[1]韩梅① 周旋 周罗绮 赖少阳 葛逸盟② 赵捷**②.环形电刀切除术后宫颈环扎对妊娠结局与阴道微生态的影响[J].中国微创外科杂志,2021,01(3):243-247.
　Han Mei,Zhou Xuan*,Zhou Luoqi*,et al.Effects of Cervical Cerclage on Pregnancy Outcome and Vaginal Microenvironment in Pregnant Women With History of Loop Electrosurgical Excision Procedure[J].Chinese Journal of Minimally Invasive Surgery,2021,01(3):243-247.
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环形电刀切除术后宫颈环扎对妊娠结局与阴道微生态的影响()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年3期
页码:
243-247
栏目:
临床研究
出版日期:
2021-04-01

文章信息/Info

Title:
Effects of Cervical Cerclage on Pregnancy Outcome and Vaginal Microenvironment in Pregnant Women With History of Loop Electrosurgical Excision Procedure
作者:
韩梅① 周旋 周罗绮 赖少阳 葛逸盟② 赵捷**②
（华中科技大学同济医学院附属同济医院妇产科，武汉430030）
Author(s):
Han Mei;  Zhou Xuan*;  Zhou Luoqi*;  et al.
*Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430030, China
关键词:
环形电刀切除术; 宫颈环扎术; 妊娠结局; 阴道微生态
Keywords:
Loop electrosurgical excision procedure; Cervical cerclage; Pregnancy outcomes; Vaginal microenvironment
文献标志码:
A
摘要:
目的探讨有环形电刀切除（loop electrosurgical excision procedure，LEEP）手术史的孕妇在孕期行宫颈环扎术后对妊娠结局及阴道内菌群的影响。方法回顾性单中心研究，43例有LEEP手术史孕期行宫颈环扎术作为LEEP组，67例无LEEP手术史孕期行宫颈环扎作为对照组，比较2组环扎术后至分娩时间、分娩孕周、分娩方式、新生儿体重及Apgar评分、阴道微生态Nugent评分、菌群密集度、菌群多样性、优势菌群及pH值情况。结果LEEP组环扎孕周明显短于对照组［16.0（14.4，18.6）周 vs. 18.9（15.4，23.7）周，Z=-2.712，P=0.007］，宫颈环扎术后至分娩时间中位数明显延长［128.0（81.0，159.0）d vs. 87.0（48.0，144.0）d，Z=-2.374，P=0.018］。2组孕妇流产、顺产及剖宫产3种妊娠结局差异无显著性（χ2=0319，P=0.852）。宫颈环扎术前LEEP组中阴道菌群优势菌为乳酸杆菌的孕妇比例明显少于对照组（24例vs. 50例，χ2=4210，P=0.040），但环扎术后Nugent评分≥7分患者明显减少（5 例vs. 22例， χ2=6.553，P=0.038）。对照组环扎术后pH值较术前明显好转（47例vs. 43例，配对χ2检验，P=0.009），优势菌群为乳酸杆菌的孕妇比例明显增多（50例vs. 49例，配对χ2检验，P=0.000）。结论既往有LEEP手术史的孕妇在孕期行宫颈环扎手术后可以明显改善阴道微生态，对妊娠结局无显著影响。
Abstract:
ObjectiveTo investigate the influence of cervical cerclageon on the pregnancy outcome and vaginal microenvironment in pregnant women with a history of loop electrosurgical excision procedure(LEEP) for cervical intraepithelial neoplasia.MethodsA retrospective singlecenter study was conducted on 43 pregnant women with a history of LEEP and cervical cerclage in pregnancy (LEEP group) and 67 pregnant women who took cervical cerclage during the same period without a history of LEEP treatment (control group). The interval between ligation to delivery, delivery gestational age, delivery pattern, neonatal weight,Apgar score, Nugent score, bacterial density, bacterial diversity, vaginal dominant bacterial and pH value between the two groups were compared.ResultsFor the LEEP group, the cerclage gestational week were statistically shorter than the control group ［16.0 (144, 18.6) weeks vs. 18.9 (15.4, 23.7) weeks, Z=-2.712, P=0.007］, and the interval between ligation to delivery were longer than the control group ［128.0 (81.0, 159.0) days vs. 87.0 (480, 144.0) days, Z=-2.374, P=0.018］. There were no differences in pregnancy outcome between the two groups in abortion, vaginal delivery and cesarean section (χ2=0.319, P=0.852). At the same time, lesser pregnant women in the LEEP group had lactobacillus as vaginal dominant bacteria before cervical cerclage compared with the control group (24 vs. 50, χ2=4.210, P=0.04), but lesser women had Nugent score ≥7 points after cervical cerclage (5 vs. 22, χ2=6.553, P=0.038). In the control group, there were more women with better pH value (47 vs. 43, P=0009) and more women with lactobacillus as vaginal dominant bacteria (50 vs. 49, P=0.000) after cervical cerclage.ConclusionThe vaginal microenvironment of pregnant women with previous LEEP treatment can be improved after cervical cerclage,but there is no significant effect on pregnancy outcome.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81871311)**通讯作者，Email:2358044941@qq.com ①(重庆大学附属肿瘤医院肿瘤转移与个体化诊治转化研究重庆市重点实验室，重庆400030) ②（北京大学第三医院生殖医学中心，北京100191）
更新日期/Last Update: 2021-06-09