子宫颈鳞状上皮内病变患者LEEP后病变残留及复发的影响因素研究  

Influencing factors of residual and recurrent lesions in patients with cervical squamous intraepithelial lesions after LEEP

作　　者：贾惠荔 JIA Huili(Zhoukou Maternal and Child Health Care Hospital(Zhoukou Children's Hospital),Zhoukou,Henan 466000,China)

机构地区：[1]周口市妇幼保健院(周口市儿童医院),河南周口466000

出　　处：《中国医学工程》2023年第11期112-115,共4页China Medical Engineering

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)后病变残留及复发的影响因素。方法选取2021年6月至2022年8月就诊的子宫颈鳞状上皮内病变采取LEEP患者356例作为研究对象,收集所有研究者的资料,随访2年观察患者术后病变残留及复发情况,根据其是否有病变残留及复发分为两组:有残留/复发(94例)、无残留/复发(262例),采用Logistic回归分析疾病复发的影响因素。结果在356例接受LEEP术的子宫颈鳞状上皮内病变患者当中,无残留/复发例数为262例(73.60%),有残留/复发的患者94例(26.40%);通过分析发现,患者LEEP术后无残留/复发组与有残留/复发组比较,高危型人乳头瘤病毒(HR-HPV)、病理结果、受累象限差异有统计学意义(P<0.05);通过多因素Logistic分析显示,多重HR-HPV、腺体受累、多象限受累、宫颈上皮内癌变(CIN)Ⅲ、切缘阳性及人乳头瘤病毒(HPV)持续感染是残留及复发的独立危险因素(P<0.05)。结论子宫颈鳞状上皮内病变患者LEEP后病变残留及复发的因素与多重HR-HPV、腺体受累有关,还会受到切缘阳性、HPV持续感染的影响,在临床当中需及时复查和治疗,避免复发。【Objective】To investigate the influencing factors of residual and recurrence of cervical squamous intraepithelial lesions after LEEP.【Methods】Totally 356 cases of cervical squamous intraepithelial lesions treated with LEEP from June 2021 to August 2022 were selected as research objects,data of all researchers were collected,and patients were followed up for 2 years to observe the residual and recurrence of postoperative lesions.Patients were divided into 2 groups according to whether they had residual and recurrence of lesions:There were 94 cases of residual/recurrence,262 cases of no residual/recurrence,and the influencing factors of disease recurrence were analyzed by logistic regression.【Results】Among 356 cases of squamous intraepithelial lesion(SIL)patients with LEEP,262 cases(73.60%)had no residual/recurrence,and 94 cases(26.40%)had residual/recurrence.It was found that there were significant differences in HR-HPV,pathology results,and involved quadrants between residual/recurrence group and non-residual/recurrence group(P<0.05).Multivariate logistic analysis showed that multiple HR-HPV,glandular involvement,multi-quadrant involvement,cervical intraepithelial neoplasia(CIN)Ⅲpositive incisal margin and persistent HPV infection were independent risk factors for residual and recurrence(P<0.05).【Conclusion】The factors of residual lesions and recurrence in patients with cervical squamous intraepithelial lesions after LEEP are related to multiple HR-HPV and glandular involvement,and may also be affected by positive incisal margin and persistent HPV infection.Timely review and treatment are needed in clinical practice to avoid recurrence.

关 键 词：子宫颈鳞状上皮内病变 LEEP 病变复发 因素 

分 类 号：R737.33[医药卫生—肿瘤]