阴道镜联合宫颈环形电刀切除术治疗人乳头瘤病毒感染相关宫颈癌前病变的临床效果  

Clinical effect of colposcopy combined with loop electrosurgical excision procedure on treatment of human papillomavirus infection-associated cervical precancerous lesions

作　　者：穆博然[1] 李孟慧[1] 刘军[1] 李华 MU Bo-ran;LI Meng-hui;LIU Jun;LI Hua(Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院妇产科,北京100020

出　　处：《中华医院感染学杂志》2024年第14期2188-2191,共4页Chinese Journal of Nosocomiology

基　　金：首都卫生发展全科医学与社区卫生科研专项(首发2023-2Y-005)。

摘　　要：目的分析阴道镜结合宫颈环形电刀切除术(LEEP)治疗人乳头瘤病毒(HPV)感染相关宫颈癌前病变的临床效果.方法选取2020年1月-2022年12月首都医科大学附属北京朝阳医院收治的111例HPV感染相关宫颈癌前病变患者为研究对象,其中宫颈冷刀锥切组为对照组52例,阴道镜联合LEEP组为研究组59例.治疗6个月后评价效果.对比两组疗效、手术指标、炎症因子、并发症、复发情况、HPV清除率.结果研究组总有效率更高(P<0.05),术中出血量较少,手术时间较短(P<0.05).与治疗前相比,两组治疗后外周血炎症因子肿瘤坏死因子(TNF)-α和白细胞介素(IL)-4、IL-17水平均降低(P<0.05),与对照组相比,阴道镜联合LEEP组炎症因子水平降低更明显(P<0.05).两组总并发症对比无统计学差异.两组复发率对比无统计学差异.研究组HPV清除率高于对照组(P<0.05).结论阴道镜联合LEEP用于HPV感染相关宫颈癌前病变患者可增强治疗效果,促进患者恢复,提高HPV清除率,且安全可靠.OBJECTIVE To observe the clinical effect of colposcopy combined with loop electrosurgical excision pro-cedure(LEEP)on treatment of human papillomavirus(HPV)infection-associated cervical precancerous lesions.METHODS Totally 111 patients with HPV infection-associated cervical precancerous lesions who were treated in Beijing Chaoyang Hospital Affiliated to Capital Medical University from Jan 2020 to Dec 2022 were recruited as the research subjects,52 of whom underwent cold knife conization and were assigned as the control group,and 59 underwent the colposcopy combined with LEEP and were assigned as the study group.The curative effect was e-valuated after the treatment for 6 months.The curative effect,surgical indexes,inflammatory factors,complica-tions,recurrent rate and HPV eradication rate were observed and compared between the two groups.RESULTS The total effective rate was higher in the study group(P<0.05),the intraoperative blood loss volume was less,and the operation duration was shorter(P<0.05).The levels of peripheral blood tumor necrosis factor(TNF)-α,interleukin(IL)-4 and IL-17 of the two groups were lower after the treatment than before the treatment(P<0.05).The levels of inflammatory factors of the colposcopy combined LEEP group were significantly lower than those of the control group(P<0.05).There was no significant difference in the total complications between the two groups.There was no significant difference in the recurrent rate between the two groups.The HPV eradica-tion rate of the study group was higher than that of the control group(P<0.05).CONCLUSION The colposcopy combined with LEEP can boost the curative effect on the patients with HPV infection-associated cervical precancer-ous lesions,promote the recovery,and raise the HPV eradication rate.It is safe and reliable.

关 键 词：阴道镜 宫颈环形电刀切除术 人乳头瘤病毒 宫颈癌前病变 复发风险 

分 类 号：R737.33[医药卫生—肿瘤]