解放军医学院学报2024，Vol.45Issue(2)：142-145,168,5.DOI:10.12435/j.issn.2095-5227.2023.152
宫颈锥切术对患者妊娠结局的影响及不良妊娠结局危险因素分析
Pregnancy outcomes and associated factors of patients undergoing cervical conization
解冰 1叶明侠 2彭红梅 2肖莹 2白者乔 2马韵之 2黄楚菁 2李立安2
作者信息
- 1. 南开大学医学院,天津 300071||解放军总医院第一医学中心妇产科,北京 100853
- 2. 解放军总医院第一医学中心妇产科,北京 100853
- 折叠
摘要
Abstract
Background The need for pregnancy in patients with high grade squamous intraepithelial lesion after conization is increasing year by year,while there is no clinical consensus on the treatment and postoperative management of patients with fertility needs.Objective To study the effect of conization of cervix on pregnancy outcomes in patients with high grade squamous intraepithelial lesion and analyze the risk factors for adverse pregnancy outcomes(preterm birth,cesarean section,low birth weight).Methods A retrospective analysis was performed on 65 patients who underwent conization of cervix in the First Medical Center of Chinese PLA General Hospital from September 1,2017 to December 31,2021,and the patients were served as the observation group.Another 65 patients who gave birth at the Obstetrics Department of Chinese PLA General Hospital during the same period were collected as the control group.The general information(age,height,weight)and pregnancy outcome(preterm birth,mode of delivery)of the observation group and the control group were compared.The observation group was divided into two groups based on whether the conization height(pathological results)was greater than 1.5 cm.The general data and the pregnancy outcomes such as premature birth and cesarean section rate of the two groups were compared,and the factors associated with adverse pregnancy outcomes after conization were explored.Results The rate of preterm pregnancy after cervical conization was changed(P＜0.05).There was no significant difference in the rate of cesarean section and the incidence of premature birth when the height of conization was greater than 1.5 cm(P＞0.05).Conization height greater than 1.5 cm was associated with adverse pregnancy outcomes after cervical conization(OR=3.868,95%CI:1.256-11.918).Conclusion The preterm birth rate of pregnancy increases after electrosurgical coning of cervix.For patients with fertility requirements,the height of conization should not exceed 1.5 cm under the premise of removing the lesion,and pregnancy should be reserved after half a year of surgery.Strict monitoring of the pregnancy process and necessary cervical cerclage can avoid adverse pregnancy events.关键词
宫颈高级别鳞状上皮内病变/宫颈锥切术/早产/妊娠结局/剖宫产Key words
high grade squamous intraepithelial lesion/cervical conization/preterm birth/pregnancy outcome/cesarean section分类
医药卫生引用本文复制引用
解冰,叶明侠,彭红梅,肖莹,白者乔,马韵之,黄楚菁,李立安..宫颈锥切术对患者妊娠结局的影响及不良妊娠结局危险因素分析[J].解放军医学院学报,2024,45(2):142-145,168,5.
