阴道镜联合宫颈环形电切术治疗宫颈癌前病变的临床效果及对术后妊娠情况的影响

Clinical Effect of Colposcopy Combined with Loop Electrosurgical Excision Procedure in the Treatment of Cervical Precancerous Lesions and its Effect on Postoperative Pregnancy

目的研究阴道镜联合宫颈环形电切术治疗宫颈癌前病变临床效果及对术后妊娠情况的影响。方法选取2018年1月-2021年10月我院诊治的70例宫颈癌前病变患者为研究对象,采用随机数字表法分为对照组(n=35)和观察组(n=35)。对照组采用常规术式,观察组采用阴道镜联合宫颈环形电切术治疗,比较两组临床手术指标、临床效果、并发症发生率、妊娠结局以及生活质量水平。结果观察组手术时间、阴道出血时间、住院时间短于对照组,术中出血量少于对照组,病变切除深度大于对照组(P<0.05);观察组治疗总有效率为91.43%,高于对照组的77.14%(P<0.05);观察组并发症发生率为8.57%,低于对照组的20.00%(P<0.05);随访1年,观察组早产、胎膜早破、胎儿窘迫发生率均低于对照组(P<0.05),流产发生率与对照组比较,差异无统计学意义(P>0.05);两组术后6个月生活质量评分高于术前,且观察组高于对照组(P<0.05)。结论阴道镜联合宫颈环形电切术治疗宫颈癌前病变可提高治疗效果,降低不良妊娠结局,缩短手术及住院时间,减少术中出血量,同时术后并发症发生率低,远期生活质量水平高,值得临床应用。

Objective To study the clinical effect of colposcopy combined with loop electrosurgical excision procedure in the treatment of cervical precancerous lesions and its effect on postoperative pregnancy.Methods A total of 70 patients with cervical precancerous lesions diagnosed and treated in our hospital from January 2018 to October 2021 were selected as the research objects.They were divided into control group(n=35)and observation group(n=35)by random number table method.The control group was treated with conventional surgery,and the observation group was treated with colposcopy combined with cervical loop electrotomy.The clinical operation indexes,clinical effects,incidence of complications,pregnancy outcomes and quality of life were compared between the two groups.Results The operation time,vaginal bleeding time and hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the resection depth of the lesion was greater than that of the control group(P<0.05).The total effective rate of treatment in the observation group was 91.43%,which was higher than 77.14%in the control group(P<0.05).The incidence of complications in the observation group was 8.57%,which was lower than 20.00%in the control group(P<0.05).After 1 year of follow-up,the incidences of premature delivery,premature rupture of membranes and fetal distress in the observation group were lower than those in the control group(P<0.05),and there was no significant difference in the incidence of abortion between the two groups(P>0.05).The quality of life scores of the two groups at 6 months after operation were higher than those before operation,and the observation group was higher than the control group(P<0.05).Conclusion Colposcopy combined with loop electrosurgical excision procedure in the treatment of cervical precancerous lesions can improve the therapeutic effect,reduce the adverse pregnancy outcome,shorten the operation and hospitalization time,reduce the intraoperative blood loss.Meanwhile,the incidence of postoperative complications is low,the long-term quality of life is high,and is worthy of clinical application.