不同手术及缝合方式治疗中重度宫颈上皮内瘤变的临床观察

Surgical Suture and Different Treatment Clinical Observation of Cervical Intraepithelial Neoplasia

目的:探讨中重度宫颈上皮内瘤变(CINⅡ-Ⅲ)行宫颈锥切治疗的不同止血方式。方法分析75例在阴道镜下活检,病理诊断 CINⅡ-Ⅲ患者,其中行宫颈环形电切(LEEP)术治疗的40例,行宫颈冷刀锥切采用二、二、二式(甲、乙、丙、丁)缝合的35例,对比两组手术后的出血、宫颈残端感染、残端愈合、及病理诊断切缘情况。结果 LEEP术中出血超过20 mL者15例,占37.5%;术后宫颈残端感染者10例,占25%;病理诊断切缘阳性者5例,占12.5%;术后2个月残端愈合10例,占25%。宫颈冷刀锥切采用二、二、二式(甲、乙、丙、丁)缝合术后出血超过20 mL者0例,占0%,术后宫颈残端感染者2例,占5.7%;病理诊断切缘阳性者0例,占0%,均明显低于LEEP术组。术后2个月残端愈合35例,占100%,均明显高于LEEP术组。结论宫颈残面采用二、二、二式(甲、乙、丙、丁)缝合应用于宫颈冷刀锥切术,较LEEP术止血效果好,感染机会小,疤痕少,对标本切缘的病理诊断无影响,残端愈合快。

Objective Explore the relation between the cervical intraepithelial neoplasia(CIN)line of the cervical cone cut ing way of dif erent hemostatic treatment.Methods Analysis of 75 cases of biopsy under colposcope,pathologic diagnosis of CIN patients,including line for the treatment of cervical annular cut ing(LEEP)of 40 cases,lines of cervical cold knife cuts adopted 2 2 2 type cone(a b c d)suture of 35 cases,compared two groups of bleeding after the operation Cervical residual infection Stump healing and pathologic diagnosis in cut edge.Results LEEP intraoperative bleeding more than 20 ml,15 cases(37.5%);Postoperative cervical stump infections in 10 cases,accounting for 25%;Pathological diagnosis cut edge was in 5 cases,accounting for 12.5%;After 2 months stump healing in 10 cases,25%of cervical cold knife cuts adopted 2 2 2 type cone(a b c d)suture postoperative bleeding were more than 20 ml=0),(0%),postoperative cervical stump infection in 2 cases,accounting for 5.7%;Pathological diagnosis of cut edge biopsies was 0,0%,were significantly lower than after two months of LEEP surgery group stump healing in 35 cases,accounted for 100%,were significantly higher than in the LEEP technique group.Conclusion Cervical residual surface using 2 2 2 type(a b c d)cone suture used in cervical cold knife cut method,the LEEP surgery hemostatic ef ect is good,infection,scar is little,pathological diagnosis of specimens cut edge ef ect,residual heal faster.