.01） and low birth weight（OR=2.84,95%CI：1.88-4.29,P〈0.01） increased in patients with CIN undergoing cervical conization compared to those in normal people without cervical conization.Conclusion Cervical conization might increase the incidences of preterm birth,premature rupture of membranes and low birth weight,but has no effect on the incidence of abortion.