高频电刀在治疗宫颈上皮内瘤变中的应用及护理

Clinical application and nursing care of the loop electrosurgical excision procedure in the management of cervical intraepithelial neoplasia

【目的】探讨高频电刀(LEEP)的治疗宫颈上皮内瘤变(CIN)中的应用及护理方法。【方法】回顾性分析2003年6月—2004年9月,我院运用高频电刀治疗CIN患者271例,总结其疗效及护理要点。【结果】271例患者经LEEP治疗,259例(95.57%)治愈,7例(2.58%)有CIN病变残留。在146例随访超过1年的患者中,4例(2.74%)CIN病变复发。LEEP术前活检与术后病理标本间102例(37.64%)存在显著性差异(P<0.05),其中93例(34.32%)为病变降级。254例(93.73%)患者表示对CIN及LEEP术不了解,存在紧张焦虑心理。21例(7.75%)患者出现术后宫颈创面渗血过多,29例(10.70%)出现宫颈腺上皮增生。【结论】LEEP术治疗CIN,操作简单、安全,手术并发症少,治愈率高。术前健康教育利于消除患者紧张心理,积极配合手术。术前阴道准备,术后卫生指导及宫颈创面护理对促进创面愈合,减少手术并发症有重要意义。

【Objective】To study the effect and nursing care of loop electrosu rgical excision procedure(LEEP) for the management of cervical intraepithelial neoplasia(CIN).【Methods】LEEP under local anesthesia and colposcopic guidance was performed in an outpatient colposcopic clinic.Records of 271 patients treated between Jun.2003 and Sep.2004 were reviewed retrospectively.【Results】The overall cure rate in this study was 95.57% after first LEEP.The residual CIN was identified in 7 patients(2.58%).Recurrent CIN occurred in 4 patients(2.74%).There were 102 cases(37.64%) present difference in the biopsy between pre-LEEP and after it(P<0.05),among them 93 cases(34.32%) were pathological degradation.93.73% of the patients had poor knowledge about the CIN and LEEP.Complications occurred in 50 patients(18.45%) in this study.【Conclusion】LEEP is a kind of effective and safe method for the treatment of CIN.The vaginal preparation,the health instruction and the cervical wound nursing after the surgery are of great importance to help the healing of wound and decreasing of surgery complication.