宫颈上皮内瘤变微创切除范围的探讨  

The Discussion of the Range for the Minimally Invasive Resection in Cervical Intraepithelial Neoplasia Patients

作　　者：高莉丽[1] 胡丹[1] 

机构地区：[1]江苏省南通市第一人民医院妇科,南通226001

出　　处：《中国现代手术学杂志》2012年第5期383-385,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨高频电波环切术(loop electrosurgical excision procedure,LEEP)在宫颈上皮内瘤变中的不同治疗方法及相关问题。方法 2008年10月～2010年12月有宫颈上皮内瘤变的患者、细胞学检查阳性而阴道镜检查不满意的患者和ECC阳性患者共249例,随机分为A、B两组,其中A组124例,采用目前临床上普遍采取的切除病灶范围;B组125例,根据宫颈移行带的分型采取不同的LEEP刀治疗方案:Ⅰ型移行带选用LEEP刀治疗宫颈管深度为切入宫颈管内7～10 mm;Ⅱ型移行带选用LEEP刀治疗宫颈管深度为切入宫颈管内10～15 mm;Ⅲ型移行带选用LEEP刀治疗宫颈管深度为切入宫颈管内15～25 mm。结果 249例均成功利用LEEP刀完成宫颈上皮内瘤变切除术。B组在术中术后出血量、宫颈塑型效果满意度、术后愈合时间上明显优于A组,而两组在感染、术后标本切缘阳性发生率上无统计学差异。结论对于宫颈上皮内瘤变的患者,应根据病人的实际情况采取个体化治疗,使其在不影响愈合的基础上最大限度减少手术并发症,保护宫颈机能。Abstract： Objective To study the cervical canal resection depth and related issues of loop electrosurgical excision procedure （LEEP） in the treatment of cervical intraepithelial neoplasia （CIN）. Methods From Octo- ber 2008 to December 2010, there were 249 patients enrolled in this study with CIN, positive cytological examination or unsatisfied colposcopy results. All the cases were randomly divided into two groups. In 124 cases of group A, the routine resection range was taken. In 125 cases of group B, the cervical canal resection depth in type I transitional zone was 7 ～ 10mm; the cervical canal resection depth in type Ⅱ transitional zone was 10 ～ 15mm; and the type Ⅲ was 15 ～25mm. Results All the 249 cases got successfully operated. The intraoperative and postoperative bleed- ing, the cervical modeling effect and postoperative healing time of group B was better than group A. And the two groups had no statistical significance in the infection rate and the positive margin. Conclusions For patients with CIN, individualized treatment should be taken according to the patient’s actual situation, so that it does not affect the healing process on the basis of minimizing surgical complications and to protect the function of the cervix.

关 键 词：宫颈上皮内瘤样病变 LEEP术 

分 类 号：R737.33[医药卫生—肿瘤]