宫颈截除术治疗绝经后子宫颈高级别鳞状上皮内病变患者的临床效果  

Clinical effect of cervical resection in the treatment of postmenopausal patients with high-grade cervical squamous intraepithelial lesions

作　　者：王生芳 张雅薇 雷磊 WANG Shengfang;ZHANG Yawei;LEI Lei(Wuqi People's Hospital,Yan'an 717600;Dali County Maternal and Child Health Care Hospital,Weinan 715100;Shaanxi Provincial Cancer Hospital,Xi'an 710061,China)

机构地区：[1]吴起县人民医院,陕西延安717600 [2]大荔县妇幼保健院,陕西渭南715100 [3]陕西省肿瘤医院,陕西西安710061

出　　处：《临床医学研究与实践》2022年第24期76-79,共4页Clinical Research and Practice

摘　　要：目的 探讨宫颈截除术治疗绝经后子宫颈高级别鳞状上皮内病变患者的临床效果。方法 回顾性分析2018年1月至2020年8月于我院接受宫颈截除术或宫颈锥切术治疗的120例绝经后宫颈高级别鳞状上皮内病变患者的临床资料,分别将其设置为观察组和对照组,各60例。比较两组患者的手术相关指标、术后下床活动时间、住院时间、术后并发症发生情况、切缘阳性率、人乳头瘤状病毒(HPV)转阴率、复发率、疼痛程度、血清炎症因子水平、免疫功能指标。结果 两组的手术时间、术后下床活动时间、住院时间、并发症总发生率均无显著差异(P>0.05);观察组的术中出血量多于对照组,差异具有统计学意义(P<0.05)。观察组的切缘阳性率、复发率显著低于对照组,差异具有统计学意义(P<0.05);术后随访6个月,观察组的HPV转阴率显著高于对照组(P<0.05)。术后12、24、36、48 h,两组的视觉模拟评分法(VAS)评分均呈逐渐降低趋势(P<0.05),但组间比较,差异无统计学意义(P>0.05)。术后第1、2、3天,两组的C反应蛋白、降钙素原水平均呈逐渐降低趋势(P<0.05),但组间比较,差异无统计学意义(P>0.05)。术前、术后6个月,两组的白细胞分化抗原3阳性(CD3^(+))、白细胞分化抗原4阳性/白细胞分化抗原8阳性(CD4^(+)/CD8^(+))组内及组间比较,差异无统计学意义(P>0.05)。结论 宫颈截除术治疗绝经后宫颈高级别鳞状上皮内病变患者,可减少病变残留,提高术后HPV转阴率,减少复发。Objective To investigate the clinical effect of cervical resection in the treatment of postmenopausal patients with high-grade cervical squamous intraepithelial lesions.Methods The clinical data of 120 postmenopausal patients with high-grade cervical squamous intraepithelial lesions who underwent cervical resection or cervical conization in our hospital from January 2018 to August 2020 were retrospectively analyzed.The patients were set up as observation group and control group,with 60 cases in each group.The operation related indexes,postoperative out of bed activity time,hospital stay,postoperative complications,positive rate of incisional margin,negative rate of human papillomavirus(HPV),recurrence rate,degree of pain,serum inflammatory factors levels and immune function indexes were compared between the two groups.Results There were no significant differences in operation time,postoperative out of bed activity time,hospital stay and total incidence of complications between the two groups(P >0.05);the intraoperative blood loss volume of the observation group was more than that of the control group,the difference was statistically significant(P0.05).On the 1st,2nd and 3rd day after operation,the levels of C-reactive protein and procalcitonin in the two groups showed a gradual downward trend(P 0.05).Before and 6 months after operation,there were no significant differences in cluster of differentiation 3 positive(CD3+),cluster of differentiation 4 positive/cluster of differentiation 8positive(CD4+/CD8+) within and between the two groups(P>0.05).Conclusion The cervical resection in the treatment of postmenopausal patients with high-grade cervical squamous intraepithelial lesions can reduce the residual lesions,improve the negative rate of HPV and reduce the recurrence.

关 键 词：宫颈高级别鳞状上皮内病变 宫颈截除术 宫颈锥切术 人乳头瘤状病毒 

分 类 号：R711.74[医药卫生—妇产科学]