With the liberalization of the second child policy, more and more women came to the gynecological clinic for pregnancy. The most discovered and the most questioned was cervical disease.Once many women hear the word "cervical erosion", they will panic, for fear that they will have any bad diseases.The reason is that the vocabulary of "cervical erosion" is too deep -rooted. Cervical erosion is used to diagnose chronic cervicitis more than 100 years ago.A normal physiological change, but has been "demonized" for a long time.Many women often get frightened and not sleep well when they hear that they have "cervical erosion". They are afraid that they will be cervical cancer immediately, and the birth dream is broken.Don’t worry, let’s tell this problem slowly.
Cervical erosion refers to the red area with fine granules at the cervical vulva at the outer cervix.At present, the international guide has abandoned the word "cervical erosion", and it is uniformly referred to as "cervical cylindrical epithelium".
This is not a pathological change, but the physiological changes in the cervix.The cervical epithelium is covered by the scale of the scale in adolescence and menopause. At the age of the fertility period, due to the strong level of hormones, the cylindrical epithelium of the cervical pipe area was moved to the outer cervix that should have been smooth.Due to the thin columnar epithelium, the capillaries below it are revealed, making the columnar epithelial area bright red, which looks like erosion, but it is not true erosion.The reason is as follows:
1. The erosion surface under the microscope is actually cylindrical epithelium, not the true erosion of the epithelium falling off and ulcer.
2. The vaginal mirror is shifted out of the junction of the primitive scale, cylindrical epithelium.
3. The lymphocytes and lymphocytes of lymphocytes in the normal cervix and lymphocytes in the cervical inter -cervical lymphocytes do not mean cervicitis.
In the past, it was clinically divided into simplicity, granules, and nipples according to the erosion of the cervical surface. At the same time, it was divided into light, medium, and heavy three degrees according to the proportion of erosion area to the surface of the cervix.
Mild means that the erosion surface is less than 1/3 of the entire cervical area.
Whether it is severe or mild erosion, whether there is a problem with the cervix is not judged by the naked eye observation, but to be determined according to the results of the cervical screening.There are often patients who ask me: Will the cervix be cancer?I believe this problem is also a misunderstanding of many women.That’s right, smooth cervix may also be sick!What we need to pay attention to is the result of cervical examination, not whether the cervix is smooth or erosion.
There are usually two types of epithelial cells, cylindrical epithelium and scale epithelium.The smooth cervix means that the surface of the cervix visible to the naked eye is scaled epithelium, and the cylindrical epithelium shrinks in the cervical canal.The area where the cervix is prone to lesions is in the junction of the squamous epithelium and cylindrical epithelium.Especially after menopause, the cylindrical epithelium was retracted back to the cervical pipe, so the cervix looked smooth when the old lady came to check, but there were many problems.
Keep in mind that the smooth cervix does not mean that the cervix will not be lesions. The cervix looks erosion and does not mean that the cervix is ill. Whether there is a disease or not to do a cervical examination, because the cervix is not "seeing the truth", it is not seen that you can see it.It is likely to be an illusion.
If there is no problem with the cervical examination before pregnancy, this cylindrical epithelium is not necessary to treat it. It is sufficient to scree the cervix TCT and HPV regularly. Women who prepare for pregnancy do not need to worry too much or over -treatment.
As mentioned above, cervical erosion usually refers to the abnormal level of cervical cylindrical epithelium in the sense, which is a normal physiological phenomenon. It changes with the regulation of menstrual hormones.Need treatment.
【Acute cervicitis】
Most of the pathogens related to sexually transmitted diseases, such as gonorrhea, chlamydia infection, and a few are caused by staphylococcus and splin bacteria.Cervical erosion under the action of acute infections is often accompanied by clinical manifestations such as contact bleeding, leucorrhea, pus -like or bloodshot, lower abdomen swelling pain and other clinical manifestations.Cervical edema and congestion are found during the naked eye observation. There are a lot of purulent secretions, which seriously affects sexual life and quality of life. It is likely to cause pelvic infectious diseases. It must receive anti -disease preliminary treatment and related auxiliary therapy to relieve clinical symptoms, such as microwaves, such as microwaves,, such as microwaves,, such as microwaves, such as microwaves,, such as microwaves, such as microwaves,, such as microwaves,, such as microwaves,, such as microwaves,, such as microwaves,, such as microwaves,, such as microwaves,, such as microwaves,, such as microwaves,, such as microwaves,, such as microwaves, such as microwave,Physics such as laser, improve the symptoms of contact bleeding after the same room, and improve the quality of life.
