两种不同宫颈锥形切除术在宫颈上皮内瘤样病变治疗中的效果比较

The comparison of two different conizations in treatment with cervical intraepithelial neoplasia

目的比较宫颈环形电切术、冷刀宫颈锥切术在宫颈上皮内瘤样病变(CIN)治疗中的临床价值。方法 156例CIN患者按随机数字表法分为两组,A组(采用宫颈环形电切术)85例采用宫颈环形电切术治疗,B组(采用冷刀宫颈锥切术)71例采用冷刀宫颈锥切术治疗,比较两组的手术情况、治疗效果及术后感染情况。结果 A组手术时间、愈合时间、出血量及花费分别为(11.24±4.17)min、(33.49±4.51)d、(12.18±3.92)ml和(1256.24±268.91)元,明显少于B组的(28.62±7.54)min、(39.25±6.23)d、(25.36±8.23)ml和(3216.93±375.28)元(P<0.05)。两组治愈、持续存在、手术残留及复发发生率比较,以及下腹疼痛、宫颈充血肥大、宫颈赘生物及创面感染发生率比较,均差异无统计学意义(P>0.05)。结论冷刀锥切术和宫颈环形电切除术在CIN治疗效果以及术后感染方面相似,但宫颈环形电切除术可缩短手术操作时间,加速愈合,降低术中出血量,减少患者的花费,在CIN治疗中更具优势。

Objective To compare the effect of loop electrosurgical excision procedure and cold knife conization in treatment with cervical intraepithelial neoplasia (CIN).Method From March 2010 to March 2012,156 cases of CIN patients were classified into two groups,which A of 85 cases were treated with loop electrosurgical exci-sion procedure and B group of 71 cases were treated with cold knife conization.The operation,clinical effect and post-operative infection between the two groups were compared.Results The operative time,healing time,bleeding volume and cost in A group were (11.24 ±4.17)min,(33.49 ±4.51)d,(12.18 ±3.92)ml and(1256.24 ±268.91)yuan, which significantly lower than those in B group with (28.62 ±7.54)min,(39.25 ±6.23)d,(25.36 ±8.23)ml and (3216.93 ±375.28)yuan(P <0.05).There were no significant differences the incidence of cured,persistence,surgi-cal residual and recurrence between two groups(P >0.05).There were no significant differences in the incidence of abdominal pain,cervical hyperemia hypertrophy,cervical neoplasm and wound infection between two groups(P >0. 05).Conclusion There are similar effects of clinical effect and postoperative infection between loop electrosurgical excision procedure and cold knife conization in treatment with CIN.But loop electrosurgical excision procedure can shorten operation time,accelerate healing,low operation bleeding and reduce cost.