宫颈环形电切术治疗高级别宫颈上皮内瘤变患者的效果及其对术后宫颈粘连的影响  

Effect of loop electrosurgical excision procedure on patients with high-grade cervical intraepithelial neoplasia and its effect on postoperative cervical adhesion

作　　者：梁美琳 江少菊 文美婷 LIANG Meilin;JIANG Shaoju;WEN Meiting(Department of Gynecology,Jiujiang City Chaisang District Maternal And Child Health Hospital,Jiujiang,Jiangxi,332100,China)

机构地区：[1]九江市柴桑区妇幼保健院妇科,江西九江332100

出　　处：《当代医学》2023年第30期162-165,共4页Contemporary Medicine

摘　　要：目的探讨宫颈环形电切术治疗高级别宫颈上皮内瘤变患者的效果及其对术后宫颈粘连的影响。方法回顾性分析2020年2月至2021年2月九江市柴桑区人民医院收治的120例高级别CIN患者的临床资料,均行宫颈环形电切术治疗。统计手术结果、预后情况及患者临床资料,Logistic回归分析宫颈环形电切术后宫颈粘连的影响因素。结果所有患者均顺利完成手术,手术时间为(11.27±2.09)min,术中出血量为(15.29±2.83)ml,切口愈合时间为(22.91±6.74)d,术后切缘阳性率为8.0%,宫颈粘连发生率为6.7%,术后宫颈狭窄发生率为4.2%,术后出血发生率为13.3%,术后复发率为1.7%。术后粘连与术后未粘连患者年龄、CIN分级、术后是否感染比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄≥50岁、CINⅢ级、术后感染是CIN患者术后发生宫颈粘连的危险因素(OR>1,P<0.05)。结论子宫颈环形电切术治疗高级别CIN患者疗效较理想,年龄≥50岁、CINⅢ级、术后感染是CIN患者术后发生宫颈粘连的危险因素,临床应实行对性干预措施,预防高级别CIN。Objective To investigate the effect of loop electrosurgical excision procedure in the treatment of patients with high-grade cervical in-traepithelial neoplasia(CIN)and its effect on postoperative cervical adhesion.Methods The clinical data of 120 patients with high-grade CIN admit-ted to Jiujiang Chaisang District People's Hospital from February 2020 to February 2021 were retrospectively analyzed,all patients were treated with loop electrosurgical excision procedure.The surgical results,prognosis and clinical data of patients were statistically analyzed,Logistic regression was used to analyze the influencing factors of cervical adhesion after loop electrosurgical excision procedure.Results All patients successfully com-pleted the operation.The operation time was(11.27±2.09)min,the intraoperative blood loss was(15.29±2.83)ml,the incision healing time was(22.91±6.74)d,the positive rate of postoperative margin was 8.0%,the incidence of cervical adhesion was 6.7%,the incidence of postoperative cervi-cal stenosis was 4.2%,the incidence of postoperative bleeding was 13.3%,and the postoperative recurrence rate was 1.7%.There were significant dif-ferences in age,CIN grade and postoperative infection between patients with postoperative adhesion and those without postoperative adhesion(P<0.05).Multivariate Logistic regression analysis showed that age≥50 years,CINⅢ,and postoperative infection were risk factors for postoperative cer-vical adhesions in patients with CIN(OR>1,P<0.05).Conclusion Cervical loop electrosurgical excision procedure is effective in the treatment of high-grade CIN patients,age≥50 years old,CINⅢgrade,and postoperative infection are risk factors for cervical adhesion in CIN patients after sur-gery,clinical intervention measures should be implemented to prevent high-grade CIN.

关 键 词：高级别宫颈上皮内瘤变 宫颈环形电切术 术后宫腔粘连 

分 类 号：R737.33[医药卫生—肿瘤]