摘要
目的通过对妊娠期和产后2个月及产后6个月内妇女宫颈细胞学检查,观察和评价宫颈细胞学检查的作用和异常孕妇的处理。方法采集1946例宫颈外口和宫颈管的脱落细胞液基标本,采用TBS诊断分类标准进行细胞学诊断。结果1946例标本中发现感染性病变160例(8.2%),其中细菌性阴道炎51例(2.6%)、滴虫性阴道炎49例(2.5%)、念珠菌感染58例(3.0%);上皮细胞异常105例(5.4%),其中非典型鳞状细胞(ASUCS)70例(3.6%)、低度鳞状上皮内病变(LSIL)29例(1.5%)、高度鳞状上皮内病变(HSIL)5例(0.2%)、原位癌1例(0.05%);人乳头瘤病毒(HPV)感染32例(1.6%),其中HPV伴非典型鳞状细胞21例(1.1%)、HPV伴低度鳞状上皮内病变10例(0.5%)。绝大多数宫颈细胞学检查异常孕妇均正常分娩,产后检查仍为原位癌或HSIL者行锥切术,其余行物理或药物治疗。结论宫颈细胞学检查对妊娠期产妇防治癌前病变和宫颈癌有积极作用,妊娠期宫颈病变很少恶化,孕期可以观察,定期行宫颈细胞学检查,必要时做阴道镜及活检,产后2个月及6个月复查,根据病理检查结果制定治疗原则。
Objective To observe and evaluate the role of cervical cytological examination in 1946 cases in gestation, and at 2 months and 6 months after delivery, and treatment for abnormal cases. Methods The thinprep cytologic test samples of 1946 cases from external cervical orifice and cervical cavity were collected. The cytological diagnosis was performed according to TBS-diagnosis and classification system. Results In 1946 samples, there were 160 inflammatory samples （8.2%）, including bacterial vaginitis 51 ca- ses （2.6 % ） , trichomonal vaginitis 49 cases （25. % ） , candidal vaginitis 58 cases （3.0 % ） ; typical epithelial cells 105 cases （5.4 % ） , including atypical squamous cells （ASUCS） 70 cases （3.6%）, low-grade squamous intraepithelial lesions （LSIL） 29 cases （1.5 %）, high-grade squamous intraepithelial lesions （HSIL） 5cases （0.2%）, the carcinoma in situ 1 case （0.05 % ） ; human papilloma virus （HPV） 32 cases （1.6%）, including HPV combined with atypical squamous cells 21 cases （1. 1%）, HPV combined with LSIL 10 cases （0.5 % ）. Large mass of cases with a abnormally result of cervical cytological examination had a normal childbearing, the cases that re-examination after birth showed carcinoma in situ and HSIL treated by conization, and others treated with physical treatment. Conclusion Cervical cytology examination has positive effect on prevention and treatment of precancerous changes and carcinoma in gestational women. Cervical lesions less likely get worse during pregnancy. Conservative management is possible if regular cytology, copolscopy and bioposy performed when necessary. Re-examination at two and six months after birth is necessary for determining treatment method.
出处
《中国康复理论与实践》
CSCD
2005年第8期649-650,共2页
Chinese Journal of Rehabilitation Theory and Practice
关键词
妊娠并发症
宫颈上皮内瘤样病变
宫颈细胞学检查
pregnancy complication
cervical intraepithelial neoplasia
cervical cytological examination
