高频电波刀治疗宫颈上皮内瘤变的疗效分析

Analysis on the efficacy of cervical intraepithelial neoplasia treated with high frequency radiosurgical knife

目的探讨高频电波刀治疗官颈上皮内瘤变（CIN）的临床应用及疗效．方法选择电子阴道镜下活检病理诊断为CIN的病人378例，经阴道镜辅助高频电波刀治疗，治疗方法分别采用LEEP锥切术（165例）、活检术（213例），对其疗效及术后病变的持续存在和复发等情况进行分析．结果LEEP术前术后病理诊断CIN相符合者290例（76．72％），CIN级别减低118例（31．22％），CIN级别升高47例（12．43％）．6mo内总的治愈率99．73％（372／373），CIN病变持续存在率为0．27％（1／373），复发率0．54％（2／373）．19例（5．09％）出现官颈管狭窄．结论高频电波刀治疗CIN能得到完整的病理标本，治疗的同时有诊断的作用，手术安全、有效、方便，是治疗CIN的理想方法，术后定期随访十分重要．

Objective To evaluate the clinical value and effectiveness of high frequency radiosurgical knife （HFRK） on the treatment of cervical intraepithelial neoplasia （CIN）. Methods 378 cases with CIN were diagnosed after colpscopic examination and multiple biopsy. All cases were treated by HFRK under colposcopic guidance for loop electrosurgical excision procedure （LEEP） conization （165 cases）, LEEP biopsy （213 cases）. The incidences of residual and the recurrence were analysed prospectively. Results The coincidence rate in pathological diagnosis of CIN was 76.72% （290/378） before and after LEEP operation. 118 cases （31.22%） in CIN grade was decreased and 47 cases （12.43%） were increased after operation. The overall cure rate was 99.73% （372/373） in 6 months, the rate of residual CIN was 0.27% （1/373）, and the recurrent rate of CIN was 0.54% （2/373） after one year. 19 cases （5.09%） developed endocervical stricture. Conclusions HFRK can not only offer intact sample for pathological diagnosis of CIN, but also provide therapeutic effect. LEEP is a kind of effective and safe treatment option for CIN and it is very important in the period of follow-up.