宫颈HSIL患者锥切术联合重组人干扰素治疗后复发残留的影响因素  

Factors influencing recurrence residual in patients with cervical HSIL after conization combined with recombinant human interferon therapy

作　　者：杨海霞[1] 曹正青 汪莹[1] 刘丽丽[1] YANG Hai-xia;CAO Zheng-qing;WANG Ying(Maternal and Child Health Hospital of Tangshan,Tangshan Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院手术室,河北唐山063000

出　　处：《临床和实验医学杂志》2024年第9期972-976,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省卫健委项目(编号:20191526)。

摘　　要：目的探讨锥切术联合重组人干扰素治疗后宫颈高度鳞状上皮内病变(HSIL)复发残留的相关影响因素。方法回顾性选取2020年1月至2022年1月唐山市妇幼保健院收治的宫颈HSIL患者217例,收集患者术前、术后相关临床资料。根据患者术后1年是否复发或残留,分为复发残留组(n=41)及无复发残留组(n=176)。对比两组临床资料、HPV高危型及低危型发生率,并采用多因素Logistic回归分析宫颈HSIL患者锥切术后HSIL复发残留的影响因素。结果217患者经过治疗发生尿潴留7例,尿路感染3例,留置尿管时间和残余尿量分别为(10.26±3.25)d、(60.25±15.52)mL,患者均能自主排尿。复发残留组与无复发残留组年龄、初次性生活年龄、人工流产史、术前HPV感染类型、锥切标本宽度及厚度、累及腺体、切缘状态、术后用药、术后性生活比较,差异均有统计学意义(P<0.05)。锥切术前,HSIL复发残留组HPV感染以高危型为主,无复发残留患者以低危型为主。Logistic分析显示,术前HPV高危型感染、锥切标本宽度≤2 cm、锥切标本厚度≤1 cm、累及腺体和切缘阳性均为锥切术后宫颈HSIL患者复发残留的高危影响因素。结论锥切术结合重组人干扰素治疗HSIL可以有效促进患者术后排尿功能的康复;锥切术前,HSIL复发残留组HPV感染以高危型为主,术前HPV高危型感染、锥切标本宽度≤2 cm、锥切标本厚度≤1 cm、累及腺体和切缘阳性均为锥切术后宫颈HSIL患者复发残留的高危影响因素。Objective To explore the factors influencing the recurrence residual cervical high grade squamous intraepithelial lesions(HSIL)after conization combined with recombinant human interferon treatment.Methods Two hundred and seventeen HSIL patients admitted to Maternal and Child Health Hospital from January 2020 to January 2022 were retrospectively selected,and the relevant preoperative and postoperative clinical data of the patients were collected.According to whether the patients relapsed or remained 1 years after surgery,they were divided into the recurrent and residual patients group(n=41)and the recurrence-free residual group(n=176).The clinical data,incidence rates of high-risk and low-risk HPV types were compared between the two groups,and the influencing factors of residual HSIL recurrence in cervical HSIL patients after conization were analyzed using multivariate Logistic regression.Results After treatment,217 patients suffered from urinary retention in 7 cases,urinary tract infection in 3 cases,retention time of catheter and residual urine volume were(10.26±3.25)d and(60.25±15.52)mL,respectively.All patients were able to urinate autonomously.There were statistically significant differences between the recurrent residual group and the non-recurrent residual group in terms of age,age at first sexual intercourse,history of induced abortion,preoperative HPV infection type,width and thickness of conization specimen,involved glands,resection margin status,postoperative medication,and postoperative sexual life(P<0.05).Before conization,the HPV infections in the HSIL relapsed and residual group were mainly high-risk types;patients without recurrence and residual disease were mainly low-risk types.Logistic analysis showed that preoperative HPV high-risk infection,conization specimen width≤2 cm,conization specimen thickness≤1 cm,involved glands and positive resection margins were high-risk factors for residual recurrence in cervical HSIL patients after conization.Conclusion Conectomy combined with recombinant h

关 键 词：宫颈鳞状上皮内瘤变 锥切术 重组人干扰素 复发残留 

分 类 号：R713.4[医药卫生—妇产科学]