LEEP子宫颈锥切术135例临床观察  

Clinical observation on 135 cases receiving LEEP cervical conization

作　　者：谭立凤[1] 

机构地区：[1]山东省淄博市妇幼保健院门诊,255029

出　　处：《中国妇幼保健》2011年第27期4262-4264,共3页Maternal and Child Health Care of China

摘　　要：目的:评价LEEP子宫颈锥切术诊断与治疗宫颈癌前期病变的临床价值。方法:对经活检确诊为宫颈癌前期病变或符合子宫颈锥切术指征的患者135例行LEEP子宫颈锥切术,观察其手术时间、术中出血量、宫颈解剖学外观修复、并发症、病理结果以及术后随访结果。结果:手术时间3～10 min,平均5 min,出血量2～20 ml,术后宫颈解剖学外观修复良好。并发症发生率为5.93%,以术中、术后出血最为常见,占所有并发症的50%。检出宫颈浸润癌3例(2.22%),均为宫颈早期浸润癌Ⅰa1期。"即诊即治"患者38例(28.15%),经一次LEEP治愈131例(97.04%),术后病理证实有4例显示切缘未净,失访1例,接受二次LEEP术1例,行子宫全切术2例。结论:LEEP子宫颈锥切术是一种安全有效的诊治高级别CIN的方法,在阴道镜指引下用LEEP切除宫颈异常转化区,不仅可以达到"即诊即治"的目标,还可以检出LEEP术前漏诊的宫颈微小浸润癌。要严格把握LEEP子宫颈锥切术的适应证及禁忌证,最大限度地减少并发症,合理应用LEEP术。Objective：To evaluate the clinical value of LEEP cervical conization in diagnosis and treatment of precancerous lesion of cervical cancer. Methods：135 patients who were diagnosed as precancerous lesion of cervical cancer by biopsy definitely or met the indications of cervical conization underwent LEEP cervical conization;the operation time,the amount of blood loss during operation,repair of cervical anatomical appearance,complications,pathological results and follow-up results after operation were observed. Results：The operation time was 3~10 minutes,5 minutes on average;the amount of blood loss during operation was 2~20 ml,repair of cervical anatomical appearance was good.The incidence of complications was 5.93%,intraoperative and postoperative bleeding were the most common complications,accounting for 50% of all complications.Three patients were found with cervical invasive carcinoma of Ⅰ a1 stage（2.22%）,38 patients（28.15%） were ＂see and treat＂,131 patients（97.04%） were cured after the first LEEP,postoperative pathological examination confirmed that the incisal margin of four patients was not clean,one patient was lost to follow up,one patient underwent the second LEEP,two patients received total hysterectomy. Conclusion：LEEP cervical conization is a safe and effective method to diagnose and treat high-level CIN.Resection of cervical abnormal transformation area with LEEP under the guidance of colposcope not only achieve the goal of ＂see and treat＂,but also detect cervical microinvasive carcinoma misdiagnosed before LEEP.The indications and contraindications of LEEP cervical conization should be controlled strictly,the complications should be reduced to the full extent,and LEEP should be applied reasonably.

关 键 词：LEEP术 子宫颈锥切术 宫颈癌 

分 类 号：R713.4[医药卫生—妇产科学]