微波治疗子宫颈上皮内瘤样变

Treatment of cervical intraepithelial neoplasia with microwave coagulation

对１９９０年１１月至１９９３年１２月就诊于我院妇产科门诊经阴道镜和病理组织学确诊为子宫颈上皮内瘤样变（ＣＩＮ）＿（１，２）级的病例１２８例，分别进行微波治疗（微波组，４３例）、电灼治疗（电灼组，３９例）和ＣＯ＿２激光治疗（激光组，４６例）。治疗深度为子宫颈口深１．０ｃｍ，治疗范围超出病变外０．３ｃｍ，创面呈锥形。治疗后随访６～３７个月。结果：一次治愈率，微波组为９７．７％（４２／４３），电灼组为７４．４％（２９／３９），激光组为７８．３％（３６／４６）；微波组一次治愈率明显高于激光组（Ｐ＜０．０１）和电灼组（Ｐ＜０．００５）。微波组术中出血发生率为４．７％，低于激光组的３４．８％（Ｐ＜０．００１）。激光组复发率为８．７％（４／４６），电的组为２．６％（１／３９），微波组无复发的病例。提示：微波锥形凝固治疗ＣＩＮ疗效高，并发症少，手术简单。

From Nov,1990 to Dec, 1993,one hundred and twenty-eight patients with histologically diag-nosed cervical intraepithelial neoplasia (CIN)grade 1 or 2,were randomized treated with the following three rnethods:microwave conic coagulation 43 cases,electrocautery 39 cases,CO_2 laser 46 cases,The coagulation area covered 1.0 cm in depth at cervical orifice,and 0. 3cm outside of the lesions. After treatment,patients were followed-up for 6～37 months and cervical biopsies guided by colposcopy were re-examined,in order to define the initial care rate and recurrence rate. Results:the initial cure rate in microwave group (97.7%)was significantly higher than those of electracautery group(74.4%)(P<0. 005)and CO_2 laser group(78.3%)(P<0.01).The haemorrhage rate after microwave coagulation(4.7%)were lower than that of CO_2 laser(34.8%)(P<0. 001).The recurrence rate of CO_2 laser group was 8.7%(4/46 ),electrocautery was 2.6%(1/39);no recurrence was found in microwave group.It’s shown that the treatment of microwave conic coagulation for CIN is more effective,has fever complication a nd should be used widely.