宫颈环形电切术治疗宫颈上皮内瘤变的临床研究

Cervical Loop Electrosurgical Excision Procedure in the Treatment of Cervical Intraepithelial Neoplasia

目的:探讨宫颈环形电切术(LEEP)在诊治不同级别宫颈上皮内瘤变(CIN)的效果。方法:回顾性分析898例行LEEP手术的宫颈上皮内瘤变患者,观察手术时间、出血量、手术前后组织病理诊断结果变化及高危型人乳头瘤病毒变化,评价LEEP诊断情况及治疗效果。结果:LEEP平均手术时间5.1分钟,术中平均出血量5.6ml,术前电子阴道镜下活检结果与LEEP术后病理结果诊断一致率为77.73%(698/898),LEEP术后病理结果级别升高96例(10.69%),手术前后HPV-DNA负荷量下降明显,差异有统计学意义(P<0.01)。结论:LEEP手术对于宫颈病变具有较电子阴道镜下宫颈多点活检更高的宫颈浸润癌检出率,LEEP在切除病变的同时可以有效消除高危型HPV感染,是一种诊断、治疗CIN的非常理想的手段。

Objective：To evaluate the efficacy of loop electrosurgical excision procedure（LEEP） in the treatment of different grade of cervical intraepithelial neoplasia（CIN）. Methods：898 cases with CIN treated by LEEP were retrospectively analyzed. Operation time, blood loss during the operation, changes of histopathologic results and high-rick HPV before and after the operation were studied. The diagnosis and treatment results by LEEP were evaluated. Results：The average operation time was 5.1 minutes. The average blood loss during the operation was 5.6 ml. The concordance rate of pathologic results under colposcope before operation and after LEEP was 77.73%（698/898） .96 cases had increased CIN grade after LEEP（10.69%）. The HPV-DNA loading dose after operation declined significantly （ P 〈 0.01 ）. Conclusions： The detection rate of invasive cervical cancer by LEEP is higher than multiple punch biopsy under electronic colposcope. LEEP is an effective method for the diagnosis and treatment of CIN, and it can eliminate high-rick HPV at the same time of ablating the cervical lesion.