宫腔镜下宫颈“图钉形”切除术对宫颈高级别鳞状上皮内病变患者妊娠结局的影响

doi:10.3760/cma.j.issn.1007-1245.2023.16.012

国际医药卫生导报 ›› 2023, Vol. 29 ›› Issue (16): 2273-2276.DOI: 10.3760/cma.j.issn.1007-1245.2023.16.012

宫腔镜下宫颈“图钉形”切除术对宫颈高级别鳞状上皮内病变患者妊娠结局的影响

刘锦¹ 王珍珍² 王卉¹ 徐晨¹ 岳庆玲¹

¹聊城市第三人民医院妇产科，聊城　252000；²聊城市第三人民医院药剂科，聊城　252000

收稿日期:2023-02-09 出版日期:2023-08-15 发布日期:2023-08-29
通讯作者: 刘锦，Email：jl15506350166@163.com
基金资助:
山东省自然科学基金（ZR2020MH316）

Effect of hysteroscopic cervical "thumbtack" resection on pregnancy outcomes in patients with high-grade cervical squamous intraepithelial lesions

Liu Jin¹, Wang Zhenzhen², Wang Hui¹, Xu Chen¹, Yue Qingling¹

¹Department of Gynecology and Obstetrics, Liaocheng Third People's Hospital, Liaocheng 252000, China; ²Department of Pharmacy, Liaocheng Third People's Hospital, Liaocheng 252000, China

Received:2023-02-09 Online:2023-08-15 Published:2023-08-29
Contact: Liu Jin, Email: jl15506350166@163.com
Supported by:
Shandong Natural Science Foundation (ZR2020MH316)

摘要/Abstract

摘要：

目的　探讨宫腔镜下宫颈“图钉形”切除术对宫颈高级别鳞状上皮内病变患者妊娠结局的影响。方法　选取2017年6月至2022年6月聊城市第三人民医院收治的宫颈高级别鳞状上皮内病变孕妇160例，按照手术方法分为观察组88例和常规组72例。观察组年龄（30.01±6.02）岁，孕周（36.11±0.93）周；常规组年龄（30.22±6.12）岁，孕周（36.25±0.96）周。观察组行宫腔镜下宫颈“图钉形”切除术，对照组行宫颈冷刀锥切术。分析两组围手术期苏醒指标；对比两组妊娠结局和新生儿结局。采用t检验和χ²检验。结果　观察组术后苏醒时间、自主呼吸恢复时间均短于常规组（均P<0.05）。观察组早产、羊水污染、产后出血、宫内感染、胎儿窘迫发生率均明显低于常规组（均P<0.05）。观察组新生儿窒息、肺炎、病理性黄疸、感染的发生率均明显低于常规组［2.27%（2/88）比16.67%（12/72）、2.27%（2/88）比19.44%（14/72）、2.27%（2/88）比18.06%（13/72）、4.55%（4/88）比19.44%（14/72），均P<0.05］。结论　宫腔镜下宫颈“图钉形”切除术治疗宫颈高级别鳞状上皮内病变患者可缩短患者术后苏醒时间、自主呼吸恢复时间，不会增加不良妊娠结局和新生儿不良结局的发生风险，值得推广。

关键词:

孕妇, 宫颈高级别鳞状上皮内病变, 新生儿不良结局, 宫颈冷刀锥切术, 妊娠结局

Abstract:

Objective　To investigate the effect of hysteroscopic cervical "thumbtack" resection on pregnancy outcomes in patients with high-grade cervical squamous intraepithelial lesions. Methods　One hundred and sixty pregnant women with high-grade cervical squamous intraepithelial lesions admitted to Liaocheng Third People's Hospital from June 2017 to June 2022 were selected. According to the surgical methods, they were divided into an observation group (88 cases) and a conventional group (72 cases). The observation group were (30.01±6.02) years old and (36.11±0.93) weeks pregnant. The conventional group were (30.22±6.12) years old and (36.25±0.96) weeks pregnant. The observation group took hysteroscopic cervical "thumbtack" resection. The conventional group took cervical cold-knife conical resection. The perioperative recovery indicators of the two groups were analyzed. The pregnancy and neonatal outcomes were compared between the two groups. t and χ² tests were applied. Results　The postoperative recovery time and spontaneous breathing recovery time of the observation group were shorter than those of the conventional group (both P<0.05). The incidences of preterm delivery, amniotic fluid contamination, postpartum hemorrhage, intrauterine infection, and fetal distress in the observation group were significantly lower than those in the conventional group (all P<0.05). The incidences of asphyxia, pneumonia, pathological jaundice, and infection in the neonates of the observation group were significantly lower than those in the conventional group [2.27% (2/88) vs. 16.67% (12/72), 2.27% (2/88) vs. 19.44% (14/72), 2.27% vs. (2/88) 18.06% (13/72), and 4.55% (4/88) vs. 19.44% (14/72); all P<0.05]. Conclusion　Hysteroscopic cervical "pushtack" resection in the treatment of high-grade cervical squamous intraepithelial lesions can shorten the postoperative recovery time and spontaneous respiratory recovery time, and does not increase the risk of adverse pregnancy and neonatal outcomes, so it is worthy of promotion.

