宫颈环形电刀切除术治疗212例宫颈上皮内瘤变价值探讨

Loop Electrosurgical Excision Procedure for the Treatment of Cervical Intraepithelial Neoplasm:a Valuable Study of 212 Cases

目的:探讨宫颈环形电刀切除术(LEEP)治疗宫颈上皮内瘤变(CIN)的价值。方法:回顾分析2000年3月至2004年10月212例CIN患者在阴道镜辅助下行宫颈环形电切术的治疗情况。结果:阴道镜下宫颈异常结构处取活检病理结果为CIN者212例行宫颈环形电切术(LEEP),LEEP术后病理检查:宫颈粘膜慢性炎症13例(6.1%)、CINⅠ90例(42.5%)、CINⅡ77例(36.3%)、CINⅢ24例(11.3%),原位癌累及腺体伴早期浸润癌8例(3.8%)。术后195例(92.0%)宫颈标本边缘病理学检查未见CIN病变;术后降级者70例(33.0%),等级者122例(57.5%),升级者20例(9.4%);治愈率达89.2%。结论:LEEP治疗CIN安全有效、简单易行、并发症少、避免了二次手术和过度治疗,能保留患者的生育能力,在治疗的同时能进行诊断。但术后仍需定期和规范的随访以防止宫颈癌的发生和发展。

Objective：To study the value of loop electrosurgical excision procedure （LEEP） in treating cervical intraepithelial neoplasm （CIN）. Methods：212 cases of CIN operating LEEP from Mar.2000 to Oct.2004, diagnosed by biopsy on anomaly cervix under the vaginoscopic assistance, were retrospectively analyzed. Results. Before LEEP, there were 102 cases （48.1%） of CIN Ⅰ ,CIN Ⅱ 72 cases （34.0%） ,CIN Ⅲ 38 cases （18.0%）;After LEEP,the pathological result showed that 13 cases （6.1%） of chronic inflammation of cervical mucous membrane,CIN Ⅰ 90 cases （42.5%） ,CIN Ⅱ 77 cases （38.3%）,CIN Ⅲ 24 cases （11.3%） ,and there were8 cases （3.8%）of cervical carcinoma in situ implicates early invasive;After the operaUon,there were 195 cases （92.0%） of the CIN pathology disappeared on the cervical specimen edge;and the downgrade cases were 70 （33.0%） ,the rank 122 （57.6%）, the grade 20 （9.4%） ; The total cure rate was 89.2%. Conclusions： LEEP is a safe, effective, feasible, and cheap method in treating CIN with few complications, and repeating surgeries or treating excessively can be avoided, the reproductive potential can be retained also. Of course, after LEEP, regular follow-up is needed to prevent the occurrence and the devalopment of cervical carcinoma.