宫颈冷刀锥切术对宫颈上皮内瘤变患者妊娠及妊娠结局的影响

Effects of cold knife conization on pregnancy and pregnancy outcome inpatients with cervical intraepithelial neoplasia

目的分析宫颈冷刀锥切术(CKC)对宫颈上皮内瘤变(CIN)患者妊娠及妊娠结局的影响。方法回顾性分析2008年1月至2016年1月在安徽省立医院妇科行CKC治疗的育龄期妇女70例为观察组,同时期选取在本院妇科门诊行孕前检查且无宫颈病变的育龄期妇女71例为对照组。比较两组一般资料(如年龄、身高、月经周期、初潮年龄等)、妊娠率、妊娠结局(如早期流产率、晚期流产率、早产率、胎膜早破率、低体重儿发生率、新生儿窒息率、剖宫产率)等指标的变化。结果两组一般资料、妊娠率、晚期流产率差异无统计学意义(P>0.05);观察组早期流产率、早产率、胎膜早破率、低体重儿发生率、新生儿窒息率、剖宫产率分别为10%、8.6%、10%、8.6%、10%、27.1%,对照组分别为1.4%、0%、1.4%、0%、1.4%、11.3%,差异均有统计学意义(P<0.05)。结论CKC对CIN患者妊娠率无明显影响,但易导致早期流产、早产、胎膜早破等不良妊娠结局的发生。

Objective To evaluate the effects of cold knife conization(CKC)on pregnancy and pregnancy outcome inpatientswithcervical intraepithelial neoplasia(CIN).Methods This was a retrospective study,in which141 patients in the Anhui provincial hospitalwere selected from January2008 to January2016.Two groups were established:the observation group,70 patients with CIN Ⅱ-Ⅲ were treated with CKC;the control group,71 women of childbearing agebefore the pregnancy.The changes of general data(age,height,menstrual cycle,etc.),pregnancy rate,pregnancy outcome(rate of early abortion,late abortion,premature delivery,etc.)were compared between the two groups.Results There was no significant difference in general data,pregnancy rate and late abortion rate between the two groups(P>0.05).The rate of early abortion,premature delivery,premature rupture of membranes,low birth weight infants,neonatal asphyxiaand cesarean sectionin observation group was 10%,8.6%,10%,8.6%,10% and 27.1% respectively,while that in control group was 1.4%,0%,1.4%,0%,1.4% and 11.3%,respectively,which hadstatistically significant differences(P<0.05).Conclu sion CKC has no obvious effect on pregnancy rate of CIN patients,but it is prone to lead to adverse pregnancy outcomes.