早期宫颈癌不同术式对其术后妊娠妇女母婴结局的影响

Effects of Different Surgical Procedures for Early Cervical Cancer on Maternal and Infant Out-comes in Postoperative Pregnant Women

【目的】探讨早期宫颈癌不同术式对其术后妊娠妇女母婴结局的影响.【方法】回顾性分析2015年1月至2017年1月在本院诊治的早期宫颈癌术后成功妊娠孕妇125例的临床资料,其中69例行宫颈环形电切术(LEEP),56例行宫颈冷刀锥切术.比较两组妊娠结局、分娩方式、产妇及新生儿并发症.【结果】冷刀锥切术组足月产、早产、流产的构成比例为64.29%、14.29%、21.42%;与LEEP组的66.67%、14.29%、18.84%比较差异无统计学意义(P>0.05).冷刀锥切术组产妇产后出血、宫颈裂伤及总并发症发生率分别为18.18%、15.91%和43.18%,显著高于LEEP组的8.93%、7.14%和23.21%;冷刀锥切术组新生儿胎膜早破、窒息及并发症发生率为18.18%、20.45%和52.27%,高于LEEP组的3.57%、3.57%和16.07%,差异均有统计学意义(P<0.05).冷刀锥切术组剖宫产率为52.27%,明显高于LEEP组的32.15%,差异有统计学意义(P<0.05).【结论】LEEP术在改善母婴结局方面优于宫颈冷刀锥切术,值得临床推广应用.

【Objective】To analyze the maternal and infant outcomes of early cervical cancer pregnant women with different surgical methods.【Methods】Data of 125 cases of successful pregnancy after early cervical cancer surgery in our hospital from January 2015 to January 2017 were collected,among which 69 cases who underwent LEEP knife cervical electrotomy were set as the LEEP group.While 56 patients who underwent cervical coning resection were included in the coning resection group.Pregnancy outcome,delivery mode,maternal outcomes and neonatal complications were compared between the two groups.【Results】The proportion of full term birth,preterm birth and abortion in the cervical coring resection group was 64.29%,14.29%and 21.42%,respectively.While the full-term,preterm and abortion rate in the LEEP group was 66.67%,14.29%,18.84%,respectively.The difference was not statistically significant(P>0.05).The rates of postpartum hemorrhage,cervix laceration and total complications in the cervical coring resection group were 18.18%,15.91%and 43.18%,respectively,which were higher than those of LEEP group 8.93%,7.14%and 23.21%,respectively(P<0.05).The incidence of premature rupture of membranes,asphyxia and overall adverse outcomes of neonates in the cervical coning resection group was 18.18%,20.45%and 52.27%,respectively,which was higher than those in the LEEP group 3.57%,3.57%and 16.07%,respectively,.The difference was statistically significant differences(P<0.05).The cesarean section rate in the cervical coring resction group was 52.27%,which was significantly higher than the 32.15%in the LEEP group,and the difference was statistically significant(P<0.05).【Conclusion】LEEP knife electrocervix resection is superior to the cervical coning resection.It improves maternal and infant outcomes of early cervical cancer pregnant women with LEEP.