宫颈上皮内瘤样病变治疗中宫颈电环切术的作用及对妊娠结局、分娩方式的影响

Role of Cervical Electrosurgical Circumcision in the Treatment of Cervical Intraepithelial Neoplasia and its Impact on Pregnancy Outcome and Delivery Mode

目的分析宫颈电环切术对宫颈上皮内瘤样病变(CIN)患者的治疗效果及对妊娠结局、分娩方式的影响。方法选取本院2018年1月至2023年1月诊治的100例CIN患者,通过随机抽签法进行分组,各50例患者,对照组采用宫颈冷刀锥切术(CKC)治疗,观察组采用宫颈电环切术(LEEP)治疗,比较两组手术效果(残留、治愈、持续存在、复发)、手术相关指标、妊娠结局、分娩方式(早产阴道分娩、足月阴道分娩、剖宫产)、术后并发症发生情况(粘连、再出血)。结果两组手术效果比较差异无统计学意义(P>0.05);观察组手术时间、术中出血量、住院时间、住院费用、愈合时间优于对照组(P<0.05);观察组产程时间、新生儿窒息率低于对照组(P<0.05),新生儿体质量、新生儿1 min Apgar评分10分患者比例高于对照组(P<0.05);两组分娩方式比较差异无统计学意义(P>0.05);观察组粘连、再出血发生率低于对照组(P<0.05)。结论LEEP术能降低CIN患者的不良妊娠结局,提高手术安全性,具有显著的临床效果。

Objective To analyze the effect of cervical electrosurgical circumcision on patients with cervical intraepithelial neoplasia(CIN)and its impact on pregnancy outcome and delivery mode.Methods A total of 100 patients with CIN diagnosed and treated in our hospital from January 2018 to January 2023 were randomly divided into two groups,each containing 50 patients.The control group was treated with cervical cold knife conization(CKC),and the observation group was treated with loop electrosurgiral excision procedure(LEEP).The surgical effects(residual,cured,persistent,recurrent),surgical related indicators,pregnancy outcomes,delivery methods(premature vaginal delivery,full term vaginal delivery,cesarean section),and postoperative complications(adhesion,rebleeding)were compared between the two groups.Results Comparison of surgical effects between the two groups,the difference was statistically significant(P>0.05).The operation time,intraoperative bleeding,hospitalization time,hospitalization expenses,and healing time in the observation group were better than those in the control group(P<0.05).The observation group had lower labor duration and neonatal asphyxia rate than the control group(P<0.05).Comparison of delivery modes between the two groups,the difference was statistically significant(P>0.05).The incidence of adhesion and rebleeding in the observation group was lower than that in the control group(P<0.05).Conclusion The LEEP can reduce the adverse pregnancy outcomes of CIN patients,improve the surgical safety,and have significant clinical effects.