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style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">當前，隨著(zhù)人們生活習慣的改變，HPV感染呈現出年輕化的趨勢。更關(guān)鍵的是，育齡期是HPV感染的高發(fā)期，據報道<span style="color: rgb(255, 0, 0);"><strong>妊娠期HPV感染的女性比例大約為40%。</strong></span></span></p><section><section><section></section></section></section><p style="line-height: 2em;"><span style="color: rgb(0, 0, 0);"><br/></span></p><p style="text-align:center"><img src="/uploadfiles/2021/10/20211027092143398.jpg" title="微信圖片_20211027091823.jpg" alt="微信圖片_20211027091823.jpg" width="420" height="593"/></p><p style="line-height: 2em;"><span style="color: rgb(0, 0, 0); font-size: 18px;"><br/>當妊娠碰上HPV感染時(shí)，準媽媽們該怎么面對？<br/><br/></span></p><p style="line-height: 2em; text-align: center;"><span style="font-size: 20px; color: rgb(255, 0, 0);"><strong>HPV感染易發(fā)生在妊娠期</strong></span></p><section><br/></section><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">孕期那么難，為啥HPV也要來(lái)?yè)揭荒_？<br/><br/></span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">孕期HPV感染率可達24-40%，感染率較高的可能原因有以下這幾方面：</span></p><section><section><section><section><section><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">● 妊娠期激素水平波動(dòng)，免疫功能受到抑制，病毒復制加速，導致HPV-DNA檢出率增加，從而難以清除HPV；</span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">● 妊娠期盆腔和生殖器官血供豐富，陰道分泌物增多，增加了細菌和病毒的易感性；</span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">● 妊娠期宮頸上皮細胞增生狀態(tài)影響，妊娠期宮頸復層鱗狀上皮基底層和副基底層細胞增生，宮頸腺體粘液分泌增多，激活宮頸上皮化生。此外柱狀上皮更多地向子宮頸的陰道側移動(dòng)，并對不同因素（包括HPV感染）敏感。</span></p></section></section></section></section></section><p><br/></p><p style="line-height: 2em; text-align: center;"><span style="font-size: 20px; color: rgb(255, 0, 0);"><strong>HPV感染會(huì )對妊娠有影響嗎？</strong></span><span style="color: rgb(0, 0, 0);"><br/></span></p><section><br/></section><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(255, 0, 0);"><strong>● 對孕媽的影響：<br/><br/></strong></span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">如果孕媽感染了高危型HPV，可引起下生殖道癌和上皮內病變；低危型HPV感染可引起下生殖道濕疣。</span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/>目前的研究暫未發(fā)現孕期HPV感染會(huì )增加流產(chǎn)、早產(chǎn)、胎兒畸形的風(fēng)險。<br/><br/></span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(255, 0, 0);"><strong>● 對胎兒的影響：<br/><br/></strong></span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">體外實(shí)驗發(fā)現，生殖道HPV感染會(huì )抑制胎盤(pán)滋養細胞的增殖，促進(jìn)滋養細胞的凋亡，并阻止滋養細胞與子宮內膜細胞的粘附。因此可能會(huì )導致胎膜早破，甚至與胎盤(pán)因素引起的流產(chǎn)、早產(chǎn)、胎兒宮內生長(cháng)受限、低出生體重兒等有關(guān)，但目前相關(guān)結論仍有爭議，需待進(jìn)一步的研究。</span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/>不過(guò)已有證據表明<strong>HPV可通過(guò)垂直傳播至胎兒/新生兒，尤其發(fā)生在經(jīng)陰道分娩時(shí)。</strong>危害胎兒及出生后嬰幼兒健康（生殖器和肛門(mén)濕疣、眼結膜乳頭狀瘤及喉乳頭狀瘤），其中新生兒喉乳頭狀瘤可引起上呼吸道阻塞，病死率較高。</span></p><section></section><p style="line-height: 2em;"><span style="color: rgb(0, 0, 0);"><br/></span></p><p style="text-align:center"><img src="/uploadfiles/2021/10/20211027092544595.jpg" title="微信圖片_20211027091828.jpg" alt="微信圖片_20211027091828.jpg" width="640" height="292"/></p><p style="line-height: 2em;"><span style="color: rgb(0, 0, 0); font-size: 18px;"><br/>不過(guò)盡管存在HPV新生兒和兒童感染，但大部分HPV陽(yáng)性新生兒可在出生6個(gè)月-2年內左右自行清除病毒。另外，早期暴露于HPV，會(huì )對胎兒及新生兒免疫功能產(chǎn)生影響。</span><br/></p><section><br/></section><p style="line-height: 2em; text-align: center;"><span style="color: rgb(255, 0, 0); font-size: 20px;"><strong>可以通過(guò)剖宮產(chǎn)預防新生兒感染嗎？</strong></span></p><section><br/></section><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">研究發(fā)現，剖宮產(chǎn)可減少46%的垂直傳播，但不能完全阻止垂直傳播的發(fā)生，因為尚存在HPV經(jīng)胎盤(pán)、胎膜及羊水傳播的途徑。