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目的:总结妊娠妇女宫颈筛查及产后随访情况。方法:2013年6月~2014年6月间共2118例孕妇于我院行正规产检与分娩,选择其中孕前半年没有接受液基细胞学(TCT)检查,孕早期或中期接受检查,对结果异常者实施病理学、阴道镜或HPV检查,分析结果,于产后1年进行随访,观察转归情况。结果:细胞学筛查结果显示为ASCUS或以上者76例,占3.7%,包括ASCUS 61例,LSIL 5例,HSIL 10例;接受HPV检查者48例,阳性率为72.9%;接受阴道镜检查者35例,行病理活检21例,结果显示CINⅠ4例,CINⅡ2例,CINⅢ10例,炎症/湿疣变10例,CIN患者占0.76%。产后细胞学转阴率达81.6%;28例妊娠期HPV检查呈阳性者复查时转为阴性者22例,孕期与产后的HPV检查结果差异显著,有统计学意义(P<0.05);仍为CIN者7例,没有发生早期浸润癌。结论:妊娠妇女的宫颈细胞学异常与HPV感染在产后大多会转阴。对于CIN患者需要在妊娠期与产后进行密切随访,及时给予治疗,避免出现浸润癌。
Objective: To summarize the cervical screening and postpartum follow-up of pregnant women. Methods: Between June 2013 and June 2014, a total of 2118 pregnant women underwent regular childbirth and delivery in our hospital. The first half of pregnancy did not receive liquid-based cytology (TCT) and the second trimester was pregnant or early. The results were abnormal The implementation of pathology, colposcopy or HPV examination, analysis of results, 1 year postpartum were followed up to observe the outcome. Results: The results of cytological screening showed ASCUS or more in 76 cases (3.7%), including ASCUS in 61 cases, LSIL in 5 cases and HSIL in 10 cases. The HPV test was performed in 48 cases with a positive rate of 72.9%. Colposcopy was performed 35 cases of pathological biopsy in 21 cases, the results showed CIN Ⅰ 4 cases, CIN Ⅱ 2 cases, CIN Ⅲ 10 cases, inflammatory / genital warts in 10 cases, CIN patients accounted for 0.76%. The negative rate of postpartum cytology was 81.6%. Twenty-eight HPV positive cases in pregnancy were negative in 22 cases. There was significant difference in HPV test results between pregnancy and postpartum (P <0.05) CIN in 7 cases, no early invasive carcinoma. Conclusion: Cervical cytology and HPV infection in pregnant women are mostly negative after delivery. CIN patients need close follow-up during pregnancy and postpartum, timely treatment, to avoid invasive cancer.