Key words:

Pregnant women, High-grade cervical squamous intraepithelial lesions, Cervical cold-knife conical resection, Pregnancy outcomes

刘锦王珍珍王卉徐晨岳庆玲.

宫腔镜下宫颈“图钉形”切除术对宫颈高级别鳞状上皮内病变患者妊娠结局的影响 [J]. 国际医药卫生导报, 2023, 29(16): 2273-2276.

Liu Jin, Wang Zhenzhen, Wang Hui, Xu Chen, Yue Qingling.

Effect of hysteroscopic cervical "thumbtack" resection on pregnancy outcomes in patients with high-grade cervical squamous intraepithelial lesions [J]. International Medicine and Health Guidance News, 2023, 29(16): 2273-2276.

参考文献

[1] Lamagni T, Wloch C, Broughton K, et al. Assessing the added value of group B Streptococcus maternal immunisation in preventing maternal infection and fetal harm: population surveillance study [J]. BJOG, 2022, 129(2):233-240. DOI: 10.1111/1471-0528.16852.
[2] Schindler Y, Rahav G, Nissan I, et al. Group B Streptococcus serotypes associated with different clinical syndromes: asymptomatic carriage in pregnant women, intrauterine fetal death, and early onset disease in the newborn [J]. PLoS One, 2020, 15(12):e0244450. DOI: 10.1371/journal.pone.0244450.
[3] AlZuheiri STS, Dube R, Menezes G, et al. Clinical profile and outcome of group b streptococcal colonization in mothers and neonates in ras al khaimah, united arab emirates: a prospective observational study [J]. Saudi J Med Med Sci, 2021, 9(3):235-240. DOI: 10.4103/sjmms.sjmms_213_21.
[4] Gonçalves BP, Procter SR, Paul P, et al. Group B streptococcus infection during pregnancy and infancy: estimates of regional and global burden [J]. Lancet Glob Health, 2022, 10(6): e807-e819. DOI: 10.1016/S2214-109X(22)00093-6.
[5] Kadambari S, Trotter CL, Heath PT, et al. Group B streptococcal disease in England (1998 - 2017): a population-based observational study [J]. Clin Infect Dis, 2021, 72(11):e791-e798. DOI: 10.1093/cid/ciaa1485.
[6] Tano S, Ueno T, Mayama M, et al. Relationship between vaginal group B streptococcus colonization in the early stage of pregnancy and preterm birth: a retrospective cohort study [J]. BMC Pregnancy Childbirth, 2021, 21(1):141. DOI: 10.1186/s12884-021-03624-9.
[7] Naumkina EVE, Kravchenko EN, Kuklina LV. Experience in the diagnosis of group B Streptococcus infections in pregnant women and newborns in a perinatal center [J]. Klin Lab Diagn, 2021, 66(12):755-759. DOI: 10.51620/0869-2084-2021-66-12-755-759.
[8] Khalil MR, Uldbjerg N, Thorsen PB, et al. Improvement of selection of pregnant women for intrapartum polymerase chain reaction screening for vaginal group B Streptococci (GBS) colonization by adding GBS urine screening at 35-37 weeks of pregnancy [J]. Int J Gynaecol Obstet, 2020, 151(1): 124-127. DOI: 10.1002/ijgo.13267.
[9] 中华医学会妇产科学分会感染性疾病协作组. 宫颈高级别鳞状上皮内病变专家共识[J]. 中华妇产科杂志, 2016, 51(10):721-723.
[10] Chiarot E, Spagnuolo A, Maccari S, et al. Protective effect of group B Streptococcus type-Ⅲ polysaccharide conjugates against maternal colonization, ascending infection and neonatal transmission in rodent models [J]. Sci Rep, 2018, 8(1):2593. DOI: 10.1038/s41598-018- 20609-5.
[11] Cho CY, Tang YH, Chen YH, et al. Group B Streptococcal infection in neonates and colonization in pregnant women: an epidemiological retrospective analysis [J]. J Microbiol Immunol Infect, 2019, 52(2): 265-272. DOI: 10.1016/j.jmii.2017.08.004.
[12] Yao Z, Jiayin W, Xinyi Z, et al. Identification of group B streptococcus serotypes and genotypes in late pregnant women and neonates that are associated with neonatal early-onset infection in a south China population [J]. Front Pediatr, 2020, 8: 265. DOI: 10.3389/fped. 2020.00265.
[13] Haimbodi EL, Mukesi M, Moyo SR. Prevalence and molecular characterization of group B streptococcus in pregnant women from hospitals in Ohangwena and Oshikoto regions of Namibia [J]. BMC Microbiol, 2021, 21(1):224. DOI: 10.1186/s12866-021-02283-2.
[14] Hasperhoven GF, Al-Nasiry S, Bekker V, et al. Universal screening versus risk-based protocols for antibiotic prophylaxis during childbirth to prevent early-onset group B streptococcal disease: a systematic review and meta-analysis [J]. BJOG, 2020, 127(6): 680-691. DOI: 10.1111/1471-0528.16085.
[15] Sama LF, Noubom M, Kenne C, et al. Group B Streptococcus colonisation, prevalence, associated risk factors and antimicrobial susceptibility pattern among pregnant women attending antenatal care at Dschang District Hospital, West Region of Cameroon: a hospital-based cross-sectional study [J]. Int J Clin Pract, 2021, 75(10): e14683. DOI: 10.1111/ijcp.14683.
[16] Carreras-Abad C, To KN, Ramkhelawon L, et al. Detection of group B streptococcus colonisation in pregnant women: comparison of two different culture methods and study of antimicrobial resistance patterns [J]. J Infect, 2021, 82(5):186-230. DOI: 10.1016/j.jinf.2021.01.001.
[17] Yadeta TA, Worku A, Egata G, et al. Maternal group B Streptococcus recto vaginal colonization increases the odds of stillbirth: evidence from Eastern Ethiopia [J]. BMC Pregnancy Childbirth, 2018, 18(1): 410. DOI: 10.1186/s12884-018-2044-2.
[18] de Gier B, van Kassel MN, Sanders EAM, et al. Disease burden of neonatal invasive Group B Streptococcus infection in the Netherlands [J]. PLoS One, 2019, 14(5):e0216749. DOI: 10.1371/journal.pone.0216749.
[19] Absalon J, Segall N, Block SL, et al. Safety and immunogenicity of a novel hexavalent group B streptococcus conjugate vaccine in healthy, non-pregnant adults: a phase 1/2, randomised, placebo-controlled, observer-blinded, dose-escalation trial [J]. Lancet Infect Dis, 2021, 21(2): 263-274. DOI: 10.1016/S1473-3099(20)30478-3.

