宫颈细胞学检查在妊娠期的临床意义

目的评价宫颈细胞学对妊娠期和产后2个月内妇女检查的临床意义。方法将采集的1 746例宫颈外口和宫颈管的脱落细胞标本,进行TBS(the Bethesda system)诊断分类。结果1 746例中发现感染性病变143例(8.2%),其中细菌性阴道炎46例(2.6%),滴虫性阴道炎44例(2.5%),念珠菌感染53例(3.0%);上皮细胞异常94例(5.4%),其中不典型鳞状细胞(ASCUS)63例(3.6%),低度鳞状上皮内病变(LSIL)26例(1.5%),高度鳞状上皮内病变(HSIL)4例(0.2%),原位癌(CIS)1例(0.1%)。人乳头瘤病毒(HPV)感染28例(1.6%),其中HPV伴不典型鳞状细胞20例(1.1%),HPV伴低度鳞状上皮内病变8例(0.5%)。结论宫颈细胞学检查对孕妇和产后妇女防治癌前病变和癌症有积极作用,通过围生期监测和管理可以降低围生儿的病死率和病残率。

Clinical Significance of Cervical Cytological Examination in Gestation

Objective To evaluate the clinical implication of cervical cytology in gestation and 2 months postartum.Methods We collected 1 746 cases of the thinprep cytologic test samples from external cervical orifice and cervical cavity.The cytological diagnosis adopted TBS-diagnosis and classification system.Results In 1 746 cases of samples,the inflammatory samples were 143 cases(8.2%).In those cases,the bacterial vaginitis samples were 46 cases(2.6%),trichomonal vaginitis samples were 44 cases(2.5%),candidal vaginitis samples were 53 cases(3.0%).The samples of typical epithelial cells were 94 cases(5.4%).In those cases,the samples of atypical squamous cells(ASCUS) were 63 cases(3.6%),the low-grade squamous intraepithelial lesions(LSIL) were 26 cases(1.5%),the high-grade squamous intraepithelial lesions(HSIL) were 4 cases(0.2%),the carcinoma in situ(CIS) was 1 case(0.1%).The samples of human papilloma virus(HPV) were 28 cases(1.6%),in which,the HPV combined with atypical squamous cells were 20 cases(1.1%),HPV combined with LSIL were 8 cases(0.5%).Conclusion The examinations of cervical cytology has positive effects in prevention and treatment of precancerous changes and carcinoma ingestational women,through the monitoring and management in peripartum,the morbidity and mortality of the preinatal can be reduced.