高频电波刀行电圈切除治疗宫颈病变的临床应用探讨

Evaluation of loop electrosurgical excision procedure in the treatment of cervical diseases

目的 评价高频电波刀行电圈切除 (LEEP)治疗宫颈病变中的临床应用价值。方法 回顾性分析我院 2 71例LEEP治疗宫颈病变的临床资料 ,所有病例均行阴道镜下多点活检和LEEP术后病理诊断 ,在炎症和赘生物病变外缘 3mm进出电极 ,对于CINI与HPV感染患者 ,电极在病变边缘外 5mm进出。结果 阴道镜下多点活检与LEEP术标本的病理诊断差别有显著性 (P <0 0 5 )。 2 71例患者术后随访 2 4 3例 ,术后复查宫颈细胞学 ,仅 9 0 5 %出现细胞核肥大和核异质。结论 LEEP对包括炎症、损伤、癌前病变、HPV感染等宫颈病变是一种非常理想的诊断、治疗手段。宫颈细胞学检查、阴道镜下多点活检、LEEP术后病理诊断构成了宫颈病变系统的诊断模式。LEEP可以广泛地应用于治疗CIN各级病变 (原位癌除外 ) ,LEEP也适用于CINI的治疗 ,LEEP治疗的范围可以在病变边缘外

Objective To evaluate loop electrosurgical excision procedure (LEEP) in the treatment of cervical diseases Methods Two hundred and seventy-one patients with cervical diseases underwent LEEP in clinic of Fujian Province Maternal & Child Hospital from 2000 to 2002 were analyzed retrospectively All the patients were treated by excision of 3 mm or 5 mm outside from the outskirts of the cervical lesions following colposcopy and biopsy Results Histological diagnosis were discrepancy between biopsies directed by colposcope and LEEP specimens( P <0 05) After LEEP treatment,243 women were followed up and 9 05 % of them showed cervical cytological abnormal Conclusions LEEP is an ideal method of cervical diseases diagnosis and treatment,especially in the treatment of CIN I to CIN III It can provide intact sample for pathological diagnosis,and 5 mm outside from the edge of the lesion is suitable for treatment