</span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/>有意思的是，盡管剖宮產(chǎn)相比順產(chǎn)減少了約一半的HPV垂直傳播，但美國婦產(chǎn)科醫師協(xié)會(huì )建議，綜合考慮順產(chǎn)的好處，以及新生兒HPV感染大多會(huì )自主消失，不必為了擔心HPV感染而刻意要求剖宮產(chǎn)。</span></p><section><br/></section><p style="line-height: 2em; text-align: center;"><strong><span style="font-size: 20px; color: rgb(255, 0, 0);">孕期感染HPV，如何診斷和治療</span></strong><span style="color: rgb(0, 0, 0);"><br/></span></p><p><br/></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">妊娠期宮頸癌是指妊娠期、產(chǎn)褥期和產(chǎn)后 6 個(gè)月內發(fā)現的宮頸癌，是妊娠期婦科最常見(jiàn)的癌癥。</span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/>18%-59% 的妊娠期宮頸癌患者沒(méi)有臨床癥狀。妊娠期前未定期篩查宮頸的，妊娠期出現不能用妊娠相關(guān)原因解釋的陰道出血時(shí)，有必要通過(guò)細胞學(xué)、陰道鏡或有指征的宮頸活檢等方法評估是否存在宮頸病變。</span></p><p></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/></span></p><p style="text-align:center"><img src="/uploadfiles/2021/10/20211027093200230.jpg" title="微信圖片_20211027091834.jpg" alt="微信圖片_20211027091834.jpg" width="640" height="427"/></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/>如果孕期檢測出HPV感染的患者，要結合TCT篩查結果行進(jìn)一步的檢查。若TCT檢測無(wú)異常，原則上不進(jìn)行陰道鏡活檢等有創(chuàng )處理。但產(chǎn)后應及時(shí)復查HPV和TCT，處理原則同非妊娠女性。<br/></span><br/></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">孕期TCT檢測結果異常的妊娠期女性，檢查結果不同，處理原則也不同。</span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/><strong>妊娠期細胞學(xué)異常篩查指南（ASCCP 指南與國內專(zhuān)家共識對比）</strong></span></p><p></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/></span></p><p style="text-align:center"><img src="/uploadfiles/2021/10/20211027093756661.png" title="微信圖片_20211027091837.png" alt="微信圖片_20211027091837.png"/></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/>另外，<strong>孕媽不必擔心懷孕會(huì )加重HPV感染。</strong>盡管妊娠的免疫功能相對低下，但目前并沒(méi)有證據表明妊娠患者的HPV感染的病情發(fā)展和非妊娠期有統計學(xué)的差異。</span><br/></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/>總之，孕期HPV感染對母體及胎兒均有一定危害，為了自身和寶寶的健康，請廣大女性朋友們謹記<strong>定期行宮頸癌篩查，孕前行宮頸癌篩查。<br/><br/></strong></span></p><p style="text-align:center"><img src="/uploadfiles/2021/10/20211027094259023.jpg" title="微信圖片_20211027091841.jpg" alt="微信圖片_20211027091841.jpg" width="640" height="267"/></p><p style="line-height: 2em;"><br/></p><section><section><section><section><section><section><section><p></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);">艾康生物Cermiss?宮頸癌篩查系列是一個(gè)宮頸癌初篩檢測品牌，集HPV檢測TCT細胞診斷于一體，致力于為女性宮頸健康提供整體解決方案。<br/></span></p><p style="line-height: 2em;"><span style="font-size: 18px; color: rgb(0, 0, 0);"><br/>目前，針對HPV檢測系列產(chǎn)品Cermiss?已形成篩查矩陣（低危型篩查、規?；Y查、精準化篩查），為宮頸癌早期診斷、風(fēng)險分析與明確診斷提供解決方案，符合現行各大指南推薦的篩查路徑和衛生經(jīng)濟學(xué)評價(jià)，滿(mǎn)足臨床診療需求。</span></p></section></section></section><section><section><br/></section><section><br/></section><section><br/></section></section></section></section></section></section><section><br/></section><p style="line-height: 1.75em; text-align: right;">來(lái)源：醫學(xué)界婦產(chǎn)科頻道、</p><p style="line-height: 1.75em; text-align: right;">婦產(chǎn)醫學(xué)資訊<br/></p><p style="line-height: 1.75em; text-align: right;">由艾康生物整理發(fā)布<br/></p><p style="line-height: 1.75em; text-align: right;">版權歸原作者所有<br/></p><p style="line-height: 1.75em; text-align: right;">如有違規請聯(lián)系刪除</p><section><br/></section><section><br/></section> </div> <div id="2kkkkkk0k" class="news_info_back"> <div id="2kkkkkk0k" class="left"> <a href="/news/777.html">上一條：鼻咽癌治療，這項“中國方案”實(shí)現領(lǐng)跑！</a><br> <a href="/news/775.html">下一條：艾康生物邀您共赴2021年全國變態(tài)反應學(xué)術(shù)會(huì )議</a> 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