宫颈锥切术后不良妊娠结局与相关因素的研究进展  

Research Progress in Adverse Pregnancy Outcome and Related Factors after Cervical Conization

作　　者：杨帆 代荫梅[1] YANG Fan;DAI Yinmei(Department of Gynecologic Oncology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Beijing Maternal and Child Health Care Hosptial,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院妇瘤科,北京100026

出　　处：《医学综述》2021年第23期4684-4689,共6页Medical Recapitulate

基　　金：北京市科技计划课题(Z161100000116065)。

摘　　要：宫颈锥切术是治疗宫颈病变的常用方法。宫颈锥切术与术后不良妊娠结局的发生有一定关系,目前研究较多的不良妊娠结局有早产、流产、未足月胎膜早破、低出生体重儿等。宫颈锥切范围过大会导致术后不良妊娠结局的发生,但也需在保证宫颈功能的同时切除全部病变组织。手术后妊娠间隔时间过短可明显增加不良妊娠结局的发生率,锥切术后需严格避孕一段时间后再受孕,但具体避孕时间目前尚无定论,仍需进一步研究。锥切次数过多也是术后不良妊娠结局的可能危险因素,但因病例数限制,影响并不明显。深入研究宫颈锥切术后不良妊娠结局的影响因素有助于降低早产率、流产率等,进而改善妊娠结局。Cervical conization is a common method to treat cervical lesions.There is a certain relationship between cervical conization and postoperative adverse pregnancy outcomes.The adverse pregnancy outcomes that are currently more studied include premature delivery,abortion,premature rupture of membranes before term,low birth weight and so on.Excessive scope of cervical conization will lead to adverse pregnancy outcomes after operation,while it is necessary to ensure the removal of all pathological tissues with the premise of preserving the cervical function.Pregnancy with too short post-operative interval will significantly increase the incidence of adverse pregnancy outcomes,so after coning surgery,pregnancy should be strictly controlled for a period of time before conception,although there is no consensus on the specific time of contraception so far,and further study is still needed.Excessive number of conization is also a possible risk factor for postoperative adverse pregnancy outcomes,but the effect is not significant due to the number of cases.In-depth study of the factors affecting adverse pregnancy outcomes after cervical conization can help to reduce the preterm birth rates and miscarriage rates,thereby improving the pregnancy outcomes.

关 键 词：宫颈上皮内瘤变 宫颈锥切术 不良妊娠结局 影响因素 

分 类 号：R713.44[医药卫生—妇产科学]