宫颈冷刀锥切术后妊娠结局相关研究进展

Research Progress of Subsequent Pregnancy Outcomes after Cold Knife Conization

宫颈上皮内瘤变(CIN)属宫颈癌前病变,对CIN的治疗在宫颈癌预防中起着重要作用。宫颈冷刀锥切术(CKC)是治疗高级别CIN最常用的术式之一。随着宫颈癌筛查的普及以及中国二胎政策的放开,越来越多接受CKC的妇女仍有生育要求。由于CKC术后宫颈缩短、宫颈完整性受到影响,随后妊娠中晚期流产、早产、胎膜早破及围生儿死亡风险均显著增加,CKC术后妊娠风险高,故在妊娠期和分娩期应对其给予足够关注、加强宫颈长度的监测。宫颈环扎术在预防CKC术后早产中的作用尚需进一步临床研究验证。

Cervical intraepithelial neoplasia（CIN） is precancerous lesion,the treatment of which has produced a pro- found decrease in the incidence of cervical cancer. Cold knife eonization（CKC） is one of the most frequently used exeisional methods for treatment of high-grade CIN. With the introduction of cervical screening programs and China＇s second child policy over the last years, more and more women receiving CKC still have reproductive requirement. Due to the destroyed integrity and shortening of the cervix after CKC, the treatment has been con＇elated with an increased risk of second trimester pregnancy loss, preterm birth, premature rupture of the membrane, and perinatal mortality in a subsequent pregnancy. We should pay enough attention to those patients, and keep close surveillance of the cervical length. Whether cerclage can prevent preterm birth in the subsequent pregnancy still needs further clinical study and validation.