宫颈锥切术后妊娠结局临床分析  

Analysis about obstetric outcome after cervical conization.

作　　者：孟然[1] 戚红[1] 

机构地区：[1]北京市海淀区妇幼保健院产前筛查中心,北京100080

出　　处：《中国实用妇科与产科杂志》2012年第7期524-526,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨宫颈锥切术对妊娠结局的影响。方法锥切组为2007年9月1日至2011年8月31日期间在北京海淀区妇幼保健院住院分娩的共82例妊娠前曾因宫颈上皮内瘤样病变行宫颈锥切术(手术方式包括冷刀锥切术和环形电刀锥切术)的患者,随机选择同期480例未行宫颈锥切术的患者为对照组,比较两组患者的分娩方式、妊娠并发症等。结果 (1)锥切组剖宫产率59.76%(49/82),产钳助产率15.85%(13/82),明显高于对照组,自然分娩率24.39%(20/82),明显低于对照组,差异有统计学意义(P﹤0.01);如果去除剖宫产指征为社会因素的患者,锥切组剖宫产率31.71%(26/82),对照组剖宫产率29.58%(142/480),两组比较差异无统计学意义(P﹥0.05)。(2)锥切组早产发生率19.51%(16/82),胎儿窘迫发生率18.29%(15/82),明显高于对照组,差异有统计学意义(P﹤0.01);胎膜早破发生率23.17%(19/82),与对照组比较,差异有统计学意义(P﹤0.05)。软产道裂伤0例,低出生体重儿8.54%(7/82),与对照组比较,差异无统计学意义(P﹥0.05)。(3)宫颈锥切术与妊娠间隔时间≤1年早产的发生率8.6%(3/35),间隔时间﹥1年早产的发生率27.7%(13/47),后者高于前者,差异有统计学意义(P﹤0.05)。结论宫颈锥切术将会影响继之的妊娠结局,增加早产、胎膜早破等的发生率。如果去除社会因素,并没有增加剖宫产率。Objective To examine obstetric outcome of patients following conization. Methods A population-based study was performed comparing pregnancies in 82 women following conization between Sep 1, 2007 and Aug 31, 2011 with 480 women of the same period who had not undergone the procedure. The delivery mode and obstetric outcome were compared between the two groups. Results （ 1 ） The rates of cesarean section （ 59. 76% ） and forceps delivery （ 15.85 % ）were noted higher in pregnancies of women conization, whereas spontaneous delivery rate （24. 39 % ） was noted lower of the same group in comparison with that of the control group（ P 〈 0. 01 ）. However, there were no difference be- tween the two groups after removing psychological faetor（P 〉 0. 05）. （2） The risk of preterm delivery （ 19.51% ） and fetal distress （18.29%） and premature rupture of membranes （23.17%） were significantly higher than the comparison group（P 〈 0.01 ）. The same thing is true to premature rupture of membranes（ P 〈 0.05 ）. There were no significant differences comparing low birth weight and soft birth canal laceration （P 〉 0.05 ）. （3） The interval time of pregnancy af- ter eonization has significant difference for preterm delivery between the group of less than or equal to one year（ 8.6% ） and the other group of more than one year（27.7% ） （P 〈 0. 05 ）. Conclusion Cervical conization will affect obstetric outcome so that the happening rate of preterm delivery and premature rupture of membranes will be increased. However, the rates of cesarean section are similar after removing psychological factor.

关 键 词：宫颈锥形切除术 妊娠结局 

分 类 号：R713.4[医药卫生—妇产科学]