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目的探讨宫颈环状电切术(LEEP)对早期宫颈癌患者生育能力和妊娠率的影响。方法选取2013年6月至2015年6月间临朐县人民医院收治的40例早期宫颈实施宫颈锥切术患者为观察组,另选取同期门诊收治的40例无宫颈锥切术史计划的妇女为对照组。随访2年,对比两组产妇的妊娠情况、分娩方式、围生儿结局。结果与对照组比较,观察组患者的妊娠率和分娩率降低,不孕率提高,差异均有统计学意义(均P<0.05)。观察组患者中,输卵管性不孕5例(12.5%),宫颈粘连不孕1例(2.5%),宫颈管狭窄不孕1例(2.5%)。对照组中输卵管性不孕2例(5.0%)。与对照组比较,观察组患者的平产率降低,剖宫产率升高,差异均有统计学意义(均P<0.05)。与对照组比较,观察组患者的胎膜早破发生率、早产率、新生儿窒息率和新生儿低体重率明显升高,差异均有统计学意义(均P<0.05)。结论采用LEEP刀锥切术对早期宫颈癌患者的生育能力可造成一定的影响,一方面降低了妊娠率,另一方面提高了胎膜早破、早产、新生儿窒息和新生儿低体重发生率,应引起临床医师的重视。
Objective To investigate the effect of cervical ring resection (LEEP) on fertility and pregnancy rate in patients with early cervical cancer. Methods From June 2013 to June 2015, 40 patients undergoing cervical conization for early cervix in Linli County People’s Hospital were selected as the observation group. Another 40 patients without cervical conization in the same period were enrolled in the study Control group. Followed up for 2 years, compared the two groups of maternal pregnancy, mode of delivery, perinatal outcome. Results Compared with the control group, the pregnancy rate and delivery rate of the observation group decreased and the rate of infertility increased. The differences were statistically significant (all P <0.05). Among the observation group, 5 cases (12.5%) had tubal infertility, 1 case (2.5%) had cervical adhesions and 1 case (2.5%) had cervical stenosis and infertility. Two cases of tubal infertility in the control group (5.0%). Compared with the control group, the patients in the observation group had lower rates of cesarean section and cesarean section rate (all P <0.05). Compared with the control group, the incidence of premature rupture of membranes, premature birth rate, neonatal asphyxia rate and neonatal low weight rate in observation group were significantly increased (all P <0.05). Conclusion LEEP knife conization can have an impact on the fertility of patients with early cervical cancer. On the one hand, it can reduce the pregnancy rate, and on the other hand, it can increase the incidence of premature rupture of membranes, premature birth, neonatal asphyxia and low birth weight , Should attract the attention of clinicians.