The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Municipal Key Clinical Specialty, Shanghai, China.
Sci Rep. 2020 May 22;10(1):8512. doi: 10.1038/s41598-020-65170-2.
To determine whether regular cervical dilatation is effective for preventing cervical stenosis, and to identify the associated risk factors, in postmenopausal women after LEEP. This was a prospective randomized clinical trial in postmenopausal women who underwent LEEP at our hospital between August 2018 and May 2019. Patients who met the study criteria were randomly allocated to three groups: control group (without any intervention), intervention group A (underwent cervical dilatation at the 3, 5, and 8 week after LEEP) and intervention group B (underwent cervical dilatation at the 4, 8, and 12 week after LEEP). A colposcopic follow-up examination was conducted at 6 months after LEEP to determine the incidence of cervical stenosis. A total of 404 postmenopausal women were found to be finally eligible for the study. The rate of cervical stenosis in the control group was significantly higher than that in the intervention group, and the rate in group A was significantly lower than that in group B. We found regular dilatation after LEEP in postmenopausal women can prevent cervical stenosis. Further, the 3rd, 5th, and 8th weeks after LEEP are optimal time points. Finally, LEEP frequency and resection depth are significant risk factors and can be used to screen postmenopausal women at risk for cervical stenosis after LEEP.
为了确定绝经后妇女利普刀(LEEP)术后定期宫颈扩张是否能有效预防宫颈狭窄,并确定相关的危险因素,我们进行了一项前瞻性随机临床试验。该研究纳入了 2018 年 8 月至 2019 年 5 月在我院接受 LEEP 的绝经后妇女,符合研究标准的患者被随机分为三组:对照组(无任何干预)、干预组 A(LEEP 术后 3、5、8 周行宫颈扩张)和干预组 B(LEEP 术后 4、8、12 周行宫颈扩张)。LEEP 术后 6 个月行阴道镜随访检查,以确定宫颈狭窄的发生率。最终共有 404 名绝经后妇女符合研究条件。对照组的宫颈狭窄发生率明显高于干预组,而干预组 A 的发生率明显低于干预组 B。我们发现绝经后妇女 LEEP 术后定期扩张可预防宫颈狭窄,且 LEEP 术后第 3、5、8 周是最佳时间点。此外,LEEP 频率和切除深度是显著的危险因素,可用于筛选 LEEP 术后发生宫颈狭窄风险较高的绝经后妇女。