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高频电波刀用于子宫颈病变诊断与治疗的临床观察 被引量:189

Application of High Frequency Radiosurgical Knife in the Treatment of Cervical Diseases
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摘要 目的 总结应用高频电波刀的电圈切除术 (LEEP)对宫颈病变诊治的指征、病灶切除范围和病理特点。方法 将细胞学和阴道镜检查异常 [宫颈上皮内瘤样变 (CIN)、不典型鳞状细胞(ASCUS) ]的 176例患者 ,分成两部分。对≥CIN2 行锥切术 ,采用LEEP 33例、传统电刀 30例 ;对CIN1和ASCUS行活检术 ,采用LEEP 6 0例、宫颈活检钳 5 3例。LEEP锥切宫颈管组织深 15mm ,宫颈组织深7mm ;活检术切除宫颈、宫颈管组织各深 4mm。结果 LEEP锥切术后 3个月行细胞学检查 ,病变持续存在率 6 .1% ,与传统电刀的 6 .7%相似 ;手术时间 (5 .0± 0 .5 )min ,较传统电刀 (15 .0± 0 .4)min短 ;术中出血与宫颈修复时间均短于传统电刀 (P <0 .0 1)。LEEP活检术后 3个月行细胞学检查 ,病变持续存在率 1.7% ,明显少于宫颈活检钳法 (35 .8% )。其他手术情况相似。结论 LEEP适用于宫颈CIN2 ,3的锥切术和宫颈CIN1、ASCUS的活检术 ,省时、安全 ,可提供完整的病理标本 。 Objective To investigate the indication,resection scope of loop electrosurgical excision procedure (LEEP) and pathological characteristics. Methods 176 cases with abnormal cytological and colposcopical findings, including cervical intraepithelial neoplasia (CIN) and atypical squamous cells of undermined significance (ASCUS), were studied. Conization of cervix was performed in 63 cases of≥CIN 2, of which 33 cases with LEEP and 30 by traditional electrosurgical knife (TEK) as controls. Cervical biopsy was performed in 113 cases of CIN 1 and ASCUS, of which 60 cases by LEEP and 53 by cervical biopsy forceps (CBF) as controls. Results Three months after conization of cervix the cytological persistent rate of disease was 6.1% in LEEP group and 6.7% in TEK group ( P >0.05). The operation duration of LEEP is (5.0±0.5) min, and is much shorter than TEK [(15.0±0.4) min]. The bleeding and recovery time of the cervix are also shorter ( P < 0.01) . Three months after cervical biopsy the cytological persistent rate of diseases was only 1.7% in LEEP group, significantly less than that in CBF group (35.8%). Conclusion LEEP is indicated to conization of cervix of CIN 2 3 and cervical biopsy of CIN 1 and ASCUS. It is safe and time saving. The optimal depth of cervical conization and biopsy was 7 mm and 4 mm respectively in the cervix, and 15 mm and 4 mm respectively in the cervical tube. It can offer intact sample for pathological diagnosis, and has special value for detecting cervical microinvasive carcinoma and local minor carcinoma.
出处 《中华妇产科杂志》 CAS CSCD 北大核心 2000年第3期160-162,共3页 Chinese Journal of Obstetrics and Gynecology
关键词 电外科手术 子宫颈病变 CIN ASCUS LEEP Electrosurgery Cervical intraepithelial neoplasia
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参考文献1

  • 1Chanen W,Obstet Gynecol,1983年,61卷,673页

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