重度宫颈上皮内瘤变行宫颈锥切术后再行全子宫切除术的临床价值  

Clinical Value of CIN Ⅲ Line After LEEP Again all the Hysterectomy

作　　者：彭海兰[1] 杨进琼[1] 卢少红[1] PENG Hai-lan;YANG Jin-qiong;LU Shao-hong(Gaozhou People’s Hospital,Gaozhou 525200,China)

机构地区：[1]高州市人民医院,广东高州525200

出　　处：《黑龙江医学》2020年第9期1169-1171,共3页Heilongjiang Medical Journal

摘　　要：目的探究宫颈锥切术(LEEP)后的重度宫颈上皮内瘤变(CINⅢ)患者再行全子宫切除术的临床价值。方法实验对象选自于2019年1月—2019年12月间在高州市人民医院进行治疗的135例CINⅢ患者,对比CINⅢ患者行LEEP后切缘情况与全子宫切术后病理关系、对比不同型人乳头瘤病毒(HPV)子宫切除术后CINⅢ残留情况。结果患者行LEEP术后,再行全子宫切除术,术后病理切缘阴性患者80例,残留不同等级CIN患者55例,其中病灶CINⅠ残留率为23.64%(13/55),病灶CINⅡ残留率为12.73%(7/55),病灶CINⅢ残留率为63.64%(35/55),总残留率为40.74%(55/135),HPV16型阳性感染率为34.07%(46/135),HPV18型阳性感染率为9.63%(13/135),HPV33型阳性感染率为5.93%(8/135),HPV52型阳性感染率为11.85%(16/135),HPV58型阳性感染率为5.93%(8/135),其他HPV亚型阳性感染率为32.59%(44/135)。结论对于CINⅢ患者不一定需要行全子宫切除术治疗,但对于HPV16型、HPV18型可适当放宽指征,降低疾病复发率和进展至宫颈癌的风险。Objective To explore the clinical value of total hysterectomy in patients with severe cervical intraepithelial neoplasia(CIN Ⅲ)after cervical circumcision(LEEP).Methods Selecting the experimental subjects from 135 patients with CIN Ⅲ who were treated in Gaozhou People’s Hospital from January,2019 to December,2019,and comparing the pathological relationship between the post-LEEP resection margin of CIN Ⅲ patients and the postoperative hysterectomy,the residual status of CIN Ⅲ after hysterectomy of different types of HPV.Results After LEEP,the patient underwent total hysterectomy.The postoperative pathological margin was negative in 80 cases.There were 55 patients of different degrees of CIN.The residual CIN Ⅰ was 23.64%(13/55),and the residual CIN Ⅱ was 12.73%(7/55),the residual CIN Ⅲ was 63.64%(35/55),the residual rate was 40.74%(55/135),HPV16 positive infection was 34.07%(46/135),HPV18 positive rate was 9.63%(13/135),HPV33 positive rate was 5.93%(8/135),HPV52 was 11.85%(16/135),HPV58 was 5.93%(8/135),and other HPV subtypes were 32.59%(44/135).Conclusion For patients with CIN Ⅲ,total hysterectomy is not necessarily required,but for HPV16,HPV18,the indications can be appropriately relaxed to reduce the rate of disease recurrence and the risk of progression to cervical cancer.

关 键 词：宫颈环切术 重度宫颈上皮内瘤变 全子宫切除术 病灶残留 

分 类 号：R283[医药卫生—中药学]