子宫颈电环切除术诊治宫颈病变

Loop Electrosurgical Excision Procedure for Diagnosis and Treatment of Cervical Diseases

目的：探讨子宫颈电环切除术在宫颈病变诊断和治疗中的作用,以及其并发症的预防和处理。方法：回顾性分析2001年1月至2005年12月采用子宫颈电环切除术诊治本院64例宫颈上皮内瘤变和宫颈原位癌患者的手术方法、病理结果、并发症及疗效。结果：术前、后病理诊断一致占32.81%（21/64）,术后病理诊断级别下降占51.56%（33/64）,术后病理诊断级别上升占15.63%（10/64）。手术时间为2-11 min,平均（6.2±1.34）min,术中出血量平均为（38.89±8.49）mL。术后子宫颈狭窄有3例,占4.69%（3/64）。64例患者中2例半年后复发。结论：子宫颈电环切除术手术时间短、并发症少,可提高宫颈上皮内瘤变和宫颈原位癌的诊断率,对宫颈上皮瘤变和保留子宫的宫颈原位癌患者的治疗起着重要作用。

Objective：To study the use of loop electrosurgical excision procedure （LEEP） in the diagnosis and treatment of cervical disease as well as prevention and management of LEEP-related complications. Methods： From January 2001 to December 2005, data on 64 cases of cervical intraepithelial neoplasia （ CIN ） or cervical in-situ carcinoma treated by LEEP were analyzed retrospectively, including operation approach, pathology findings, complications and outcomes. Results：Compared with cytology grading before operation, consistent pathological findings were found in 32.81% （21/64） of the cases, while upgradation was noted in 15.63% （10/64） and downgradation in 51.56% （33/64）. The mean operation time was 6.2 ± 1.34 min （ 2 - 11 min） and the mean blood loss was 38.9 ± 8.49 mL. There were 3 cases （4.69%） of cervical stenosis after operation and 2 cases of recurrence half a year later. Conclusions ：LEEP showed a number of benefits including short operation time, little blood loss, few complications, and improved diagnosis of CIN and cervical carcinoma in situ, which may be promising for uterus-sparing of CIN and cervical carcinoma in situ.