宫腔镜下宫颈“图钉形”切除术对宫颈高级别鳞状上皮内病变患者妊娠结局的影响

Effect of hysteroscopic cervical "thumbtack" resection on pregnancy outcomes in patients with high-grade cervical squamous intraepithelial lesions

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 9

编辑推荐

Metrics

[1]	张利敏. 卡前列素氨丁三醇对凶险性前置胎盘的治疗效果及对妊娠结局的影响 [J]. 国际医药卫生导报, 2023, 29(9): 1253-1257.
[2]	张亚南李亚丽. 孕期营养与体质量管理在孕产妇保健中的效果及对新生儿妊娠结局的影响 [J]. 国际医药卫生导报, 2023, 29(8): 1175-1179.
[3]	马传燕张桥韩海霞李晶张健. 不同硬膜外自控镇痛方法对无痛分娩产妇妊娠结局的影响 [J]. 国际医药卫生导报, 2023, 29(5): 647-651.
[4]	丛晓庆刘晓赵娟唐晓华王晶莉. 大剂量维生素D联合胰岛素泵持续注射对妊娠期糖尿病患者血糖水平及妊娠结局的影响 [J]. 国际医药卫生导报, 2023, 29(4): 501-505.
[5]	邵帅门贵香孙菊香洪善玲任国华. 拉贝洛尔联合酚妥拉明对妊娠期高血压患者的疗效 [J]. 国际医药卫生导报, 2023, 29(3): 377-380.
[6]	赖晓端陈志雄陈少虹. 妊娠中期妇女甲状腺功能与妊娠结局的临床研究[J]. 国际医药卫生导报, 2022, 28(23): 3304-.
[7]	程玲. 男方年龄对冻融胚胎移植周期妊娠结局的影响[J]. 国际医药卫生导报, 2022, 28(21): 2985-2989.
[8]	冯世香　汪云　董小利. 妊娠合并TTP 1例报道并文献复习[J]. 国际医药卫生导报, 2022, 28(13): 1888-1892.
[9]	冯云倩, 霍艳, 王爽. 琥珀酸氢化可的松联合腺苷蛋氨酸对妊娠期肝内胆汁淤积症患者肝功能及妊娠结局的影响[J]. 国际医药卫生导报, 2021, 27(6): 799-801.