宫颈冷刀锥切术治疗宫颈上皮内瘤变Ⅲ级135例临床分析

CLINICAL ANALYSIS OF CERVICAL COLD KNIFE CONIZATION IN THE TREATMENT OF 135 CASES CERVICAL INTRAEPITHELIAL NEOPLASIA Ⅲ

目的探讨宫颈冷刀锥切术(cold knife conization,CKC)治疗宫颈上皮内瘤变Ⅲ级(cervicalintraepithelial neoplasia Ⅲ,CINⅢ)的意义及价值。方法采用CKC对135例经电子阴道镜多点活检病理确诊为CINⅢ的患者进行治疗,再次病理检查后分析其病理分级变化。结果与CKC术前电子阴道镜下宫颈多点活检的诊断结果相比,135例CKC术后患者病理诊断级别升高者7例,符合者75例,降级者53例,电子阴道镜下宫颈多点活检宫颈病变病理与CKC术后宫颈病变病理的符合率为55.56%,同时发现宫颈腺上皮内瘤变18例及宫颈癌7例并进一步扩大手术范围。结论 CKC是治疗CINⅢ安全、有效的手段,能提高诊断的准确性。

Objective To investigate clinical significance and value of cervical intraepithelial neoplasia Ⅲ treated by cervical cold knife conization.Methods Cervical cold knife conization was used to treat 135 cervical intraepithelial neoplasia Ⅲ patients who were diagnosed by cervical biopsy of electronic colposcopy and their pathological changes were analysed after pathological examination.Results The pathological grade was increased,identical,reduced after cervical cold knife conization compared with biopsy-based diagnosis in 7,75,53 cases,there was a correlation present which was 55.56% in pathology between cervical biopsy of electronic colposcopy and cervical cold knife conization,at the same time,18 cases of cervical glandular intraepithelial neoplasia and 7 cases of cervical carcinoma were found out and operated again. Conclusion Cervical cold knife conization is a safe and effective measure to treat cervical intraepithelial neoplasia Ⅲ,and it can enhance diagnosed accuracy of cervical intraepithelial neoplasia Ⅲ.