CO_2激光宫颈锥切术治疗宫颈上皮内瘤变的疗效

CO_2 Laser Conization Treatment in Patients with Cervical Intraepithelial Neoplasia

目的评价CO_2激光宫颈锥切术治疗宫颈上皮内瘤变(CIN)的疗效。方法CIN患者60例,其中CINⅠ33例,CINⅡ25例,CINⅢ2例。合并HPV阳性病例16例。以功率15 W,光斑直径0.3～0.5 cm的CO_2激光对病变圆锥形烧灼、深度10～20 mm,超过病灶5 mm。结果6个月内一次治愈率为93.3%(56/60);二次治愈率5.0%(3/60);总的治愈率为98。3%。病变持续存在率1.7% (1/60)。16例HPV阳性病例,术后3个月细胞学检查转为阴性者75.0%(12/16例);6个月转为阴性者25.0%(4/16例)。术后无一例发生宫颈管狭窄及粘连。未生育7例中有3例术后妊娠并足月经阴道正常分娩。结论CO_2激光锥切术治疗CIN手术操作简便,术中不出血或少量出血,治愈率高,术后并发症少,HPV感染可以同时得到治疗,不影响妊娠及阴道分娩,为治疗CIN的有效疗法。

Objective To evaluate the curative effect using CO2 laser conization for cervical intraepithelial neoplasia（CIN）. Methods Total 60 patients were treated by CO2 laser conization including 33 cases of CIN Ⅰ , 25 cases of CIN Ⅱ 1 and 2 cases of CINⅢ2. Sixteen of all patients had CIN with HPV positive. Results The primary curative rate in 6 months treatment was 93.3% （56/60） ; the secondary curative rate was 5. 0% （3/60）. The total curative rate was 98.3%. Non-curative rate was 1.7% （1/60）. Sixteen patients with HPV positive were treated and total 75. 0% （12/16） of patients had negative cytologic examination 3 months after treatment; 25. 0% （4/16） of patients were negative 6 months after treatment. No complications, such as cervical stenosis and adhension were found after procedure. Seven patients had no children before, but 3 of them gave a birth to their children through the normal vaginal delivery after treatment. The recurrence in total 60 patients has not been reported after treatment until now. Conclusions The CO2 laser conization is simple and safe with high curative rate. In addition, it is hard to find the complications after the procedure. During the procedure, bleeding can be avoided or only a small amount of bleeding may accept. HPV infection can be treated in the same time. Finally, there is no side effect of CO2 laser conization treatment on the natural childbirth in future. It is a useful and efficient method for CIN treatment.