| Cervical cancer is the most common gynecological malignancy.In recent years,due to the widespread use of cervical cytology screening,cervical cancer and precancerous lesions have been detected and treated inearly stages.Cervical intraepithelial neoplasia(CIN)reflects the continuous process of cervical cancer development,itis a significant measure to prevent cervical cancer in time to treat high-grade lesions,can effectively reduce the incidence and mortality of cervical invasive cancer,and can keep the fertility of young patients.Cervical ring electrotomy(LEEP)and cold knife conization(CKC)are commonly used for patients of CINII and CINIII.LEEP knife technology uses a series of ring-type tungsten wire electrodes to treat various cervical lesions.It is an advanced operationto treating cervical diseasescurrently.Cervical conization is a section of cervical tissue cut from the outer to the inside in a conical shape.On the one hand,it is a practice of pathological examination,to diagnose the lesion of the cervix;on the other hand,it is also a treatment for resection of the lesion.Cervical anatomical changes after conization may cause somedysfunction.For example,excessive cervical resection leads to insufficient cervical function.Influencesperms passage and infertility.Scar formation affects cervical dilatation and increases cesarean section rate.Whether these factors affect the outcome of postoperative pregnancy is still controversial.In this paper,we collected the clinical data of young patients with CINII-III who had birth requirements in xx hospital,and conducted a clinical cohort control study to investigate the effects of LEEP and CKC on pregnancy outcomes after cervical lesions,In order to provide a surgical referenceto handle high-level CIN for doctors.Research PurposesAnalysis of the effects of high frequency electric wave knife(LEEP)and cold knife cervical conization(CKC)on pregnancy outcomeResearch methodFrom January 1,2008 to January 01,2016,the patients diagnosed of CINII-?was treated with cervical conization at xxhospital,and after treatment for more than 6 months,there was no recurrence after at least 1 year of follow-up,and 71 patients met the criteria,set these patients were experimental group;the healthy women who had the fertility requirements before the pregnancy in the xx hospital clinic were selected as the control group according to the sameamountlocal contemporaneouscollection(age,height,menstruation,etc.).The general clinical data of the patients were collected by reviewing the information of patients and telephone them the follow-up,and the coincidence rate of LEEP and CKCwith colposcopy biopsy and the effect on pregnancy outcomeResearch Result(1)71 cases of conical group,including 30 cases of CINII and 41 cases of CINIII.The postoperative pathological results were 26 cases of CINII,the coincidence rate with colposcopy biopsy was 86.67%;39 cases of CINIII,the coincidence rate with colposcopy biopsy was 95.12%,and the overall coincidence rate was 91.55%;(2)In 36 cases of LEEP group,32 cases werepregnantedafter operative,pregnancy rate was 88.9%;in 35 cases of CKC group,32 cases were pregnanted,pregnancy rate was 91.4%;in control group,65 cases werepregnanted,pregnancy rate was 91.5%.There was no significant difference in pregnancy rates between the three groups(P>0.05);(3)Patients in the LEEP group,5 had early abortion and 2 were late abortion;patients in the CKC group had early abortion were 5 and late abortion were 3,in control group 1 case had early abortion,and late abortion were 4.As for early abortion,LEEP group and control group has significant different(P<0.05),CKC group and control group hassignificant different(P<0.05),but there was no statistical difference between LEEP group and CKC group;for late abortion,three groups has no statistical difference between the two;(4)Patients in the LEEP group had 2 premature births,2 cases of premature rupture of membranes,3 cases of low birth weight infants,1 case of neonatal asphyxia,the same situations happened in CKC group were 8 cases,9 cases,9 cases,4 cases respectively;and in control group,there were 3 cases,4 cases,4 cases,1 case respectively.There was no significant difference in preterm birth and premature rupture of membranes between LEEP group and control group(P>0.05),while low birth weight infants and neonatal asphyxia has statistically significant.(P<0.05),CKC compared with the control group,premature delivery,premature rupture of membranes,low birth weight infants and neonatal asphyxia were statistically significant(P<0.05);LEEP group compared with CKC group,premature delivery,fetal Premature rupture of membrane,low birth weight infants and neonatal asphyxia has statistically significant(P<0.05);(5)In LEEP group 4 patients selected cesarean section,12 patients in the CKC group,and 10 patients in the control group.The cesarean section rates of the three groups were 16%,52%,and 16%,respectively.There was no significant difference between the LEEP group and the control group(P>0.05),CKC group was significantly different from the control group and LEEP group(P<0.05);(6)Repeated measures analysis of variance of cervical length changes showed that there has no significant difference in cervical length between the three groups(F=1.44,P=0.24>0.05).Multivariate analysis of variance showed the results of cervical length in three groups of different time periods:there has no significant difference in cervical length between different measurement time points(P>0.05).(7)Set 12 months as a line after operation,the interval between the gestation and operation plays an important role in the abortion,premature delivery,premature rupture of membranes,low birth weight infants and neonatal asphyxia,and the differences has statistically significant.Conclusion1.The pregnancy rate of patients after conization is similar to normal women,but it is easy to cause poor pregnancy outcomes such as abortion,premature delivery,premature rupture of membranes,low birth weight infants,neonatal asphyxia;2.There was no significant change in early abortion and late abortion rate in the LEEP group compared with the CKC group.3.Compared with CKC,the LEEP group had less premature birth,premature rupture of membranes,low birth weight infants and neonatal asphyxia;4.Compared with CKC,LEEP has a significantly lower cesarean section rate;5.Compared with CKC,there was no significant change in cervical length at different time points after LEEP.6.Time to pregnancy interval after operation less than or equal to 12 months pregnancy has a greater impact on abortion,premature delivery,premature rupture of membranes,low birth weight infants,neonatal asphyxia. |
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