高频电波刀环形电切术对宫颈病变的诊断和治疗价值

EVALUATION OF LOOP ELECTROSURGICAL EXCISION IN THE DIAGNOSIS AND TREATMENT OF CERVICAL LESIONS

目的评价高频电波刀环形电切术(LEEP)对宫颈病变的诊断和治疗价值。方法对经液基细胞学检测系统(LCT)筛查阳性的病人191例及LCT筛查阴性但临床高度怀疑宫颈病变病人64例,行阴道镜检查和镜下活组织病理检查(活检)及LEEP治疗。对治疗前后病理检查结果进行比较,并于治疗后3个月及6个月复查LCT。结果LEEP后标本病理检查结果与术前阴道镜下活检结果符合者173例(71.49%),结果有差异者69例(28.51%),两者间病理诊断结果比较差异有极显著性(χ2=17.357,P<0.001)。结论宫颈细胞学检查、阴道镜下多点活检、LEEP术后病理诊断构成了宫颈病变系统的诊断及治疗模式,值得推广应用。

Objective To assess loop electrosurgical excision procedures （LEEP） in the diagnosis and treatment of cervical lesions. Methods Colposcopy, cervical biopsy and LEEP were performed on 191 patients with positive LCT results and 64 patients with negative LCT results but highly suspected clinically. The pathological results were compared before and after LEEP, and LCT were repeated three and six months after LEEP. Results The pathological changes of the biopsy samples taken via colposcopy were identical to the samples from LEEP in 173 patients. The coincident rate of these two examination methods was 71.49%. The inconsistent rate was 28.51% （69 cases）. There was significant difference between colposcopic biopsy results and LEEP specimens （Х^2=17, 357,P〈0. 001）. Conclusion Combined LCT,colposcopy and LEEP can serve as a systemic model for screening and treating cervical lesions.