221例宫颈上皮内瘤变患者的治疗与随访  

A Follow-up Study of 221 Women With Cervical Intraepithelial Neoplasia

作　　者：陆晓媛[1] 高之睦[1] 

机构地区：[1]徐州医学院附属医院妇产科,江苏徐州221005

出　　处：《中国医师杂志》2003年第4期488-490,共3页Journal of Chinese Physician

摘　　要：目的　分析宫颈上皮内瘤变 (CIN)不同治疗方案的随访结果 ,评价其临床疗效。方法　对 1995～ 1999年我院宫颈活检诊断为CIN的 2 35例患者 ,根据病变程度及本人意愿施以不同的治疗和处理 ,并对随访结果进行回顾性分析。结果　低度上皮内病变 (LGSIL)即CINI中期待治疗组 12个月及 2 4个月后自然转常率分别为 78 33%和 81 67% ;期待治疗组与激光治疗组转常率间差别无显著性 (P >0 0 5 )。高度上皮内病变 (HGSIL)组中 ,激光治疗组与LLETZ组及与全子宫切除治疗组间差别均有显著性 (P<0 0 5 ) ;而LLETZ组与全子宫切除组间 ,差别无显著性 (P <0 0 5 )。结论　在保证良好依从性的前提下 ,期待治疗对CINI患者是一种安全的疗法。LLETZ是治疗HGSIL安全而有效的方法 。Objective To evaluate the different therapeutic schedule and its clinical effect on cervical intraepithelial neoplasia (CIN).Methods 235 patients diagnosed as CIN were treated with different treatment(14 were lost to followed-up). The follow-up results were analyzed retrospectively.Results In low grade squamous intraepithelial lesion (LGSIL),the rates of spontaneous resolution in expectant group in 12 months and 24 months were 78 33% and 81 67% respectively. The resolution rates in expectant group and laser therapy group were no significantly different (P>0 05). In high grade squamous intraepithelial lesion (HGSIL), the differences between the laser treated group and either LLETZ or total hysterectomy groups turned into normal rate was significantly (P<0 05). There was no significant difference between LLETZ and total hysterectomy groups (P>0 05).Conclusions Expectant treatment for CIN I is safe in a reliable patient population. LLETZ is a safe and effective treatment for HGSIL. The long-term efficacy of LLETZ should be investigated and assessed by extending the period of follow-up.

关 键 词：宫颈上皮内瘤变 随访 期待治疗 

分 类 号：R737.33[医药卫生—肿瘤]