改良式宫颈电环切除术在诊治宫颈病变中的疗效观察  

Curative effect of improved loop electrosurgical excision procedure for diagnosis and treatment of cervical diseases

作　　者：谭伟坚[1] 赵雅绯[1] 

机构地区：[1]广州医学院第一附属医院妇产科,广州510120

出　　处：《中国医师杂志》2010年第8期1019-1021,共3页Journal of Chinese Physician

基　　金：广东省社会发展领域科技计划资助项目（63076）

摘　　要：目的 探讨改良式宫颈电环切除术在治疗宫颈病变的疗效.方法 将本院70例宫颈上皮内瘤变及宫颈原位癌患者按不同手术式分研究组采用改良式宫颈电环切除术治疗21例,其中CIN Ⅰ 4例、CJN Ⅱ 10例、CIN Ⅲ 4例、CIS 3例,对照组行宫颈电环切除术治疗49例,其中CIN Ⅰ7例、CIN Ⅱ 21例、CIN Ⅲ 16例、CIS 5例.观察2组患者手术时间、术中出血量、术后出血天数、锥体面积与出血量的关系.结果 研究组术中出血量[（16.57±17.47）ml],手术时间[（9.07±3.34）min],术后出血时间[（9.10±2.23）d]均低于对照组[（39.80±37.43）ml、（12.19±5.34）min、（10.49±2.76）d],其差异均有统计学意义（P〈0.05）;宫颈锥体体积[（14.70±13.35）mm3]与术中出血量[（32.83±14.32）ml]对数资料转为正态资料,呈正相关（r=0.430,P〈0.05）.两组疗效及预后比较差异均无统计学意义（P〉0.05）.结论 宫颈锥体体积与术中出血量有一定关系,对于锥切面积大、血运丰富,术前估计手术过程中出血多的患者,术前在宫颈3点和9点缝扎子宫动脉下行支可减少术中、后出血,从而缩短减少手术时间.Objective To study the effect of using improved loop electrosurgical excision procedure for diagnosis and treatment of cervical diseases. Methods The clinical data of 70 cases of cervical intraepithelial neoplasia or carcinoma in situ from January 2006 to Decemder 2008 in our hospital was collected.The operation time, the mean volume of blooding, days of blooding, relationship between the mean blood and areas of pyramid area of pyramid was compared between study group and control group. Improved loop electrosurgical excision procedure was executed on 21 cases of study group （ CIN Ⅰ 4 cases, CIN Ⅱ 10 cases,CIN Ⅲ4 cases, CIS3 cases ） and loop electrosurgical excision procedure was used on 49 cases in control group （CIN Ⅰ7 cases,CIN Ⅱ21 cases, CIN Ⅲ 16 cases, CIS5 cases）. Results Blood loss [（16.57 ±17. 47 ） ml], operative time [（ 9.07 ± 3.34 ） min] and postoperative bleeding time [（9.10 ± 2.23） d] in study group were lower than that in control group [（ 39.80 ± 37.43 ） ml, （ 12. 19 ± 5.34 ） min, （ 10. 49 ±2. 76）d], and the differences were statistically significant （ P 〈 0. 05 ）. Cervical cone volume [（ 14. 70 ±13. 35 ） mm3] and blood loss [（32. 83 ± 14. 32 ） ml] were positively correlated （ r = 0. 430, P 〈 0. 05 ）. No significant difference between prognosis of two groups was found（ P 〉0. 05 ）. Conclusion There was positive relationship between the averge blood loss in surgery and areas of pyramid excision. It＇d be better to stitch the ramus descendents of uterine artery at three and nine o＇clock of the cervix uteri, when the patients were expected to have large pyramid areas and abundant blood flow who may bleed more than normal. which can reduce the blood loss after surgery and reduce the time of surgery.

关 键 词：电外科手术/方法 子宫颈/外科学 宫颈疾病/外科学 

分 类 号：R737.33[医药卫生—肿瘤]