宫颈电圈环切术联合阴道镜在宫颈病变诊治中的临床分析

Clinical analysis of application of loop electrosurgical excision procedure associate with colposcopy for diagnosis and treatment of cervical diseases.

目的:探讨宫颈电圈环切术(Loop electrosugiral excision Prcedure,LEEP)联合阴道镜在宫颈病变诊治中的临床应用价值。方法:回顾性分析经宫颈薄层液基细胞学(TCT)检测异常和电子阴道镜下宫颈多点组织病理检查异常的174例患者,均经LEEP治疗,切除组织行病理检查。结果:电子阴道镜下宫颈活检诊断结果与LEEP术后诊断符合率为72.41%,LEEP术后3个月随访慢性宫颈炎100%治愈,ClNⅠ100%治愈,CINⅡ96.7%治愈,CINⅢ93.3%治愈。原位癌术后6月、1年随访正常。结论:LEEP对包括炎症、损伤、癌前病变等宫颈疾病是一种非常理想的诊断、治疗手段。宫颈细胞学检查,阴道镜下活检,LEEP术后病理诊断构成了宫颈病变系统的一个新的诊断模式,尤其是对微小浸润癌和原位癌的早期诊断价值高。

Objective： To evaluate the clinical value of loop electrosurgical excision procedure （LEEP） associated with colposcopy in diagnosis and treatment of cervical diseases. Methods： 174 patients who were abnormal in colposcopy guided biopsy and TCT test were analyzed retrospectively. After treatment of LEEP, all surgical specimens were checked successfully for pathology diagnosis. Results： The correction rate of the diagnosis by colposeopy guided biopsy were 72. 41% compared to the diagnosis after LEEP. 3 months after LEEP treatment all patients were followed up. The cure rate of chronic cervicitis patients, CIN Ⅰ , CIN Ⅱ , CIN Ⅲ were 100%, 100%, 96. 7%, 93. 3% respectively. 6 and 12 months after operation, patients of preinvasive carcinoma were normal. Conclusion： LEEP is an ideal method for diagnosis and treatment of cervical diseases including inflammation, trauma, precancerous lesions. Cervical cytology test, colpeseopy guided biopsy, pathological diagnosis after LEEP make up a new diagnosis model. It is high valuable to diagnose microinvasive carcinoma and preinvasive carcinoma early.