宫腔镜宫颈锥形电切术治疗宫颈病变的价值

The value of the cervical cone electrosection through hysteroscopy in the therapy of cervical affection

目的:评价宫腔镜宫颈锥形电切术在CIN中的诊断和治疗价值。方法:回顾分析60例宫颈锥切术患者的细胞学、阴道镜检查及活检结果;宫颈锥切病理及子宫切除术的病理结果及并发症的防治及随诊结果。结果:宫颈锥切术的病理结果与阴道镜活检的病理结果相符者35例(58.3%),较活检病理结果重者10例(16.7%),较活检病理结果轻者15(25%),9例CIN(包括CIS)保留生育功能,术后每3个月随诊宫颈刮片均阴性。术后出血15例(2.5%),宫颈粘连狭窄2例(3.3)。结论:宫腔镜宫颈锥形电切术在CIN的诊断中能明确病变程度,决定下一步处理方式,对年轻有生育要求的CIN(包括CIS)患者是一个合适的方法。

Objective:To assess the value of the cervical cone electrosection through hysteroscope in the diagnosis and treatment of CIN.Methods:We reviewed the results by cytological exam,colposcope exam and biopsy,as well as the pathologic consequences after the cervical cone eletrocision and the uterine excision,of 60 patients with the cervical cone eletrocision through hysteroscope,and analyzed the prevention and follow-up consequence of the compications.Results:Compared with the biopsy results of the colposcope,the pathologic consequences of 35 patients were coincident(58.3%).The pathologic consequences of 10 patients were severer than the biopsy results(16.7%).The pathologic consequences of 15 patients were lighter than the biopsy results(25.0%).9 patients in CIN III level(include CIS)still retained the procreation ability,and the cervical scraping results were all negative in the follow-up in every three months after the operations.15 patients had hemorrhage after the operations(2.5%).2 patients had cervical conglutination and stenosis after the operation(0.3%).Conclusions :The cervical cone eletrocision through hysteroscope can identify the extent of affection in the diagnosis of CIN,determine the further treatments,and also is a suitable therapy for young patients in CIN III level(include CIS)who have procreation requests.