聚焦超声与子宫颈环形电切术治疗子宫颈高级别鳞状上皮内病变疗效研究  

A study on the therapeutic efficacy of focused ultrasound and loop electrosurgical excision procedure for cervix high grade squamous intraepithelial lesions

作　　者：杨雨露 姚玉琴 张苗[2] 刘玉娟[2] 王文平[2] 廖萍 瞿大成[2] 周洪贵[2] YANG Yu-lu;YAO Yu-qin;ZHANG Miao;LIU Yu-juan;WANG Wen-ping;LIAO Ping;QU Da-cheng;ZHOU Hong-gui(North Sichuan Medical College,Nancong 637000,China;不详)

机构地区：[1]川北医学院,四川南充637000 [2]川北医学院附属医院,四川南充637000

出　　处：《中国实用妇科与产科杂志》2023年第12期1241-1244,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：四川省卫生健康委员会科技项目(2022JDXM006);超声医学工程国家重点实验室开放课题面上项目(2023KFKT014)。

摘　　要：目的 比较聚焦超声与子宫颈环形电切术(LEEP)治疗子宫颈高级别鳞状上皮内病变(HSIL)的转归及高危型人乳头瘤病毒(HR-HPV)清除情况,探讨聚焦超声治疗对子宫颈HSIL的安全性及有效性。方法 收集2020年1月至2022年6月川北医学院附属医院收治的HR-HPV感染且病理活检确诊为子宫颈HSIL患者140例,分为聚焦超声组70例和环形电切组70例,观察术后6、12个月患者子宫颈病变转归及HR-HPV转阴率。结果 聚焦超声组符合纳入条件者67例,其中完成随访者共61例;环形电切组符合纳入条件者共58例,其中完成随访者53例。治疗后6、12个月随访聚焦超声组HR-HPV累积清除率分别为49.2%、72.1%,子宫颈病变治愈率分别为72.7%、77.0%;环形电切组HR-HPV累积清除率分别为50.9%、71.7%,子宫颈病变治愈率分别为75.7%,77.4%。两组HR-HPV清除率及子宫颈病变治愈率差异均无统计学意义(P>0.05)。聚焦超声组治疗后发生子宫颈粘连、局部组织增生、瘢痕患者分别为0例、2例、0例,环形电切组分别为6例、5例、1例,两组比较差异有统计学意义(Z=-2.513,P<0.05)。结论 聚焦超声与子宫颈环形电切术治疗对于子宫颈HSIL能够达到相同疗效,聚焦超声治疗的并发症发生率更低,在把握适应证的前提下,聚焦超声可作为治疗子宫颈HSIL的选择之一。Objective The study aims to compare the outcomes of focused ultrasound with those of loop electrosurgical excision procedure(LEEP)in the treatment of cervical high-grade squamous intraepithelial lesions(HSIL)and the clearance of high-risk human papillomavirus(HR-HPV).We also aim to investigate the safety and efficacy of focused ultrasound therapy for HSIL.Methods A total of 140 patients diagnosed with HR-HPV infection and HSIL through pathological biopsy between January 2020 and June 2022 at the Affiliated Hospital of North Sichuan Medical College were included in this study.They were divided into two groups:the focused ultrasound group(n=70)and the loop electrosurgical excision procedure group(n=70).We observed the cervical lesion outcomes and HR-HPV clearance rates at 6 and 12 months after treatment.Results A total of 67 cases in the focused ultrasound group met the inclusion criteria,of which 61 cases completed follow-up;A total of 58 cases met the inclusion criteria in the LEEP group,of which 53 cases completed follow-up.The cumulative HR-HPV clearance rates in the focused ultrasound group at 6 and 12 months after treatment were 49.2%and 72.1%,respectively.The cure rates of cervical lesion were 72.7%and 77.0%at these respective time points.In the loop electrosurgical excision procedure group,the cumulative HR-HPV clearance rates at 6 and 12 months after treatment were 50.9%and 71.7%,respectively,and the cure rates of cervical lesion were 75.7%and 77.4%.There were no statistically significant differences in HR-HPV clearance rates or cure rates of cervical lesion between the two groups(P>0.05).The incidence of cervical adhesion,local tissue hyperplasia,and scarring after treatment in the focused ultrasound group was 0 case,2 cases,and 0 case,respectively,while in the loop electrosurgical excision procedure group,it was 6 cases,5 cases,and 1 case,respectively,and the differences between the two groups were statistically significant(Z=-2.513,P<0.05).Conclusion Focused ultrasound and loop electrosurgical excision

关 键 词：聚焦超声 环形电切术 高级别鳞状上皮内病变 高危型人乳头瘤病毒 疗效 

分 类 号：R711.422.27[医药卫生—妇产科学]