保留生育功能的宫颈病变治疗方法选择及预后

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1、授予单位代码10089学号或申请号10010010020中国图书分类号R711.74硕士学位论文专业学位保留生育功能的宫颈病变治疗方法选择及预后研究生:白雪导师:王丽丽教授专业:妇产科学二级学院:河北医科大学第二医院2018年3月目录中文摘要············································································································1英文摘要······················································

2、······················································2英文缩写············································································································3综述保留生育功能的宫颈病变治疗方法选择及预后································4致谢·······························································

3、···················································17个人简历··········································································································18中文摘要保留生育功能的宫颈病变治疗方法选择及预后摘要近年来宫颈上皮内瘤变和宫颈癌患者有明显年轻化趋势，其中生育年龄妇女治疗后迫切希望保留生育功能。因此许多学者对宫颈病变保留生育功能的术式、妊娠并发症及妊娠结局等进行研究。CIN是宫颈癌进展过程中的

4、一个阶段。CIN根据病变程度分为三级：CINⅠ、CINⅡ、CINⅢ，不同的病变分级对应不同的治疗方法。CIN对妊娠无风险，对孕妇也不会构成立即风险，故选择治疗的时机很重要。早期宫颈癌（IA1期、IA2期及IB1期）患者可行保留生育功能的术式，研究证明保留生育功能的术式与传统的宫颈癌术式相比，术后复发率没有明显差异。目前早期宫颈癌保留生育功能的术式主要有宫颈锥切术及RT。无论是宫颈锥切术还是RT，均会对患者的妊娠率及妊娠结局产生不同程度的影响，包括流产、绒毛膜羊膜炎、胎膜早破、早产、低出生体重儿及宫颈裂伤等。应积极寻找预防及治疗的方法来提高术后患者的妊娠率及改善妊娠结局。

5、综合国内外文献，就宫颈上皮内瘤变及早期宫颈癌患者治疗方法的选择及预后进行阐述。关键词：宫颈上皮内瘤变,宫颈癌,保留生育功能,宫颈锥切术,根治性宫颈切除术,妊娠结局1英文摘要ThetherapeuticmethodsandprognosisoffertilitypreservingsurgicalprocedurestotreatcervicallesionsABSTRACTTheageofpatientswithcervicalintraepithelialneoplasia(CIN)andcervicalcancershowsamoreapparenttendency

6、ofyounger.Mostofthemareofchildbearingage,whoareeagertopreservetheirfertilityaftertreatment.Inrecentyears,thereweremanystudiesonfertilitypreservingsurgicalprocedures,pregnantcomplicationsandpregnancyoutcomes.CINisaperiodduringthedevelopmentofcervicalcancer.CINisclassifiedintothreecategori

7、esaccordingtodifferentcervicallesiondegreesanddifferentdegreesarecorrespondingtodifferenttreatments.CINcarriesnoimmediatelyrisktothepregancy,soitisveryimportanttochoosethetreatmentopportunity.Thepatientswithearlycervicalcancercanchoosecervicalconizationandradicaltrachelec