Impact of LEEP on the pregnancy outcomes for CINIII patients
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摘要:
目的 探究LEEP刀技术对宫颈上皮内瘤变(CIN)Ⅲ患者妊娠结局的影响。 方法 研究对象为2014年6月~2015年6月收入的CINⅢ患者,采用LEEP手术治疗,1年后怀孕的80例患者为观察组,与80例正常孕妇(对照组)进行比较,分析两组患者妊娠及胎儿并发症情况、分娩方式、胎儿情况。 结果 观察组在妊娠糖尿病、胎儿窘迫、子痫前期、羊水量异常发生率上与对照组相比差异无统计学意义(P>0.05);对照组妊娠成功率高于观察组(100%vs 83.57%,P<0.05),观察组胎膜早破(13.43%vs 2.50%)、宫颈裂伤(10.45% vs 1.25%)发生率高于对照组(P<0.05);在妊娠分娩方式上,观察组早产、顺产、剖宫产发生率与对照组相比差异无统计学意义(P>0.05),观察组平均体质量比对照组低(P<0.05),低体质量儿发生率高于对照组(14.93%vs 5.00%,P<0.05)。 结论 宫颈CINⅢ患者采用LEEP手术治疗后,患者保留生育能力,妊娠时胎膜早破、宫颈裂伤发生率较高,且低体质量胎儿发生率较高,临床应密切关注此类妊娠患者,并给予针对性干预。 Abstract:Objective To explore the impact of loop electrosurgical excision procedure (LEEP) on the pregnancy outcomes of cervical intraepithelial neoplasm (CIN) III patients.. Method 80 pregnant women one year after receiving LEEP because of CIN III from June 2014 to June 2015 in our hospital were selected as the observation group, while 80 normal pregnant women were selected as the control group. The incidence rate of pregnancy and fetal complications, delivery modes and fetal conditions were observed and compared. Result The incidence rates of gestational diabetes, fetal distress, preeclampsia and amniotic fluid volume abnormality of the observation group (2.99%, 1.49%, 4.48%, 2.99%) and control group (2.50%, 1.25%, 2.50%, 2.50%) were not significantly different(P>0.05); the successful pregnancy rate of control group (100%) was significantly higher than that of observation group (83.75%)(P<0.05);the incidence rates of premature rupture of membrane and cervical laceration of observation group (13.43%, 10.45%) were significantly higher than that of control group (2.50%, 1.25%) (P<0.05); the incident rates of premature delivery, natural labor and Cesarean section of observation group (7.46%, 40.30%, 52.24%) and control group (5.00%; 50.00%; 45.00%) were not significantly different (P>0.05); the average body weight of observation group was lower than that of control group (P<0.05); the incidence rate of low birth weight of observation group (14.93%) was significantly higher than control group (5.00%)(P<0.05). Conclusion CIN III patients still preserve reproductive potency after the LEEP. However, the incidence rates of premature rupture of membrane, cervical laceration and low birth weight newborn are higher. Therefore, close concern should be paid on the patient’s condition and specific nursing interventions should be taken. -
Key words:
- LEEP /
- CIN III /
- clinical effect /
- pregnancy outcome
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表 1 两组妊娠及胎儿并发症情况[n=80,n(%)]
组别 妊娠成功率 妊娠糖尿病 胎儿窘迫 子痫前期 胎膜早破 羊水量异常 宫颈裂伤 观察组 67(83.75) 2(2.99) 1(1.49) 3(4.48) 9(13.43) 2(2.99) 7(10.45) 对照组 80(100) 2(2.50) 1(1.25) 2(2.50) 2(2.50) 2(2.50) 1(1.25) χ2 17.687 0.045 0.021 0.582 8.150 0.045 7.684 P 0.000 0.832 0.884 0.446 0.004 0.832 0.006 表 2 两组分娩方式比较(n,%)
组别 早产 顺产 剖宫产 观察组(n=67) 5(7.46) 27(40.30) 35(52.24) 对照组(n=80) 4(5.00) 40(50.00) 36(45.00) χ2 0.529 1.900 1.049 P 0.467 0.168 0.306 表 3 对比两组胎儿情况(n,%)
组别 体质量 低体质量儿 观察组(n=67) 2973.53±295.77 10(14.93) 对照组(n=80) 3289.87±328.69 4(5.00) t/χ2 –6.081 5.495 P 0.000 0.019 -
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