宫颈电环切除术治疗76例子宫颈上皮内瘤样病变的分析  

Analysis on the Treatment of Cervical Intraepithelial Neoplasia with Loop Electrosurgical Excision Procedure for 76 Cases

作　　者：李桂梅[1] 李雪连[2] 

机构地区：[1]广东省惠州市惠阳区人民医院,广东惠州516211 [2]哈尔滨医科大学药理学教研室黑龙江省生物医药工程重点实验室,黑龙江哈尔滨150086

出　　处：《现代生物医学进展》2007年第10期1539-1540,共2页Progress in Modern Biomedicine

摘　　要：目的:探讨子宫颈电环切除术(LEEP)治疗子宫颈上皮内瘤样病变(CIN)的价值。方法:回顾性分析2004年10月至2006年9月收治的76例CIN患者行LEEP术治疗情况。结果:本研究的CIN 76例中CIN-Ⅰ37例,CIN-Ⅱ7例、CIN-Ⅲ2例,cIN-Ⅰ-Ⅱ21例,CIN-Ⅱ-Ⅲ9例。76例CIN患者行LEEP术治疗后最长的随访2年,最短的三个月。术后三个月新柏氏膜式液基层细胞学检测(Thin-prep Cytolosy Test,TCT)正常者76例(100%),人乳头瘤状病毒(HPV)转阴者75例(98.68%),阴道镜检查正常者74例(97.37%)。本组治愈率为98.68%,复发率为0例。结论:LEEP术治疗CIN具有以下优点:①安全、快捷又出血量少;②手术时间短,可在门诊进行手术;③可达到传统电刀达不到的非常精细的手术效果;④不易产生传统电刀切割时组织被拉长、碳化现象,可以得到不影响病理检查的完好的组织标本,对临近组织损伤小,治疗的同时能进行诊断;⑤疼痛少,不易留下瘢痕,感染少;⑥对宫颈损伤小,可以保留生育功能,更适合年轻患者。⑦避免了二次手术和过度治疗。但术后长期的规范随访,早期发现CIN复发及宫颈癌至关重要。Objective： To assess the effects of loop electrosurgical excision procedure （LEEP） in treating cervical intraepithelial neoplasia （CIN）. Methods： 76 cases fi＇om October, 2004 to September, 2006 with CIN and LEEP treatment were retrospectively analyzed. Results： During the two years, 76 cases were diagnosed CIN and treated by LEEP, of whom 37 cases were CIN-Ⅰ, 7 CIN-Ⅱ, 2 CIN-Ⅲ, 21 CIN-Ⅰ-Ⅱ, 9 CIN-Ⅱ-Ⅲ. The time of follow-up visit ranged from three months to two years. Three months after LEEP, all cases （100%） showed a normal Thin-prep Cytolosy Test （TCT）; 75 cases （98.68%） were negative for HPV; 74 cases（97.37%）showed a normal presentation when examined by colposcopy. The cure rate for this group of CIN cases was 98.68% with no relapse. Conclusions： LEEP is a good technique in treating CIN with a lot of advantages. First, it is safe, speedy and few bleeding. Second, it costs just a few time so that the operation can be finished in outpatient department. Third, it has a very elaborate effect, which the traditional electrotome can not make. Forth, it has fewer opportunities for the tissue to be prolonged and carbonized than the traditional electrotome, so that undamaged tissue can be available for biopsy besides a diagnose which can be made during the treatment. Fifth, there was less infected, pain and scar by LEEP. Sixth, patients, especially young women with LEEP, can still breed because of less damage to cervix. Seventh, it avoids the second operation and excess treatment. However, a long time of following-up is necessary in case of the relapse of CIN and cancer.

关 键 词：子宫颈上皮内瘤样病变 子宫颈电环切除术 新柏氏膜式液基层细胞学检测 人乳头瘤状病毒 

分 类 号：R711.4[医药卫生—妇产科学]