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目的探讨育龄妇女宫颈上皮内瘤变(cervical intraepithelial neoplasias,CIN)行宫颈环形电切除术(loop electrosurgical excision procedure,LEEP)术后对生育能力及妊娠结局的影响。方法选取2010年6月至2012年6月在肇庆市端州区妇幼保健院因CIN行LEEP的育龄妇女118例(CINⅠ29例,CINⅡ64例,CINⅢ25例)中于2013年6月前正常妊娠的育龄妇女107例作为观察组。选取同期在本院住院分娩的健康孕妇121例作为对照组。比较两组的分娩方式及妊娠结局。结果 (1)观察组术后妊娠率90.68%,与普通人群妊娠率(93%)比较,差异无统计学意义(P>0.05)。(2)观察组剖宫产率高于对照组(P<0.05);两组非社会因素剖宫产率比较差异无统计学意义(P>0.05)。(3)两组流产的发生率比较差异无统计学意义(P>0.05);观察组早产、胎膜早破的发生率高于对照组(P<0.05);观察组新生儿出生体重低于对照组(P<0.05)。(4)观察组CINⅠ、CINⅡ、CINⅢ患者流产率比较,差异无统计学意义(P>0.05)。CINⅢ组术后早产率、胎膜早破发生率、新生儿低体重发生率均高于CINⅠ组和CINⅡ组(P<0.05);而CINⅠ组和CINⅡ组术后流产率、早产率、胎膜早破发生率、新生儿低体重发生率相比较,差异无统计学意义(P>0.05)。结论 CIN患者行LEEP术只要严格控制好切除范围,对患者妊娠能力无影响,亦不影响分娩方式。CINⅢ患者术后早产率、胎膜早破发生率、新生儿低体重发生率均明显高于CINⅠ和CINⅡ患者。
Objective To investigate the effects of cervical intraepithelial neoplasias (CIN) on fertility and pregnancy outcome after operation of loop electrosurgical excision procedure (LEEP). Methods From June 2010 to June 2012, 118 pregnant women of childbearing age (CINⅠ29 cases, CINⅡ64 cases, CINⅢ25 cases) in CEPEP from June 2010 to June 2012 in Duanzhou District Maternal and Child Health Care Hospital of Zhaoqing City were enrolled in this study. 107 women as observation group. Select the same period in hospital hospital delivery of healthy pregnant women 121 cases as a control group. The mode of delivery and pregnancy outcome were compared between the two groups. Results (1) The pregnancy rate of the observation group was 90.68%, which was not significantly different from that of the general population (93%) (P> 0.05). (2) The cesarean section rate in observation group was higher than that in control group (P <0.05). There was no significant difference in cesarean section rate between the two groups (P> 0.05). (3) There was no significant difference in the incidence of miscarriage between the two groups (P> 0.05). The incidence of premature labor and premature rupture of membranes in the observation group was higher than that in the control group (P <0.05) Control group (P <0.05). (4) There was no significant difference in the miscarriage rate between observation group CINⅠ, CINⅡ and CINⅢ (P> 0.05). The incidence of preterm birth, premature rupture of membranes and low birth weight in newborns in CINⅢ group were significantly higher than those in CINⅠand CINⅡgroups (P <0.05), while the rates of abortion, preterm birth, fetal membranes There was no significant difference in the incidence of premature rupture and low birth weight (P> 0.05). Conclusion As long as the LEEP technique is performed in CIN patients, the extent of resection should be controlled strictly and the pregnancy ability of the patients should not be affected, and the mode of delivery should not be affected. Postoperative preterm birth rate, premature rupture of membranes and low birth weight in neonates with CINⅢ were significantly higher than those in patients with CINⅠ and CINⅡ.