LEEP术治疗宫颈上皮内瘤变临床疗效以及高危型HPV检测在LEEP术后的随访价值  

The Clinical Efficacy of LEEP for Cervical Intraepithelial Neoplasia and the Value of High Risk HPV in the Postoperative Follow-up

作　　者：叶宇齐[1] 陈思[1] 张秀 钟伟萍[1] 王静[1] 邢玉霞[1] 陈玥 YE Yu-qi;CHEN Si;ZHANG Xiu(Department of Obstetrics and Gynecology,Jiangsu traditional Chinese and Western medicine hospital, Nanjing 210028,China)

机构地区：[1]江苏省中西医结合医院妇产科,江苏南京210028

出　　处：《吉林医学》2018年第3期453-455,共3页Jilin Medical Journal

摘　　要：目的:研究宫颈环形电切术(Leep术)治疗宫颈上皮内瘤变的临床疗效,为临床治疗宫颈上皮内瘤变(CIN)提供理论基础。方法:对阴道镜下宫颈活检诊断为CIN的180例患者采用Leep宫颈环形电切术,观察手术时间、手术出血量及伤口愈合时间,比较宫颈活检术前后的病理结果,HPV转阴率及术后HR-HPV阳性与宫颈病变持续存在的关系。结果:Leep术后病理活检与阴道镜病理活检完全符合者141例,符合率达到78.3%;高级别上皮内瘤变中HR-HPV阳性率显著高于低级别上皮内瘤变中HR-HPV的阳性率;Leep术后6个月患者HR-HPV总阳性率显著低于术前HR-HPV总阳性率;Leep术后HR-HPV阳性患者CIN持续存在率显著高于HR-HPV阴性患者。结论:Leep术治疗CIN操作简单,安全有效,值得临床推广应用,HR-HPV的随访对预测术后宫颈病变的持续存在有重要意义。Objective To study the clinical curative effect for the treatment of cervical intraepithelial neoplasia of Leep,in order to provide theoretical basis for the clinical treatment of cervical intraepithelial neoplasia(CIN).Method Leep cervical loop electrosurgical excision procedure was performed on180patients diagnosed with CIN under colposcopy,The operation time,the amount of bleeding and the time of wound healing were observed,The pathological findings before and after cervical biopsy,the rate of HPV negative change and the relationship between the positive rate of HR-HPV and the persistence of cervical lesions were analyzed.Results After Leep,pathological biopsy and colposcopy biopsy were complete in141cases,and the coincidence rate was78.3%.High-grade intraepithelial neoplasia in HR-HPV positive rate was significantly higher than that of low level intraepithelial neoplasia in HR-HPV positive rate.With six months after Leep,HR-HPV total positive rate of HR-HPV was significantly lower than preoperative HR-HPV total positive rate of HR-HPV.After Leep,the persistence of CIN of HR-HPV positive patient was significantly higher than HR-HPV negative patients.Conclusion Leep treat CIN is simple,safe and effective,worthy of clinical application,and the follow-up of HR-HPV to the prediction of postoperative cervical lesions persist has important significance.

关 键 词：宫颈环形电切(Leep) 宫颈上皮内瘤变(CIN) 临床疗效 高危型HPV 

分 类 号：R737.33[医药卫生—肿瘤]