子宫颈环形电切术对宫颈癌前病变200例疗效分析  

Efficacy of Loop Electrosurgical Excisional Procedure in the Treatment of 200 Cases of Cervical Precancerous Lesion

作　　者：杨婷[1] 张卫霞[1] 

机构地区：[1]西安医学院第二附属医院,710038

出　　处：《实用癌症杂志》2017年第4期675-677,共3页The Practical Journal of Cancer

摘　　要：目的探讨子宫颈环形电切术(LEEP)对宫颈癌前病变的疗效。方法选取200例宫颈上皮内瘤样病变(CIN)患者,均行LEEP治疗,观察并记录患者的手术时间、术中出血量、不同程度CIN患者治愈例数,对比患者术前阴道镜下宫颈活检和LEEP术后病理组织检查结果,记录随访1个月期间并发症情况。结果患者所需手术时间6~22 min,平均手术时间(7.9±1.8)min;术中出血量16~41 m L,平均术中出血量(21.3±8.9)min。术后病理结果证实:CINⅠ72例患者,全部治愈,治愈率100%,CINⅡ87例患者,治愈81例,治愈率93.1%,CINⅢ41例患者,治愈37例,治愈率90.2%。不同程度CIN患者治愈率相比,无统计学差异(P>0.05)。术前阴道镜宫颈活检与LEEP术后病理诊断结果比较,CINⅠ病理符合率94.1%,CINⅡ病理符合率83.5%,CINⅢ病理符合率74.5%,不同程度CIN的术后病理符合率相比,差异有统计学意义(P<0.05)。随访1个月,6例出现宫颈粘连,3例宫颈管狭窄,下腹坠痛伴烧灼感7例,并发症发生率8%。结论 LEEP对宫颈癌前病变具有较好的治疗与诊断效果,诊断效果好于术前阴道镜宫颈活检,术后创伤小,并发症少,值得临床推广使用。Objective To discuss the efficacy of loop electrosurgical excisional procedure（ LEEP ） in the treatment of cervical precancerous lesion. Methods 200 patients with cervical intraepithelial neoplasia were selected, they were given LEEP after admission. The efficacy of LEEP in the treatment of cervical precancerous lesion was evaluated by operation time, bleeding volume, the number of cured CIN patients, comparison of preoperative colposcopy results and postoperative patbological diagnosis and complications during 1 months follow-up. Results The operation time was 6 - 22 min and the average was （7.9 ± 1.8） min. The bleeding volume was 16 -41 mL and the average was （21.3 ± 8.9） mL. 72 CIN Ⅰ were cured and the cured rate was 100%. 81 CIN Ⅱ were cured and the cured rate was 93.1%. 37 CINⅡ were cured and the cured rate was 90.2%. There were no statistical significance in cured rate among these groups（P 〉 0.05 ）. The preoperative colposcopy results was compared with postoperative pathological diagnosis. The coincidence rate was 94.1% on CIN Ⅰ . The coincidence rate was 83.5% on CIN Ⅱ. The coincidence rate was 74.5% on CINⅡ. There were statistical significance on concidence rate（ P 〈 0.05 ）. During 1 month follow-up,there were 6 cases of cervical adhesion,3 cases of cervical canal stenosis and 7 cases of lower abdominal pain with burning sensation. The complication rate was 8.0%. Conclusion LEEP has a good therapeutic effect on cervical precancerous lesion and the diagnostic effect was better than that of colposcopy, with less trauma and complications. It is worthy of clinical application.

关 键 词：子宫环形电切术 宫颈癌前病变 病理 阴道镜 并发症 

分 类 号：R737.33[医药卫生—肿瘤]