妊娠期宫颈细胞学涂片的临床应用

Clinical application of cervical smear in pregnancy.

目的 :探讨薄层宫颈涂片检查在妊娠期应用的必要性及异常细胞学涂片对产后评估的意义。方法 :对 734例孕妇和 318例同龄非孕者普查的薄层宫颈涂片结果进行分析对比。结果 :孕妇组感染性病变检出率 10 .2 2 % ,明显高于对照组的 5 .97% (P <0 .0 1)。孕妇组宫颈鳞状上皮内病变的发生率 5 .0 4 % ,与对照组相似 ;对孕期存在宫颈上皮病变的妇女在产后 6～ 12周重复宫颈涂片 ,进行再评估 ,有宫颈鳞状上皮内病变的 19例 ,15例病变程度降低 ,4例病变程度无进展 ,无浸润癌发生。结论 :妊娠期需常规行细胞学涂片检查 ,产前涂片异常者 。

Objective:To explore the clinical significance of uterine cervical cytology during pregnancy.Methods:734 pregnant women and 318 non-pregnant women underwent cervical cytology by cervical smear and the results of two groups were compared.The pregnant women with abnormal findings were reexamed in their postpartum.Results:10.22% of the 734 pregnant women were diagnosed with infection and the incidence was significantly higher than that of the non-pregnant women(5.97%,P<0.01).In pregnant and non-pregnant women,the incidence of squamous intraepithelial lesion(SIL),including high grade (HSIL) and low grade (LSIL),was 5.04% and 5.03% respectively (P>0.05).Of these,16 LISL and 3 HISL during pregnant were repeated cervical smear in their postpartum (6～12weeks), no case was found progressed after delivery and 4 cases remained.Conclusions:Cervical smear plays an important role in cervical cytology screening for uterine cervical cancer in the pregnant women,which has an equal effectiveness to that in the mass-screened non-pregnant women.During postpartum,to repeat cervical smear in the pregnant women with abnormal cytology is necessary.