摘要
目的探讨宫颈环形电切术(LEEP)诊断治疗宫颈上皮内瘤变(CIN)的临床价值。方法2004年4月至2007年4月在本院妇科门诊经过细胞学、阴道镜下宫颈多点活检病理诊断CIN的82例患者采用LEEP进行进一步的诊断和治疗,对其进行回顾性分析。结果术前术后病理诊断一致46例,占56.09%,级别下降30例,占36.59%,升级6例,占7.32%。术后3个月复查阴道镜、细胞学,除外2例因宫颈浸润癌行宫颈癌根治术外,均正常。2例术后标本宫颈管切缘CINⅡ阳性,均于术后1个月后再次行宫颈LEEP治疗,随诊痊愈。术中平均出血8mL,1例术后感染,无宫颈管狭窄病例。结论LEEP是治疗CIN最安全有效的方法,只要掌握手术指征,规范手术操作,注意术后病理观察,术后定期随访,可以有效地阻止宫颈癌前病变发展为浸润癌。
Objective To investigate the clinical and application values of loop electrosurgical excision procedure（LEEP） on diagnosis and treatment for cervical intraepithelial neoplasia（CIN）. Methods 82 cases with CIN identified by cytology and pathological biopsy under colposcopy treated by LEEP from April 2004 to April 2007 were analyzed retrospectively. Results The postoperative diagnosis of 46 cases（56.09% ） were in accordance with the preoperative one. The postoperative diagnosis were downgraded in 30 cases（36.59 %） and upgraded in 6 cases （7.32 %）,80 cases （excluding 2 cases of squamous cell carcinoma who accepted radical hysterectomy） were showed no abnormalities in Pap smear postoperative three months, While 2 cases among them demonstrated readable resection margin and treated by LEEP again after one month. Conclusion LEEP is a safe and effective procedure in treating CIN. Satisfactory results can be achieved by mastering surgical indication and standard procedure,excising cervical canal sufficiently and paying attention to postoperative pathology. Its widespread use in diagnosis and curing of CIN can block development of precancerosis to infiltrating carcinoma effectively.
关键词
宫颈环形电切术
宫颈上皮内瘤变
诊治
loop electrosurgical excision procedure（LEEP）
cervical intraepithelial neoplasia（CIN）
diagnosis and treatment
