子宫颈锥切术后妊娠早产的高危因素分析  

High Risk Factors of Preterm Birth after Cervical Conization: A Retrospective Cohort Study

作　　者：尹婕[1] 宋英娜[1] YIN Jie;SONG Yingna(Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院,北京100730

出　　处：《实用妇产科杂志》2018年第9期678-682,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:通过单中心数据分析子宫颈锥切术对早产的影响以及其引起早产的高危因素。方法:收集我院产科2007~2017年分娩的无明显妊娠合并症和并发症且既往有子宫颈锥切术史患者(锥切组)的临床资料,随机选择同期分娩正常人群为对照组,回顾性队列分析两组早产率差异。129例患者中有67例患者能够获得完整的锥切病理资料,并进一步进行单因素回归分析该67例锥切患者引起早产的高危因素。结果:研究纳入129例孕前接受过子宫颈锥切术的孕妇,与对照组相比,两组在年龄、吸烟、不良孕产史、产次等方面比较差异无统计学意义(P>0.05),但锥切组早产率显著升高(13.2%vs 5.2%)(P=0.000)。67例锥切患者中锥切深度>15 mm患者早产率为20.0%(8/40),而锥切深度≤15 mm早产率为3.7%(1/27)(P=0.055);子宫颈上皮内瘤变Ⅲ(CINⅢ)患者早产率25.7%(9/35),而CINⅠ和CINⅡ患者早产率为0%(0/32)(P=0.008)。Logistic单因素回归分析发现,CINⅢ是锥切手术引起早产的高危因素(P=0.006)。结论:子宫颈锥切手术后妊娠早产发生的风险显著增加,CINⅢ是锥切手术引起早产的危险因素。Objective： According to data from single-center,the effect of cervical conization to preterm birth and high risk factors were detected. Methods： Women who had cervical conization history and delivered after cervical operation during 2007 to 2017 were collected.These women did not suffer from any other severe medical diseases.Normal women delivered at the same time were chosen as control.Based on retrospective cohort analysis,preterm birth rate was compared.Besides,SPSS software was used to complete and single factor regression analysis.Results： Totally 129 women were collected,compared with control group,there were no significant differences amongage,smoke,history of bad pregnancy and childbirth,complication of pregnancy（ P〉0. 05）. Preterm birth rate（ 13. 2% vs 5. 2%） increased significantly in cervical conization group（ P = 0. 000）.Pathological details of 67 in129 patients were recorded.The preterm rate in depth of excisional treatment over 15 mm group was 20. 0%（ 8/40）,while only 3. 7%（ 1/27） in ≤15 mm group（ P = 0. 055）.Besides,25. 7%（ 9/35） of CINⅢ patients occurred preterm birth,but none of CINⅠ and CINⅡ patients（ P = 0. 008）.Logistic analysis found that CINⅢ was a high risk factor for premature birth due to cervical conization（ P = 0. 006）.Conclusions： The risk of preterm birth increased after cervical conization,and CINⅢ was the high risk factor of preterm birth.

关 键 词：子宫颈锥切 早产 子宫颈上皮内瘤变 锥切深度 

分 类 号：R713.4[医药卫生—妇产科学]