冷刀锥切术或Leep术治疗164例CIN2～3的临床分析  

Clinical analysis of cold knife or Leep conization in the treatment of 164 cases of CIN2～3

作　　者：干晓琴[1] 张凌[1] 林海[1] 刘江[1] 周萍[1] 王骧 范从红 杨冬泉[1] 黄瓒[1] 扎西[1] 陈颖[1] 代倩苓 辜定纤[1] 

机构地区：[1]成都市第九人民医院,四川成都610015

出　　处：《四川医学》2010年第5期558-560,共3页Sichuan Medical Journal

基　　金：四川省卫生厅科学研究项目(编号:080174)

摘　　要：目的比较冷刀锥切术或Leep术在治疗CIN2~3级的临床价值。方法对164例LCT异常,高危型HPV阳性,阴道镜活检证实为CIN2~3的患者行Leep锥切或宫颈冷刀锥切,比较两种方法的手术时间、术中出血、术后出血、术后住院时间和术后病理、病变残留和复发率、高危型HPV转阴率等。结果①Leep锥切组平均手术时间和平均住院时间明显短于冷刀锥切组;术中出血量明显少于冷刀锥切组;但术后出血量则明显多于冷刀锥切组,差异均有统计学意义（P〈0.05）;②两组术后病理无明显差异,所有患者经治疗后均无病变残留,其治愈率为100%。随访3年,两组均无复发,高危型HPV的转阴率无明显差别。结论 Leep锥切术治疗效果和冷刀锥切术相同,Leep锥切术能有效进行创面止血,缩短手术时间和术后住院时间,但术后出血量则明显多于冷刀锥切组,因此,Leep锥切术和冷刀锥切术各有利弊,临床中可根据患者的具体情况进行选择。Objective To compare the values of two methods of conization（cold-knife conization and Leep surgery）for the treatment of CIN2~3.Methods 164 cases of CIN2~3 confirmed by colposcopy bioplsy with LCT abnormalities and high-risk HPV positive were undertaken Leep conization or cold knife conization,and operation time,blood loss,postoperative bleeding,postoperative hospitalization time and postoperative pathology,residual or recurrent rate and high risk HPV negative rate were compared between the two groups.Results ①Mean operative time of Leep group was significantly shorter than that of the cold knife conization group;average length of hospitalization time was significantly shorter than that of cold-knife conization group,intraoperative bleeding was significantly less than that of cold-knife conization group,but postoperative bleeding was heavier than that of cold-knife conization group（P0.05）;②There was no significant difference in postoperative pathology between the two groups,all cases were treated and had no residual,the cure rate was 100%.There was no significant difference of high-risk HPV negative rate between the two groups after three-year follow-up.Conclusion sLeep conization and cold treatment had the same therapy value.Leep can decrease the volume of blood,reduce operation time and hospitalization time,but postoperative bleeding of Leep group was heavier than those of cold-knife conization group.Therefore,each method has its own dominance in curing CIN and should be chosen according the conditions of the patients in clinical practices.

关 键 词：宫颈上皮内瘤变 冷刀锥切术 LEEP术 

分 类 号：R737.33[医药卫生—肿瘤]