中国医科大学学报

中国医科大学学报
  • 中文核心期刊
  • 中国科技核心期刊
  • 中国高校百佳科技期刊
  • BA、CA收录

中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (9): 812-815.doi: 10.12007/j.issn.0258-4646.2018.09.010

• 论著 • 上一篇    下一篇

子宫颈上皮内瘤变患者子宫颈环形电切除术后妊娠结局及分娩方式的临床分析

张晶, 潘育翔, 马瑞肖, 张淑兰   

  1. 中国医科大学附属盛京医院妇产科, 沈阳 110004
  • 收稿日期:2017-09-21 出版日期:2018-09-30 发布日期:2018-09-08
  • 通讯作者: 张淑兰 E-mail:zsl0909@sina.com
  • 作者简介:张晶(1981-),女,主治医师,博士.
  • 基金资助:
    辽宁省博士科研启动基金(201601134)

Clinical Analysis of Obstetric Outcomes after Loop Electrosurgical Excision Procedure Treatment for Cervical Intraepithelial Neoplasia

ZHANG Jing, PAN Yuxiang, MA Ruixiao, ZHANG Shulan   

  1. Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang 110004, China
  • Received:2017-09-21 Online:2018-09-30 Published:2018-09-08

摘要: 目的 探讨子宫颈环形电切除术(LEEP)对子宫颈上皮内瘤变(CIN)患者术后妊娠分娩的影响。方法 随访2013年1月至2015年12月在中国医科大学附属盛京医院妇科门诊因CIN行LEEP治疗且术后成功妊娠的患者,分析其自然流产率、早产率、低出生体质量率以及剖宫产率等。结果 35例患者术后成功妊娠,完成随访并获得妊娠结局30例,人工流产1例(3.3%),胚胎停育3例(10.0%),早产4例(13.3%),足月产22例(73.3%)。2例低出生体质量儿,新生儿均健康。已分娩的26例患者中,自然分娩11例(42.3%),剖宫产15例(57.7%)。早产率与锥切深度、锥切直径、手术次数及妊娠距手术的间隔时间均不相关(P>0.05)。结论 LEEP对术后妊娠分娩影响较小,合理的切除范围不增加不良结局,术后3个月以上可考虑妊娠。LEEP锥切手术史不是剖宫产指征。

关键词: 子宫颈环形电切除术, 子宫颈上皮内瘤变, 妊娠结局, 分娩方式

Abstract: Objective To assess the effect of a loop electrosurgical excision procedure(LEEP) on subsequent pregnancy outcomes and the delivery mode in women diagnosed with cervical intraepithelial neoplasia (CIN). Methods A retrospective study was performed at Shengjing Hospital of China Medical University between January 2013 and December 2015. We studied women diagnosed with CIN who got pregnant after a LEEP. The rates of abortion, preterm births, low birth weight newborns, and cesarean sections performed were analyzed. Results Of the 35 women enrolled, data regarding follow-up pregnancy outcomes were available for only 30, One woman(3.3%) showed artificial abortion, 3(10.0%) showed spontaneous abortion, 4(13.3%) showed preterm labor, and 22(73.3%) showed full-term birth. All newborns were healthy, although 2 had low birth weight. Of the 26 women who had delivered, 11 (42.3%) underwent spontaneous labor and 15 (57.7%) underwent a cesarean section, The risk of preterm labor was not associated with the depth of conization, diameter of LEEP, number of operations, and the time interval between the LEEP and the pregnancy(P>0.05). Conclusion The effect of LEEP on obstetric outcomes is mild. Optimal surgery should be chosen based on the lesion. We propose that women can get pregnant 3 months after an LEEP and that a history of LEEP is not an indication to perform a cesarean section.

Key words: loop electrosurgical excision procedure, cervical intraepithelial neoplasia, pregnancy outcome, delivery mode

中图分类号: 