[Cervical epithelial tumor changes]
If the cervical disease has progressed as a cervical epithelial tumor (CIN), treatment must be performed.CIN2-3 is a pre-cancer lesion and requires cervical cone cutting. At present, most hospitals use Leep surgery. The tissue of cervical lesions with high-frequency electric knife is used.Essence
[Is it true that it will affect the fertility after doing leep?.
Without investigation, there is no right to speak, and it is irresponsible to say that leep is affecting fertility.Let’s take a look at the relevant research results and let the data tell you the answer.
Yanming Jiang et al. Compared the fertility ending of LEEP. As a result, Plos One was published on January 26, 2017.In this study, LEEP’s postoperative residual lesions and recurrence rates are satisfactory. The most important point is that there is no significant effect on the end of pregnancy, and there are relatively few obstetric complications after pregnancy.
The length of the cervical tube after leep is considered to be the most closely influencing factor with the complications of obstetrics.The most worried about patients is that leep will cause shortening cervical length after surgery, so the saying "postoperative influence fertility" appears.So what is the truth?please watch the following part:
Studies have found that after 3 months of LEEP, the cervical recovery phase will increase, and the cervical length will grow.Kenro and others in Japan studied the changes in cervix length after 6 months of Leep.
They found that the cervix length increased significantly within 6 months after Leep, and it was not related to age, pregnancy, production, and CIN range.The cervical length will naturally increase with the healing of the cervix after the operation.If you are pregnant soon after leep, you will increase the risk of premature birth. It is recommended to spend 3 to 6 months of pregnancy after leep.Therefore, it is best to wait for patients to wait 6 months to reduce the risk of pregnancy.This is the same as the research results of scholars such as BJeRge T and other scholars in Norway.
[How is LEEP most suitable for women with fertility?.
Leep’s cervical cone cutting range is generally: the depth of the cervix is 1 ~ 1.5cm, and the depth of the cervical tissue is 0.5 ~ 0.7cm.Many studies have found that the larger the range of cone cutting, the higher the risk of obstetric complications.For women with fertility, how to choose the scope of LEEP is very important, which can not only achieve the purpose of removing lesions, but also reduce the risk of fertility facing as much as possible.
An article published by Yin G et al. Published in 2017 has reference value.They adopt four different resection methods: the cone -shaped area of group A resection ≥ 2/3 cervical tissue; group B is ≥1/ 3 but <2/3; group C <1/3; group D cervix inner tubecut.The cure rates of A, B, C, and D were 99.1 %, 98.5 %, 100.0 %, and 93.2 % (P> 0.05), respectively.The pregnancy rate of two years after the operation of group C and group D was significantly higher than that of group A (P <0.05).The four LEEP techniques are very effective for the treatment of CIN.However, large -scale resection may cause adverse results after pregnancy.
Liverani and others also believe that the length of the removal of the cervical canal is related to the lower age of the tire at birth, not the horizontal diameter and volume.When the length of the cervical tissue is between 15-19mm, the risk of pregnancy complications is the least.When resection under strict vaginal lens, the length of the cone resection is correctly adjusted, and the risk of premature birth and cesarean section will not increase.Some literatures have reported that the depth of cervical tissue that has been removed is 15mm and 18mm in diameter. It has no effect on pregnancy. Only Leep resection greater than 25mm can cause advanced pregnancy complications such as premature birth.
In 2012, the International Cervical and Pposity Physician Alliance released a latest guide, suggesting that about 1cm of cervical resection has no effect on pregnancy.Because the length of the cervix is about 3-4cm and the resection is 1cm, it is about 1/3 of the cervical length, which will not affect the cervical tissue anatomy structure.If you cut to 2cm, there will be a risk of premature fetal membrane.
So how much cervix is appropriate?Combined with the guidelines and related documents, the cervical length of the resection does not exceed 1/3 of the cervical length, and the removal diameter is determined according to the size of the lesion, which does not exceed 25mm, which is more suitable for women with fertility requirements.
[Can LEEP be born after surgery?.
It is generally believed that the elasticity of the cervical tubes in the LEEP duct may affect the expansion of the cervical tube during the outbuitation and cause difficulty in giving birth.However, a large number of studies at home and abroad have shown that LEEP has no significant effect on childbirth. You can choose vaginal trial production, and it is not a sign of cesarean section.Evaluate the cervical conditions correctly during the output process, observe closely, and find problems in time to discover problems.
For the cervix, what we need to do is to check regularly, and timely treatment when there are problems, this is the best measure to ensure our own health.
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