高频电波刀治疗宫颈上皮内瘤变的临床分析

Clinical analysis on cervical intraepithelial neoplasia treatd by loop electrosurgical excision procedure

目的:分析高频电波刀联合阴道镜下多点活检治疗宫颈上皮内瘤变(CINⅡ～Ⅲ)的临床效果。方法:回顾性分析了2005年1月～2007年6月在武警吉林部队医院妇科门诊宫颈疾病治疗中心经阴道镜下多点活检病理诊断为CINⅡ～Ⅲ级,继之行高频电波刀术治疗的78例患者的临床资料。采用自身对照,对比分析阴道镜下多点活检和高频电波刀治疗后的病理检查结果及复发情况。结果:78例CINⅡ～Ⅲ患者,阴道镜下多点活检与高频电波刀术病理诊断符合率为70.51%(55/78),升级8.97%(7/78),降级20.51%(16/78),阴道镜下多点活检与高频电波刀术病理诊断差异有统计学意义(P<0.05)。高频电波刀治愈率为93.42%(71/76),复发率为2.63%(2/76)。结论:高频电波刀是治疗CINⅡ～Ⅲ级安全有效的方法,其治愈率高,术后并发症少;在诊断CINⅡ～Ⅲ级和早期宫颈癌方面,阴道镜下宫颈多点活检联合高频电波刀术有更高的临床价值。

Objective： To analyse the clinical effect of multiple punch biopsy under colposeopy combined with loop electrosurgical excision procedure （LEEP） on cervical intraepithelial neoplasiaⅡ-Ⅲ. Methods： A retrospective analysis was performed on 78 CIN Ⅱ-Ⅲ cases after multiple punch biopsy under colposeopy combined with LEEP from January 2005 to June 2007. The pathological results and recurrence of 78 cases by multiple punch biopsy under colposeopy and LEEP were compared by before - after study. Results： The pathologic diagnostic accordance rate of multiple punch biopsy under eolposcopy and LEEP was 70. 51% （55/78） , the proportions of upgrading and downgrading were 8.97% （7/78） and 20. 51% （16/78） , respectively, there was significant difference in pathologic diagnostic rate between multiple punch biopsy under eolposeopy and LEEP （P 〈0.05） . The cure rate was 93.42% （71/76） , and the recurrence rate was 2. 63% （2/76） . Conclusion： LEEP is a safe and effective method to treat CINⅡ-Ⅲ, which has ahigh cure rate and less postoperative complications. It is very significant to apply multiple punch biopsy under colposeopy combined with LEEP in the diagnosis of CINⅡ-Ⅲ and early cervical cancer.