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

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