LEEP术治疗宫颈癌前病变对产妇妊娠结局的影响研究

Effect of LEEP on Pregnancy Outcome of Patients with Cervical Intraepithelial Neoplasia

目的研究LEEP术治疗宫颈癌前病变对产妇妊娠结局的影响。方法回顾性分析475例接受LEEP手术的孕妇和441例未处理的孕妇的临床资料。结果 LEEP治疗的妇女中,69例(14.5%)在24周以内出现自然流产,26例(6.4%)在24~36周内早产,380例(93.6%)患者足月妊娠。对照组441例妇女,62例(14.1%)在24周以内出现自然流产,19例(5.0%)在24~36周内早产,360例(95.0%)患者足月妊娠。2组早产率比较无显著差异。LEEP组和未处理组的自然流产率分别为14.5%和14.1%。LEEP组和未处理组早产率分别为6.4%和5.0%。女性宫颈长度<30mm的患者LEEP组最多,但不影响早产率。LEEP组宫颈长度<15 mm的患者接受宫颈组织广泛切除,同时增加早产的风险。早产与宫锥切除组织尺寸显著相关。LEEP组85例患者行大尺寸宫锥切除,其中10例(11.8%)出现早产,75例(88.2%)足月妊娠。结论 LEEP术对早产率无显著影响。早产与孕中期宫颈长度和锥切尺寸有关。

Objective To determine effect of loop electrosurgical excision procedure( LEEP) on pregnancy outcome of patients with cervical intraepithelial neoplasia. Methods Clinical data of 475 pregnant women who underwent LEEP and 441 untreated pregnant women were retrospectively analyzed. Results Pregnancy outcome of patients treated with LEEP,there had 69cases( 14. 5%) of spontaneous abortion within 24 weeks,26 cases( 6. 4%) of prematurity at 24-36 weeks,380 cases( 93. 6%)of full-term pregnancy. 441 cases of women in the control group,there had 62 cases( 14. 1%) of spontaneous abortion within 24 weeks,19 cases( 5. 0%) of prematurity at 24-36 weeks,360 cases( 95. 0%) of full-term pregnancy. Premature birth rates between the 2 group s had no significant difference. Spontaneous abortion rates in LEEP group and the untreated group were 14. 5%and 14. 1%,respectively. Premature birth rates in LEEP group and the untreated group were 6. 4% and 5. 0%,respectively. Female patients with cervical length less than 30 mm were in maximum number in LEEP group,but did not affect the rate of premature birth. Patients with cervical length less than 15 mm received wide excision of cervical tissue in LEEP group,while increased the risk of premature delivery. Premature delivery and size of cervical tissue in the cone palace had significant correlation. In LEEP group,among 85 patients treated with large-size cone excision,10 cases( 11. 8%) had premature birth,75 cases( 88. 2%)had full-term pregnancy. Conclusion The premature delivery rate has no significant relation with LEEP,and it is associated with cone size and cervical length in the second trimester.