不同方式治疗宫颈高级别上皮内瘤变对妊娠结局的影响研究

Study on the Effects of Different Treatment Methods for High-grade Cervical Intraepithelial Neoplasia on Pregnancy Outcome

目的:探究不同方式治疗宫颈高级别上皮内瘤变患者的效果及对妊娠结局的影响。方法:选取2021年7月—2022年12月阳江市人民医院收治的100例宫颈高级别上皮内瘤变患者作为研究对象,所有患者均经病理学诊断为宫颈上皮内瘤变Ⅲ级且有妊娠意愿,采用随机分组法将患者分为宫颈环形电切术(LEEP)组和宫颈冷刀锥切术(CKC)组,各50例。比较两组手术相关指标、术后并发症发生率和治疗总有效率及妊娠结局。结果:LEEP组术中出血量和切口深度小于CKC组,且手术时间、创面愈合时间、住院时间均短于CKC组,差异有统计学意义(P<0.05)。LEEP组并发症总发生率低于CKC组,治疗总有效率高于CKC组,差异有统计学意义(P<0.05)。两组术后妊娠率比较,差异无统计学意义(P>0.05);LEEP组妊娠患者的流产率、早产率、低出生体重儿发生率、剖宫产率均低于CKC组,差异有统计学意义(P<0.05)。结论:LEEP治疗宫颈上皮内瘤变Ⅲ级患者对其妊娠率的影响情况与CKC相当,但LEEP创伤更小,疗效更好,且并发症和不良妊娠结局的发生率更低,因此对有生育求的宫颈上皮内瘤变Ⅲ级患者可优先选用LEEP治疗。

Objective:To explore the effect of different treatment methods on high-grade cervical intraepithelial neoplasia and its influence on pregnancy outcome.Method:A total of 100 patients with high-grade cervical intraepithelial neoplasia admitted to Yangjiang People's Hospital from July 2021 to December 2022 were selected as the study objects,all of whom were pathologically diagnosed as cervical intraepithelial neoplasiaⅢgrade and had pregnancy intention.The patients were divided into loop electrosurgical excision procedure(LEEP)group and cervical cold knife conectomy(CKC)group by random grouping method,with 50 cases in each group.The relative indexes of operation,incidence of postoperative complications,total effective rate and pregnancy outcome were compared between the two groups.Result:The amount of intraoperative blood loss and incision depth in LEEP group were less than those in CKC group,and the operative time,wound healing time and hospital stay were shorter than those in CKC group,the differences were statistically significant(P<0.05).The total complication rate in LEEP group was lower than that in CKC group,and the total effective rate was higher than that in CKC group,the differences were statistically significant(P<0.05).There was no significant difference in postoperative pregnancy rate between the two groups(P>0.05).The rate of abortion,premature birth,low birth weight and cesarean section in LEEP group were lower than those in CKC group,the differences were statistically significant(P<0.05).Conclusion:The effect of LEEP on the pregnancy rate of cervical intraepithelial neoplasiaⅢgrade patients is similar to that of CKC,but LEEP has less trauma,better efficacy,and lower incidence of complications and adverse pregnancy outcomes.Therefore,LEEP can be preferred for the treatment of cervical intraepithelial neoplasiaⅢgrade patients who have fertility requirements.