子宫颈鳞状上皮内病变子宫颈环形电切术术后病变残留或复发情况及影响因素研究  

Study on the factors affecting residual or recurrent lesions in patients with cervical squamous intraepithelial lesion after loop electrosurgical excision procedure

作　　者：王雅卉 郑颖龄 周丽[1] WANGYa-Hui;ZHENG Ying-Ling;ZHOU Li(Department of Obstetrics and Gynecology,the First People's Hospital of Hangzhou,Medical College of Zhejiang University,Hangzhou,Zhejiang 310006,China)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院妇科,浙江杭州310006

出　　处：《中国妇幼保健》2020年第19期3567-3571,共5页Maternal and Child Health Care of China

基　　金：杭州市卫生科技计划(一般)项目(2018B026)。

摘　　要：目的探讨子宫颈鳞状上皮内病变(SIL)患者子宫颈环形电切术(LEEP)后病变残留或复发情况及其影响因素。方法选取2017年1月-2018年1月在该院行LEEP术且经术后病理诊断结果为SIL的患者96例为研究对象,随访2年观察术后病变残留或复发情况,采用单因素分析和多因素Logistic分析其影响因素。结果 96例患者中,术后病变残留率为5.21%,复发率为10.42%,累计残留/复发率为15.63%。多因素Logistic回归分析结果显示,多重HR-HPV、腺体受累、多象限受累、切缘阳性、HPV持续感染均是残留/复发的独立危险因素(均P<0.05)。结论多重HR-HPV感染、腺体受累、多象限受累、切缘阳性、术后HPV持续感染的CIN患者LEEP术后具有较高的残留/复发风险,密切随访和针对性管理对减少CIN复发具有积极作用。Objective To investigate the riskfactors for residual or recurrent lesions in patients with cervical squamous intraepithelial lesion(SIL)after loop electrosurgical excision procedure(LEEP).Methods A total of 96 patients who underwent cervical circular electrotomy in the hospital from January 2017 to January 2018 and were diagnosed as SIL by postoperative pathology were selected as the study subjects,followed up for 2 years to observe postoperative lesion residual or recurrence.The riskfactors wereanalyzedby univariate analysis and Logisticanalysis.Results Among the 96 patients,the residual lesions rate was 5.21%,the recurrence rate was 10.42%,and the cumulative residual/recurrent rate was 15.63%.Multivariate Logistic regression analysis showed that,multiple HR-HPV,lesions involving glands,multiple quadrants involvement,positive resection margin,and persistent HPV infection were the independent risk factors forresidual/recurrent lesions(all P<0.05).Conclusion The patients with multiple HR-HPV infection,lesions involving glands,multiple quadrants involvement,positive resection margin and persistent HPV infection are at high-risk of residual/recurrent lesions after LEEP.Close follow-up and targeted management has positive effect on reducing CIN recurrence.

关 键 词：子宫颈鳞状上皮内病变 子宫颈环形电切术 病变残留 病变复发 危险因素 

分 类 号：R711.74[医药卫生—妇产科学]