环形电切术治疗宫颈上皮内瘤病变的临床分析

Clinical Analysis of Cervical Intraepithelial Neoplasia Treated with Loop Electrosurgical Excision Procedure

目的:探讨高频电波刀环形电切术(LEEP)治疗宫颈上皮内瘤变(CIN)的有效性与可行性。方法:选取电子阴道镜下活检病理诊断为CIN的病人108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(42例)、活检术(66例),观察术后组织病理变化以及术后随访情况,并对其疗效进行分析。结果:LEEP术前术后病理诊断CIN相符合者83例(76．85%)。CIN病理诊断级别降低32例(29．63%),CIN病理诊断级别升高15例(13．89%)。半年总治愈率99．05%,CIN病变持续存在率为0．95%,复发率1．9%。4例(3．81%)出现宫颈管狭窄。结论:高频电波刀环形电切术是治疗CIN安全、有效的方法,能得到完整的病理标本,治疗的同时有诊断的作用。术后的定期随访十分重要。

Objective：To investigate the clinical value and effectiveness of high frequency rediosurgical knife（HFRK） on the treatment of cervical intraepithelial neoplasia（CIN）. Methods： 108 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（42 cases）, LEEP biopsy（66 cases）. The change of histopathology and complications after operation were analyzed prospectively. Results： The coincidence rate in pathological diagnosis of CIN was 83（76.85%） before and after LEEP operation. The CIN grade of 32 cases（29.63%） were decreased and 15 cases （13.89%）were increased after operation. The overall cure rate was 99.05% in 6 months,the residual CIN was 0. 95%. The recurrent CIN occured in 1.9% after one year. 4 cases（3.81%） developed endocervical stricture. Conclusion：LEEP is a safe and effective procedure in treating CIN. It can not only offer intact sample for patheological diagnosis of CIN,but also provid therapeutic effect. It is very important in the period of follow-up.