  • R711.74
[1] TAN L, PEPRA E, HALOOB RK. The outcome of pregnancy after large loop excision of the transformation zone of the cervix[J]. J Obstet Gynaecol, 2004, 24(1):25-27. DOI:10.1080/01443610310001620242.
[2] KYRGIOU M, ATHANASIOU A, PARASKEVAIDI M, et al. Adverse obstetric outcomes after local treatment for cervical preinvasive and early invasive disease according to cone depth:systematic review and meta-analysis[J]. BMJ, 2016, 354:i3633. DOI:10.1136/bmj.i3633.
[3] 罗岩, 郭奇桑, 隋龙, 等. 宫颈LEEP术对HSIL患者妊娠分娩方式及妊娠结局的影响[J]. 现代妇产科进展, 2014, 23(10):794-796. DOI:10.13283/j.cnki.xdfckjz.2014.10.010.
[4] CONNER SN, FREY HA, CAHILL AG, et al. Loop electrosurgical excision procedure and risk of preterm birth:a systematic review and meta-analysis[J]. Obstet Gynecol, 2014, 123(4):752-761. DOI:10.1097/AOG.0000000000000174.
[5] ACHARYA G, KJELDBERG I, HANSEN SM, et al. Pregnancy outcome after loop electrosurgical excision procedure for the management of cervical intraepithelial neoplasia[J]. Arch Cynecol Obstet, 2005, 272(2):109-112. DOI:10.1007/s00404-005-0727-1.
[6] KALLIALA I, ANTTILA A, NIEMINEN P, et al. Pregnancy incidence and outcome before and after cervical intraepithelial neoplasia:a retrospective cohort study[J]. Cancer Med, 2014, 3(6):1512-1516. DOI:10.1002/cam4.300.
[7] 舒焰红, 肖小敏, 钱德英, 等. 宫颈电环切除术后妊娠结局的临床相关研究[J]. 现代妇产科进展, 2012, 21(10):768-770. DOI:10.13283/j.cnki.xdfckjz.2012.10.019.
[8] HIMES KP, SIMHAN HN. Time from cervical conization to pregnancy and preterm birth[J]. Obstet Gynecol, 2007, 109(2Pt1):314-319. DOI:10.1097/01.AOG.0000251497.55065.74.
[9] KYRGIOU M, KOLIOPOULOS G, MARTIN-HIRSCH P, et al, Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions:systematic review and meta-analysis[J]. Lancet, 2006, 367(9509):489-498. DOI:10.1016/S0140-6736(06) 68181-6.
[1] 张琰, 王晓彩, 孙晓, 薛慧英, 成文文. 一日门诊联合心理干预对妊娠期糖尿病孕妇妊娠结局的影响[J]. 中国医科大学学报, 2019, 48(4): 372-375.
[2] 常小垒,郭科军,张颐. HPV亚型与子宫颈癌前病变及癌变的关系探讨[J]. 中国医科大学学报, 2014, 43(8): 720-723.
[3] 关丽丽,王英华. 微信群平台在孕妇孕期产前检查中的应用[J]. 中国医科大学学报, 2014, 43(12): 1147-1149.
[4] 郑莉彦,杨宏,孙春燕,李巨. 不同角色陪伴分娩对产妇心理、产程和分娩方式的影响[J]. 中国医科大学学报, 2012, 41(5): 444-445.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 邹飞, 任高伟, 周晓薇, 马艳萍, 齐莹, 阮强, 孙峥嵘. 人巨细胞病毒UL135蛋白结合蛋白的酵母双杂交筛选[J]. 中国医科大学学报, 2009, 38(9): 647 .
[2] 刘冬妍, 丁鹏, 刘沛. NO对肠上皮Caco-2细胞表达分泌片的影响[J]. 中国医科大学学报, 2009, 38(9): 651 .
[3] 张占帅, 王绍久, 王一丁, 林英子, 朱杰. 奥美沙坦对自发性高血压大鼠延髓腹外侧区AT1受体mRNA表达的影响[J]. 中国医科大学学报, 2009, 38(9): 666 .
[4] 高社干, 王立东, 冯笑山, 曲智锋, 单探幽, 谢萱虎. Photofrin-Diomed 630-PDT对人永生化食管上皮细胞系SHEE及其癌变细胞系SHEEC的抑制研究[J]. 中国医科大学学报, 2009, 38(10): 730 .
[5] 张秀丽, 马健飞, 吴咏今, 樊怡, 董齐, 王力宁. 姜黄素预处理后大鼠急性腹膜炎腹膜肿瘤坏死因子α的检测[J]. 中国医科大学学报, 2009, 38(10): 749 .
[6] 刘学敏, 杜鹃. 不同孕龄产妇胎盘和脐带组织中S100B蛋白的表达[J]. 中国医科大学学报, 2009, 38(10): 781 .
[7] 何杭明, 郭克建, 宋少伟, 马刚. 腹膜后神经鞘瘤15例分析[J]. 中国医科大学学报, 2009, 38(10): 790 .
[8] 王波, 阎德民, 肖德绵, 师恩祎, 李庆志, 樊国亮. 原发性感染性心内膜炎180例诊断治疗分析[J]. 中国医科大学学报, 2009, 38(10): 797 .
[9] 张梅英, 吴红联, 蔺美娜, 李兆阳, 周生来, 于洋, 王惟, 吕相川, 王禄增. 突变DJ-1转基因小鼠模型的建立[J]. 中国医科大学学报, 2009, 38(11): 820 .
[10] 王宗立, 范红杰, 庞超健, 马玉朝. 骨髓间充质干细胞移植对缺血再灌注大鼠脑神经细胞凋亡及survivin、caspase-3蛋白表达的影响[J]. 中国医科大学学报, 2009, 38(11): 834 .

中国医科大学学报版权所有©2018

未经允许,严禁擅自转载本站图文资料

地址:中国 沈阳市沈北新区蒲河路77号 110122

辽ICP备05014850

JOURNAL OF CHINA MEDICAL UNIVERSITY

ADDRESS: NO.77 PUHE ROAD

SHENYANG NORTH NEW AREA, SHENYANG

LIAONING PROVINCE, P.R. CHINA