宫颈环状电切术对早期宫颈癌患者生育能力和妊娠率的影响  

Effect of cervical loop electrosurgical excision procedure on fertility and pregnancy rate in patients with early stage cervical cancer

作　　者：毕云丽 彭文[2] 

机构地区：[1]山东省临朐县人民医院产科,潍坊262600 [2]山东省立医院产科,济南250021

出　　处：《中国肿瘤临床与康复》2016年第10期1176-1178,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨宫颈环状电切术(LEEP)对早期宫颈癌患者生育能力和妊娠率的影响。方法选取2013年6月至2015年6月间临朐县人民医院收治的40例早期宫颈实施宫颈锥切术患者为观察组,另选取同期门诊收治的40例无宫颈锥切术史计划的妇女为对照组。随访2年,对比两组产妇的妊娠情况、分娩方式、围生儿结局。结果与对照组比较,观察组患者的妊娠率和分娩率降低,不孕率提高,差异均有统计学意义(均P<0.05)。观察组患者中,输卵管性不孕5例(12.5%),宫颈粘连不孕1例(2.5%),宫颈管狭窄不孕1例(2.5%)。对照组中输卵管性不孕2例(5.0%)。与对照组比较,观察组患者的平产率降低,剖宫产率升高,差异均有统计学意义(均P<0.05)。与对照组比较,观察组患者的胎膜早破发生率、早产率、新生儿窒息率和新生儿低体重率明显升高,差异均有统计学意义(均P<0.05)。结论采用LEEP刀锥切术对早期宫颈癌患者的生育能力可造成一定的影响,一方面降低了妊娠率,另一方面提高了胎膜早破、早产、新生儿窒息和新生儿低体重发生率,应引起临床医师的重视。Objective To explore and analyze the effect of cervical loop electrosurgical excision procedure（ LEEP） on fertility and pregnancy rate in patients with early stage cervical cancer. Methods Forty patients with early stage cervical cancer undergoing LEEP treated in the Linqu County People＇s Hospital were selected as observation group frome June 2013 to June 2015,while 40 pregnancy women receiving outpatient treatment without the history of cervical conization in the same period were selected as control group. After 2 years of follow-up,pregnancy status,mode of delivery and perinatal outcomes were compard between groups. Results Compared with the control group,the rates of pregnancy and delivery decreased but the rate of infertility increased in the observation group（ P〈 0. 05）. In the observation group,5 patients（ 12. 5%） had tubal infertility,1 patient（ 2. 5%） had cervical adhesions infertility and 1 patient（ 2. 5%）had infertility caused by cervical stenosis. In the control group,2 patients（ 5. 0%） had tubal infertility.Compared with control group,normal birth rate reduced and cesarean section rate increased in the observation group（ P〈 0. 05）. Compared with control group,the incidence of premature rupture of membranes,premature birth rate,neonatal asphyxia rate and low birth weight rate were significantly higher in the observation group than those in the control group（ P〈 0. 05）. Conclusions LEEP knife conization surgery for patients with early stage cervical cancer had an influence on fertility. On the one hand,it reduces the pregnancy rate; on the other hand,it increases the incidence of premature rupture of membranes,premature birth,neonatal asphyxia and low birth weight. It should arouse the attention of clinicians.

关 键 词：宫颈肿瘤 宫颈环状电切术 锥切术 生育能力 妊娠结局 

分 类 号：R737.33[医药卫生—肿瘤]