宫颈病变锥型切除锥长对妊娠结局的影响

Effects of the cone length on pregnancy outcome in cervical lesions

目的分析宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)行宫颈锥切术对术后妊娠结局的影响。方法回顾性分析2012年1月至2013年12月江西省妇幼保健院妇瘤科收治的138例行宫颈锥切术CIN患者临床资料,对患者进行电话及门诊随访,分析妊娠周数、妊娠结局和终止妊娠的方式与锥长的关系。结果138例患者不良妊娠结局42例(30.43%)、足月产96例(69.56%);其中剖宫产63例(45.60%)、经阴道分娩54例(39.13%)、27周前流产21例(15.21%),流产患者平均锥长(20.10±4.50)mm。138例患者平均锥长(14.30±6.60)mm,足月及不良妊娠结局患者锥长分别为(12.00±6.10)mm、(19.60±4.10)mm,差异有统计学意义(P<0.05);线性回归分析结果显示,锥长与妊娠孕龄呈负相关(F=20.38,P<0.05)。结论锥长与出生时胎龄呈负相关,当锥长>15 mm时,不良妊娠结局的风险渐增高,但不会增加低出生体重儿的发生率及剖宫产率。

Objective To analyze the influence of cervical conectomy for cervical intraepithelial neoplasia(CIN)on postoperative pregnancy outcome.Methods The clinical data of 138 patients with CIN undergoing cervical conectomy admitted to the department of gynecology in Jiangxi Maternal and Child Health Hospital from January 2012 to December 2013 were retrospectively analyzed,the patients were followed up by telephone and outpatient clinics,and the relationship between gestation weeks,pregnancy outcomes,pregnancy termination methods and cone length was analyzed.Results Among the 138 patients,42 cases(30.43%)had adverse pregnancy outcomes and 96 cases(69.56%)had full-term births.There were 63 cases(45.60%)of cesarean section,54 cases(39.13%)of vaginal delivery and 21 cases(15.21%)of abortion before 27 weeks.The mean cone length of the aborted patients was(20.10±4.50)mm.The mean cone length of 138 patients was(14.30±6.60)mm,and that of full-term patients and patients with adverse pregnancy outcome were(12.00±6.10)mm and(19.60±4.10)mm,respectively,the difference was statistically significant(P<0.05).Linear regression analysis showed that cone length was negatively correlated with gestational age(F=20.38,P<0.05).Conclusion Cone length was negatively correlated with gestational age at birth,when cone length was>15 mm,the risk of adverse pregnancy outcomes was gradually increased,but the incidence of low birth weight infants and cesarean section rate were not increased.