宫腔镜辅助冷刀锥切术在子宫颈上皮内瘤变诊断和治疗中的应用  

Evaluation of hysteroscopic coagulation adjuvant cold-knife conization in diagnosis and treatment of cervical intraepithelial neoplasis

作　　者：杨保军[1] 张学军[1] 冯力民[1] 邢风玲[1] 郭蕾[1] 张丽梅[1] 王伟娟[1] 

机构地区：[1]首都医科大学附属北京天坛医院妇产科,北京100050

出　　处：《中国内镜杂志》2007年第8期811-814,共4页China Journal of Endoscopy

摘　　要：目的探讨宫腔镜下电凝止血辅助宫颈冷刀锥切术在宫颈上皮内瘤变(CIN)诊断与治疗中的价值。方法追踪随访分析2001年12月～2005年12月,因宫颈病变行宫腔镜辅助宫颈冷刀锥切术的患者54例,统计手术中出血量、术后病率及住院天数。术后定期随访行细胞学检查和HPV检测,必要时行阴道镜下活检。结果平均手术时间(25.3±3.6)min,平均出血量(21.8±12.4)mL,平均住院时间(2.8±1.9)d,2例发热。冷刀锥切术后,行全子宫切除术者13例(24.1%)。41例(75.9%)患者术后密切随诊,平均随诊时间为(29.1±12.4)个月,无1例出现宫颈细胞学检查异常。HPV均转阴性。宫腔镜下电凝止血辅助宫颈锥切术术后出血的发生率7.4%。结论宫颈冷刀锥切术在CIN治疗中具有举足轻重的作用,宫腔镜下电凝止血辅助宫颈冷刀锥切术是CIN较为理想的治疗方法,能明显减少并发症。[Objective] To explore the valuation of hysteroscopic coagulation adjuvant cold-knife conization in diagnosis and treatment of cervical intraepithelial intraepithelial neoplasis. [Methods] From December 2001 to December 2005, 54 patient with cervical intraepithelial intraepithelial neoplasis were treated by hysteroscopic coagulation adjuvant cold-knife conization. Bleeding amount of operation, in-hospital time and morbidity after operation were recorded. Follow-up PAP smear and colposcopyhuman papillomaviruses （HPV） and colposcopic biopsy were done regularly after opration. [Results] The average operation time was （25.3±3.6） min. The average operation bleeding was （21.8±12.4） mL The average in-hospital time after operation was （2.8±1.9） days. 2 cases had fever. 13 cases （24.1%） that unerderwent conization were taken hysterectomy and 41 cases （75.9%） that unerderwent conization were fellowed up. The mean fellow-up time was （29.1±12.4） months. No recurrent dysplasia was observed during follow-up. High risk human papiUomavirus （HPV） was eradicated after procedure in all cases. Postoperation significant bleeding rate of hysteroscopic coagulation adjuvant cold-knife conization was 7.4%. [Conclusions] Cold-knife conization plays a very important role in diagnosis and treatment in CIN. Hysteroscopic coagulation adjuvant cold-knife conization is a safe and effective mode of treatment for CIN, it can reduce side effect of conization.

关 键 词：宫颈上皮内瘤样病变 冷刀锥形切除术 宫腔镜电凝 

分 类 号：R711.74[医药卫生—妇产科学]