高频电波刀术对宫颈上皮内瘤变(CIN)Ⅰ的治疗价值  

Application of high frequency loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia (CIN)Ⅰ

作　　者：李明艳[1] 苏光[1] 鞠蕊[1] 邓春霞[1] 张凡[1] 杨文静[1] 杨雪梅[1] 王敬[1] 王春敏[1] 张宇[1] 

机构地区：[1]北京市垂杨柳医院妇产科,100022

出　　处：《北京医学》2012年第7期596-598,共3页Beijing Medical Journal

基　　金：首都医学发展科研基金(2009-3217)

摘　　要：目的探讨高频电波刀术(LEEP术)对宫颈上皮内瘤(CIN)Ⅰ合并宫颈人乳头状瘤病毒(HPV)感染的治疗效果。方法选择符合入组标准C1NⅠ伴HPV感染患者60例,分成两组。治疗组(30例)采用LEEP术;观察组(30例)不做治疗。3个月后复查TCT、HPV和阴道镜点活检,首次复查后每6个月复查TCT、HPV和阴道镜点活检,随访2年。观察两组C1NⅠ转归情况及HPV清除率。结果 LEEP术治疗组C1NⅠ显效率/HPV转阴率第3、6、12、24个月分别为60.0%/46.7%、70.0%/56.67%、76.7%/73.3%、86.7%/83.3%;观察组为30.0%/16.7%、36.7%/30.0%、46.7%/36.7%、63.3%/50.0%,治疗组优于观察组,差异有统计学意义(P<0.01)。结论 LEEP术能有效破坏宫颈表面病灶,抑制CINI进展复发,是诊断和治疗CIN安全有效的方法,能提高HPV清除率。Objective To evaluate the role of high frequency loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia （CINI）. Methods An analysis was conducted in 367 patients with ASC or cervical intraepithelial neoplasia preliminarily diagnosed by Liquid-based thin-layer cytology technique selected from 19397 patients between June, 2008 and February, 2010 at Chuiyangliu Hospital.Sixty patients with cervical intraepithelial neoplsia were caused by by human papilloma virus infection. They were divided into two groups, one with 30 patients treated by loop electrosurgical excision procedure and another with 30 patients without treatment. Two groups underwent liquid-based cytology test, colposcopic assessment and the cervical cells for HPV genotype testing by the polymerase chain reaction （PCR） respectively at 3rd, 6th, 12th, 18th,24th months after treatment. Prognosis and clearing rate of HPV of the two groups were evaluated. Results The effective rate of treatment of CIN I and the HPV clearing rate was 60.0%/46.7%、70.0%/56.7%、76.7%/73.3%、86.7%/83.3% and 30.0%/16.7%、36.7%/30.0%、46.7%/36.7%、63.3%/50.0% at the 3rd, 6th, 12th, 18th,24th months after treatment, respectively in the group of patients treated by LEEP and those with- out treatment. Conclusions Loop electrosurgical excision procedure is a therapeutic method for treating cervical lesions, lowering cervical load of HPV DNA and controlling evolvement and recurrence of CIN I.LEEP is a safe and effective approach for the treatment of CIN.

关 键 词：高频电波刀术 人乳头状瘤病毒 宫颈上皮内瘤变 

分 类 号：R737.33[医药卫生—肿瘤]