冷刀锥切术治疗CIN Ⅲ的疗效及生存质量分析  

Therapeutic effect of CKC in treating CIN Ⅲ and quality of life

作　　者：齐淑琴[1] 罗柳珍 

机构地区：[1]浙江省建德市第一人民医院,浙江建德311600

出　　处：《中国妇幼健康研究》2014年第3期474-475,478,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的评价冷刀锥切术治疗宫颈上皮内瘤变(CIN)Ⅲ级的有效性及其改善患者生存质量的作用。方法纳入2009年1月至2011年6月在建德市第一人民医院妇产科住院的宫颈上皮内瘤变Ⅲ级患者56例,行冷刀锥切术,观察手术时间、术中出血量、并发症及住院时间等;随访2年,进行生存质量量表SF-36评分,并加以分析。结果手术平均时间为37.10±19.63min,平均住院时间5.10±2.13天,平均出血量为34.77±15.30mL;手术治愈率为94.64%(53/56),复发率为5.36%(3/56)。术中出现1例大量出血,手术后并发出血6例。术后即刻生存质量较术前无差异(均P>0.05);远期(2年)生存质量较术前提高,差异有统计学意义(t值为-3.292～-2.028,均P<0.05)。结论对有宫颈锥切指征的患者,严格按照指征以宫颈锥切来明确诊断,可以提高宫颈癌的早期诊断率,及时发现早期病变并予以阻断,从而提高患者的生存率和远期生存质量。Objective To evaluate the effect of cold knife conization （ CKC） in treating cervical intraepithelial neoplasia Ⅲ （ CIN Ⅲ） and how it improves patients ’ quality of life （ QOL） .Methods Totally 56 CINⅢcases hospitalized in department of obstetrics and gynecology of First People ’ s Hospital of Jiande City from January 2009 to June 2011 were treated with CKC .Operation time , blood loss during operation, complication and length of stay were observed .After two-year follow-up visit, QOL Scale SF-36 was used to evaluate life quality.Results The average operation time was 37.10 ±19.63 min, average hospital stay was 5.10 ±2.13 d and average blood loss was 34.77 ±15.3mL, respectively.The cure rate of CKC was 94.64% （53/56）, and recurrence rate was 5.36% （3/56）.There was one case with excessive bleeding during operation and 6 cases complicated with bleeding after operation .QOL immediately after operation was not different from that before operation （P〉0.05）, but the long-term QOL （two years after operation） was significantly higher （t value ranged -3.292--2.028, both P〈0.05）.Conclusion For patients with indication of CKC , we should clarity a clear diagnose in strict accordance with the indication of CKC .Thus early diagnosis rate of cervical cancer can be improved , and early pathological changes can be found timely and blocked .Therefore patients ’ survival rate and long-term life quality can be improved .

关 键 词：宫颈上皮内瘤变 冷刀锥切术 肿瘤学 生存质量 

分 类 号：R711[医药卫生—妇产科学]