高频电波刀对宫颈病变的诊治价值

Clinical effect of loop electrosurgical excision procedure （LEEP） in diagnosis and treatment of cervical diseases

目的探讨高频电波刀环切术（LEEP）对各级宫颈上皮内瘤变（CIN）、宫颈中重度炎症、宫颈HPV感染及宫颈息肉的诊治效果。方法回顾性分析136例宫颈病变患者进行LEEP治疗后的随访资料。结果LEEP术后病理级别升高者18例，占13．2％，降级者38例，占27．9％，术前术后诊断符合率为58．8％，差异有统计学意义（P〈0．05）。136例LEEP手术历时平均11min，术中出血量平均15ml，术后出血发生率2．2％，宫颈管粘连发生率1．5％。CIN治愈率为96％，病变残留率4％，复发率2％。术后第12个月，HPV转阴率86．7％，持续阳性率13．3％。HPV转阴率术后逐步上升。结论LEEP术是治疗CIN的安全有效方法，对宫颈HPV清除具有较好疗效。

Objective To study the clinical effect of cervical loop electrosurgical excision procedure （LEEP） in diagnosis and treatment of cervical diseases （including cervical intraepithelial neoplasia of different grade, cervical erosion of moderate and aevere degree, cervical with human papillomavirus （HPV） infection and cervi- cal polyp） ： M.etht^l The data ~ 136 caa0a with cervical disease treated by LEEP were analyzed retrospectively. Re- sult The postoperative diagnosis were upgraded in 18 cases （ 13.2% ） ,and downgraded in 38cases （27.9 % ） . The preoperative diagnosis of 80 cases （58.8 % ） were in accordance with the postoperative ones. The difference was sig- nificant（P 〈0.05）. The mean operative time was 1 l minutes, the mean bleeding volume was 15 nil. Postoperative bleeding of LEEP occurred in 2.2 % （3/136） patients. Postoperative cervical conglutination of LEEP occurred in 1. 5 % （2/136） patients. The cure rate of CIN was 96 % after LEEP. The residual CIN occurred in 4 patient （4 % ）. Recurrence CIN occurred in 2 patient （2 % ）. At 12th months after LEEP, the negative rate of HPV detection was 86. 7% and the persistent positive rate was 13.3%. The HPV clearance rate was increased gradually after LEEP. Conclu- sion LEEP was safe and effective for the treatment of the cervical disease and was a kind of good method to clear HPV infection in cervical.