线圈套扎治疗妊娠早期合并宫颈息肉出血的效果观察(1)
[摘要]目的 观察线圈套扎治疗妊娠早期合并宫颈息肉出血的效果，探讨其临床价值。方法 选取2013年1月～2016年12月我院收治的63例妊娠早期合并宫颈息肉出血患者的诊治资料进行回顾性分析，根据治疗方式不同将其分为治疗组(32例)和对照组(31例)。治疗组患者行宫颈息肉线圈套扎治疗，对照组患者行药物保守治疗。比较两组患者的阴道流血时间、再发阴道流血率以及流产率。结果 治疗组患者的阴道流血时间短于对照组，再发阴道流血率低于对照组，差异有统计学意义(P<0.05)。两组患者的流产率比较，差异无统计学意义(P>0.05)。治疗组患者套扎术中切除的病理标本均提示良性息肉病变。结论 线圈套扎治疗妊娠早期有出血表现的宫颈息肉，方法安全、可行，且有病理排除恶性病变，很好缓解患者心理压力，有效改善妊娠体验，值得推广。
[关键词]线圈套扎；妊娠早期；宫颈息肉；出血
[中图分类号] R711.74 [文献标识码] A [文章编号] 1674-4721(2018)2(a)-0129-04
[Abstract]Objective To observe the effect of coils ligation in the treatment of cervical polyp bleeding during the early pregnancy，and to explore its clinical value.Methods A retrospective analysis was made of the diagnosis and treatment data of 63 early pregnancy women occurred with cervical polyps bleeding treated in our hospital from January 2013 to December 2016.They were divided into treatment group (32 cases) and control group (31 cases) according to different treatment methods.The treatment group was treated with cervical polyp coil ligation，and the control group was treated with conservative drug therapy.The duration of vaginal bleeding time，the rate of vaginal bleeding and miscarriage rate were compared between the two groups.Results The duration of vaginal bleeding in the treatment group was shorter than that in the control group，and the rate of vaginal bleeding was lower than that in the control group，the differences were statistically significant (P<0.05).The rate of miscarriage was compared between the two groups，and the difference was statistically significant (P>0.05).In the treatment group，the pathological specimens excised during the ligation were all indicative of benign polyps.Conclusion Coil ligation is a safe and feasible method for the treatment of cervical polyps with bleeding in early pregnancy.Besides，the malignant lesions can be excluded，which greatly relieve psychological pressure and effectively improve pregnancy experience.It is worth promotion.
[Key words]Coil ligation；Early pregnancy；Cervix polyps；Bleeding
近年來随着“二孩”政策的放开，生育高峰逐渐到来，但由于大龄孕妇增多、心理压力大和社会、生态环境复杂化等多方面影响，妊娠早期因阴道流血住院安胎治疗的患者也逐渐增加。但导致妊娠期异常阴道流血的原因很多，包括胚胎自身质量、子宫腔内环境、宫颈病变及阴道病变等，宫颈息肉并出血便是其中之一[1-3]。一般情况下，宫颈息肉为良性病变，无明显临床表现，患者较难自行发现并就诊，偶有阴道流血或者分泌物增多，症状也较轻[4]。但妊娠期，由于局部环境改变，易导致反复阴道出血，有时难以与宫腔内出血相鉴别，易误诊为先兆流产，而选择安胎治疗，导致治疗效果欠佳，并增加患者生理及心理压力，导致不良妊娠结局。非妊娠期，宫颈息肉首选宫腔镜下电切治疗，此术式能较彻底切除息肉特别是根部，减少复发。但由于妊娠胚胎的存在，妊娠期宫腔镜及其他进入宫腔的操作都成为禁忌，盲目操作易导致流产，或被患者与不良妊娠结局相关联，导致医疗关系紧张[5]。既往对于上述情况，一般选择药物保守治疗[6]，但效果欠佳，治疗时间长，可能导致凝血功能异常，且易反复发作，长时间反复阴道流血还增加感染风险[7]，导致宫内感染而流产。本研究选取我院收治的63例妊娠早期合并宫颈息肉出血患者的诊治资料进行回顾性分析，探讨线圈套扎治疗有出血表现的妊娠早期宫颈息肉的可行性，现报道如下。, http://www.100md.com(陈洁波)
[关键词]线圈套扎；妊娠早期；宫颈息肉；出血
[中图分类号] R711.74 [文献标识码] A [文章编号] 1674-4721(2018)2(a)-0129-04
[Abstract]Objective To observe the effect of coils ligation in the treatment of cervical polyp bleeding during the early pregnancy，and to explore its clinical value.Methods A retrospective analysis was made of the diagnosis and treatment data of 63 early pregnancy women occurred with cervical polyps bleeding treated in our hospital from January 2013 to December 2016.They were divided into treatment group (32 cases) and control group (31 cases) according to different treatment methods.The treatment group was treated with cervical polyp coil ligation，and the control group was treated with conservative drug therapy.The duration of vaginal bleeding time，the rate of vaginal bleeding and miscarriage rate were compared between the two groups.Results The duration of vaginal bleeding in the treatment group was shorter than that in the control group，and the rate of vaginal bleeding was lower than that in the control group，the differences were statistically significant (P<0.05).The rate of miscarriage was compared between the two groups，and the difference was statistically significant (P>0.05).In the treatment group，the pathological specimens excised during the ligation were all indicative of benign polyps.Conclusion Coil ligation is a safe and feasible method for the treatment of cervical polyps with bleeding in early pregnancy.Besides，the malignant lesions can be excluded，which greatly relieve psychological pressure and effectively improve pregnancy experience.It is worth promotion.
[Key words]Coil ligation；Early pregnancy；Cervix polyps；Bleeding
近年來随着“二孩”政策的放开，生育高峰逐渐到来，但由于大龄孕妇增多、心理压力大和社会、生态环境复杂化等多方面影响，妊娠早期因阴道流血住院安胎治疗的患者也逐渐增加。但导致妊娠期异常阴道流血的原因很多，包括胚胎自身质量、子宫腔内环境、宫颈病变及阴道病变等，宫颈息肉并出血便是其中之一[1-3]。一般情况下，宫颈息肉为良性病变，无明显临床表现，患者较难自行发现并就诊，偶有阴道流血或者分泌物增多，症状也较轻[4]。但妊娠期，由于局部环境改变，易导致反复阴道出血，有时难以与宫腔内出血相鉴别，易误诊为先兆流产，而选择安胎治疗，导致治疗效果欠佳，并增加患者生理及心理压力，导致不良妊娠结局。非妊娠期，宫颈息肉首选宫腔镜下电切治疗，此术式能较彻底切除息肉特别是根部，减少复发。但由于妊娠胚胎的存在，妊娠期宫腔镜及其他进入宫腔的操作都成为禁忌，盲目操作易导致流产，或被患者与不良妊娠结局相关联，导致医疗关系紧张[5]。既往对于上述情况，一般选择药物保守治疗[6]，但效果欠佳，治疗时间长，可能导致凝血功能异常，且易反复发作，长时间反复阴道流血还增加感染风险[7]，导致宫内感染而流产。本研究选取我院收治的63例妊娠早期合并宫颈息肉出血患者的诊治资料进行回顾性分析，探讨线圈套扎治疗有出血表现的妊娠早期宫颈息肉的可行性，现报道如下。, http://www.100md.com(陈洁波)