不同子宫颈锥切方案治疗高级别子宫颈上皮内瘤变的临床对比  

Clinical Comparison of Different Cervical Conization Schemes in the Treatment of High-grade Cervical Intraepithelial Neoplasia

作　　者：傅慧琴 FU Huiqin(Zhangshu Third People's Hospital,Jiangxi Province,Zhangshu 331200,China)

机构地区：[1]江西省樟树市第三人民医院,江西樟树331200

出　　处：《中国医学创新》2023年第7期62-66,共5页Medical Innovation of China

摘　　要：目的:对比分析子宫颈环形电切术(LEEP)、普通电刀锥切术(EKC)在高级别子宫颈上皮内瘤变(CIN)患者中的应用效果。方法:本研究采用前瞻性随机对照的研究方法,选取2018年1月-2021年6月樟树市第三人民医院收治的84例高级别CIN患者,以随机数字表法将患者分为LEEP组(行LEEP治疗)与EKC组(行EKC治疗),每组42例。比较两组一般资料、手术时间、术中出血量、锥切高度及锥切面积、切缘状态;比较两组人乳头瘤病毒(HPV)感染、病灶残留、病灶复发及并发症发生情况。结果:两组手术时间、术中出血量比较,差异均无统计学意义(P>0.05)。LEEP组锥切面积小于EKC组,锥切高度低于EKC组,差异均有统计学意义(P<0.05)。LEEP组切缘阳性率高于EKC组,差异有统计学意义(P<0.05)。术前,两组HPV感染率比较,差异无统计学意义(P>0.05);术后6个月,两组HPV感染率均低于术前,差异有统计学意义(P<0.05);但两组术后6个月HBV感染率对比,差异无统计学意义(P>0.05)。两组病灶残留率对比,差异无统计学意义(P>0.05)。LEEP组病灶复发率高于EKC组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:LEEP、EKC治疗高级别CIN的手术时间、术中出血量相当,但EKC在维持切割深度、切除病灶、降低切缘阳性率方面更具优势,且LEEP、EKC治疗高级别CIN均具有较好的安全性。Objective:To compare and analyze the application effect of loop electrosurgical excisional procedure(LEEP)and common electrosurgical knife conization(EKC)in patients with high-grade cervical intraepithelial neoplasia(CIN).Method:A prospective randomized controlled study was used in this study,84 cases of high-grade CIN patients admitted to the Zhangshu Third People’s Hospital from January 2018 to June 2021 were selected,they were divided into LEEP group(received LEEP treatment)and EKC group(received EKC treatment)by random number table method,with 42 cases in each group.The general data,operation time,intraoperative blood loss,conization height,conization area and the status of incision margin were compared between the two groups;human papillomavirus(HPV)infection,lesion residual,recurrence and complications were compared between the two groups.Result:There were no significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).The cone-cutting area in LEEP group was lower than that in EKC group,and the cone-cutting height in LEEP group was lower than that in EKC group,the differences were statistically significant(P<0.05).The positive rate of incisal margin in LEEP group was higher than that in EKC group,the difference was statistically significant(P<0.05).Before operation,there was no significant difference in HPV infection rate between the two groups(P>0.05).After 6 months of operation,the infection rate of HPV in both groups were lower than those before operation,the differences were statistically significant(P<0.05).However,there was no significant difference in HPV infection rate between the two groups after 6 months of operation(P>0.05).There was no significant difference in lesion residual rate between the two groups(P>0.05).The recurrence rate in LEEP group was higher than that in EKC group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:The operati

关 键 词：子宫颈上皮内瘤变 子宫颈环形电切术 普通电刀锥切术 

分 类 号：R737.33[医药卫生—肿瘤]