宫颈锥形电切术治疗宫颈上皮内瘤变102例疗效分析  

Effect of loop electrosurgical excision procedure in treatment of cervical intraepithelial neoplasia

作　　者：罗红凤[1] 周洁莉[1] 董明华[2] 韩文玲[1] 

机构地区：[1]赣南医学院第一附属医院妇产科,赣州341000 [2]赣南医学院预防医学系

出　　处：《中国计划生育学杂志》2011年第4期221-223,共3页Chinese Journal of Family Planning

摘　　要：目的:探讨宫颈电热圈锥切术(LEEP)治疗宫颈上皮内瘤变(CIN)的临床价值,分析高危型人乳头瘤病毒(HPV)的感染情况与疗效的相关性。方法:对阴道镜活检诊断为CIN的102例予LEEP术治疗,采用阴道镜和PCR荧光定量检测高危HPV进行随访,观察治疗效果。结果:LEEP术后随访半年,治愈82例,治愈率达80.4%。病变残留20例(19.6%),复发14例(13.7%)。在所有患者中,高危型HPV检测阳性率为76.5%。CINⅢ患者高危型HPV阳性率(90.0%)较CINⅡ患者(69.0%)明显升高,差异有统计学意义(P<0.05)。高危型HPV阳性组LEEP术后病变残留率与HPV阴性组比较,差异无统计学意义(P>0.05)。CIN复发14例中,13例高危型HPV阳性,与HPV阴性复发率比较有差异(P<0.05)。因病变残留或复发而再次行LEEP术的26例中,23例(88.46%)高危型HPV阳性。结论:LEEP术治疗CIN疗效确切、安全、成功率高,是诊断和治疗CIN有效且理想的方法。高危型HPV阳性与否与CIN复发有关。Objective：To evaluate the clinical significance of cervical conization by loop electrosurgical procedure（LEEP）in treatment of cervical intraepithelial neoplasia（CIN）and analyze relevant factors of the high-risk human papillomavirus（HPV）infection and its removal.Methods：A total of 102 women with CIN identified by cytology and pathological biopsy under colposcopy were treated by LEEP.The clinical effects were evaluated by cytology and fluorescent quantity ploymerse chain reaction（PCR）.Results：The follow-up result after LEEP revealed 82 curative cases with a cure rate of 80.39%,20（19.6%）cases of residual disease and 14（13.7%）cases of recurrence.In addition,78 cases of high-risk HPV were positive in the test with an infection rate of 76.5%.The positive rate of HPV in CIN III women（90.0%）was significantly higher than that in CIN II women（69.0%）,showing a significant difference（P0.05）.There was no significant difference in residual disease rate between the positive group of high-risk HPV after LEEP and the negative group（P0.05）.In 14 cases of CIN recurrence,13 were found the high-risk HPV infection（P0.05）.In 26 women retreated with LEEP due to residue or recurrence of CIN,23（88.46%）were found the high-risk HPV infection（P0.05）.Conclusions：LEEP is an ideal and effective method for treatment of CIN due to its obvious curative effect,safe and simple operation,and high success rate.High-risk HPV is associated with CIN occurrence.

关 键 词：宫颈电热圈锥切术 宫颈上皮内瘤样病变 人乳头瘤病毒 

分 类 号：R737.33[医药卫生—肿瘤]