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目的:研究不同时机行第2次宫颈电环锥切术(LEEP)对手术出血、残留/复发及妊娠结局的影响。方法:选择行LEEP术后切缘阳性需行第2次手术且有生育要求的CIN患者共288例,根据第2次LEEP术的间隔时间将其分为观察组(间隔3天)和对照组(间隔3个月),比较两组患者第2次LEEP术的手术时间、出血量及预后。结果:两组患者第2次LEEP手术时间、术后残留/复发、自然受孕率、不良妊娠事件发生率差异均无统计学意义(P>0.05),观察组第2次LEEP术出血量(14.79±4.47)ml较对照组(9.51±2.69)ml多,但观察组剖宫产率9.52%较对照组25.34%有明显下降。结论:对于需行二次LEEP手术的CIN患者,3天后行第2次手术并不增加术后残留、复发等不良结局,同时也不增加不良妊娠事件的发生,并且可以明显地降低剖宫产率。
Objective: To study the effect of LEEP on the operation bleeding, residual / recurrence and pregnancy outcome at different time points. METHODS: A total of 288 CIN patients who underwent LEEP surgery for the second time and had reproductive requirements were selected and divided into observation group (interval 3 days) and control group according to the interval of the second LEEP operation (Interval 3 months). The operative time, bleeding amount and prognosis of the second LEEP operation were compared between the two groups. Results: There was no significant difference in LEEP operation time, postoperative residual / recurrence rate, spontaneous conception rate and incidence of adverse pregnancy between the two groups (P> 0.05). The LEEP amount of bleeding in the observation group was 14.79 ± 4.47) ml more than the control group (9.51 ± 2.69) ml, but the observation group, the rate of cesarean section 9.52% compared with the control group 25.34% decreased significantly. Conclusions: For CIN patients undergoing second LEEP surgery, the second operation after 3 days does not increase the postoperative residual, recurrence and other adverse outcomes, but also does not increase the incidence of adverse pregnancy events, and can significantly reduce the cesarean section rate.