手术治疗对宫颈上皮内瘤变患者阴道分娩的影响被引量：8

Delivery outcomes after cervical surgery in patients with cervical intraepithelial neoplasia

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摘要目的探讨手术治疗对宫颈上皮内瘤变（CIN）患者阴道分娩的影响.方法回顾性研究2002年10月～2012年10月因CIN实施过宫颈电刀环切术（LEEP）或宫颈冷刀锥切术（CKC）在首都医科大学附属北京妇产医院行阴道分娩的128例患者,其中实施过LEEP术的72例患者作为LEEP组;实施过CKC术的56例患者作为CKC组,随机抽取同期无宫颈手术治疗史且正常阴道分娩的妇女128例作为对照组,比较各组产程时间、会阴侧切、产钳助娩、宫颈裂伤、产后出血等情况,评估分析手术治疗对CIN患者阴道分娩的影响.结果 ①第一产程时间、潜伏期时间、活跃期时间、第二产程时间、第三产程时间LEEP组分别为：（9.82±1.14）h、（7.35±1.25）h、（2.47±0.46）h、（42.36±5.56） min、（14.31±3.59） min;CKC组分别为：（9.81±1.21）h、（7.22±1.24）h、（2.59±0.50）h、（41.96±5.70） min、（14.20±3.54） min; 对照组分别为：（9.78±1.01）h、（7.18±1.05）h、（2.60±0.46）h、（42.18±5.59） min、（14.16±3.54） min,三组在产程时间方面的差异均无统计学意义（均P＞ 0.05）.②CKC组侧切率、产钳率、宫颈裂伤率、产后出血率分别为：46.4％、3.6％、8.9％、3.6％;LEEP组分别为：48.6％、2.8％、13.9％、2.8％;对照分别为：43.8％、3.1％、9.4％、3.9％,三组在并发症方面的差异均无统计学意义（均P＞ 0.05）.结论本研究LEEP组、CKC组与对照组阴道分娩产程无明显差异,说明手术治疗后宫颈机能没有明显异常,可以自然阴道分娩,所以不应轻易以宫颈手术史作为剖宫产的理由. Objective To investigate the effects of cervical surgery on delivery outcomes of patients with cervical intraepithelial neoplasia （CIN）.Methods 128 women with CIN who had underwent cervical surgery from October 2002 to October 2012 in the Affiliated Beijing Obstetrics and Gynecology Hospital of Capital Medical University were studied retrospectively,72 patients of which with loop eelectrosurgical excision procedure （LEEP） were selected as LEEP group,56 patients with Cold Knife Conization （CKC） were selected as CKC group,and 128 healthy women who delivered during the same period were selected as control group.The birth process time,rate of episiotomy,forceps delivery,laceration of cervix,and postpartum hemorrhage were compared in three groups,the effect of cervical surgery on delivery of patients with CIN was evaluation analyzed.Results ①The first stage of labor,the incubative stage,active stage,the second stage of labor,and the third stage of labor of LEEP group were （9.82 ± 1.14） h,（7.35 ± 1.25） h,（2.47 ±.46） h,（42.36 ± 5.56） min,（14.31 ± 3.59） min respectively; those in CKC group were （9.81 ±1.21） h,（7.22 ± 1.24） h,（2.59 ± 0.50） h,（41.96 ± 5.70） min,（14.20 ± 3.54） min respectively; and those in control group were （9.78 ± 1.01） h,（7.18 ± 1.05） h,（2.60 ± 0.46） h,（42.18 ± 5.59） min,（14.16 ± 3.54） min respectively,there were no statistically significant difference between the three groups （all P ＞ 0.05）; ②The rate of episiotomy,forceps delivery,laceration of cervix,and postpartum hemorrhage in LEEP group were 48.6％,2.8％,13.9％,and 2.8％,those in CKC group were 46.4％,3.6％,8.9％,and 3.6％ respectively,those in control group were 43.8％,3.1％,9.4％,and 3.9％ respectively,there were no statistically significant difference between the three groups （all P ＞ 0.05）.Conclusion No significant difference was found in laboring between LEEP group and CKC group,suggesting that there is no obvious abnormal in cervical function after cervical surgery,women underwent cervical surgery should not to be the reason of cesarean section.

作者雷玲玲刘晓巍

机构地区首都医科大学附属北京妇产医院产科

出处《中国医药导报》 CAS 2013年第33期42-44,共3页 China Medical Herald

基金首都卫生发展科研专项基金(项目编号:首发2011-2011-01)

关键词宫颈上皮内瘤变阴道分娩宫颈电刀环切术宫颈冷刀锥切术 Cervical intraepithelial neoplasia Vaginal delivery Loop electrosurgical excision procedure Cold-knife conization

分类号 R737.33 [医药卫生—肿瘤]

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