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目的探讨液基细胞学检查用于妊娠期妇女宫颈病变筛查的安全性和妊娠期宫颈病变的特征。方法应用液基细胞学检查方法,分别对在本院就诊的1951例妊娠期妇女(A组)和3752例同龄非妊娠期妇女(B组)及5069例同期、同龄进行健康检查妇女(C组)的宫颈脱落细胞进行宫颈病变筛查,依据目前国际通用的Bethesda系统(TBS)分类标准进行诊断,对有宫颈病变的非妊娠期妇女同时进行阴道镜检查,必要时进行镜下活检,依据病理学检查结果给予必要的临床处理和随访。结果(1)宫颈病变总发生率A组为23·58%(460/1951),B组为19·22%(721/3752),C组为13·40%(679/5069),3组分别比较,差异均有统计学意义(P<0·01)。(2)在宫颈病变中以感染为主,A组宫颈感染发生率为19·02%(371/1951),B组为10·66%(400/3752),C组为9·23%(468/5069),A组宫颈感染发生率明显高于B、C两组,差异有统计学意义(P<0·05)。(3)A组宫颈鳞状上皮内病变的发生率为1·13%(22/1951),而非妊娠的B、C两组宫颈鳞状上皮内病变的总发生率为1·24%(109/8821),两者比较,差异无统计学意义(P>0·05)。(4)A组宫颈腺上皮细胞不典型增生的发生率为0·62%(12/1951),C组为0·95%(48/5069),两组比较,差异无统计学意义(χ2=1·37,P>0·05)。(5)A组妇女行TCT检查后有49例发生出血,局部压迫后止血;孕早期行TCT检查者,无一例出血发生。结论妊娠期妇女与非妊娠期妇女宫颈病变发生率相似;液基细胞学检查用于妊娠期妇女宫颈病变的筛查安全、可行。
Objective To investigate the safety of liquid-based cytology in the screening of cervical lesions in pregnant women and the characteristics of cervical lesions during pregnancy. Methods A total of 1951 pregnant women (group A), 3752 women of the same age (group B) and 5069 women of the same age who underwent health checkup (group C) were enrolled in this study. ) Of cervical exfoliated cells for cervical lesions screening, based on the current international classification of Bethesda system (TBS) classification criteria for non-pregnant women with cervical lesions at the same time colposcopy, if necessary, underwent microscopic biopsy, depending on the disease Neutrophil test results give the necessary clinical treatment and follow-up. Results (1) The total incidence of cervical lesions was 23.58% (460/1951) in group A, 19.22% (721/3752) in group B, 13.4% (679/5069) in group C, Respectively, the differences were statistically significant (P <0.01). (2) In cervical lesions, the infection rate was 19.2% (371/1951) in group A, 10.66% (400/3752) in group B, and 9.23% in group C 468/5069). The incidence of cervical infection in group A was significantly higher than that in group B and C (P <0.05). (3) The incidence of cervical squamous intraepithelial lesion in group A was 1.13% (22/1951), while the incidence of cervical squamous intraepithelial lesion in non-pregnant group B and C was 1.24% ( 109/8821). There was no significant difference between the two groups (P> 0.05). (4) The incidence of atypical hyperplasia of cervical glandular epithelial cells in group A was 0.62% (12/1951) and in group C was 0.95% (48/5069), there was no significant difference between the two groups (χ2 = 1.37, P> 0.05). (5) A group of women underwent TCT after bleeding in 49 cases of bleeding, local oppression after hemostasis; TCT during early pregnancy, no bleeding occurred. Conclusions The incidence of cervical lesions in pregnant women and non-pregnant women is similar. Liquid-based cytological examination is safe and feasible for the screening of cervical lesions in pregnant women.