宫颈冷刀锥切加宫腔镜下电凝止血术诊治CIN 193例临床分析

Cervical Intraepithelial Neoplasia Managed by Cold Knife Conization with Electrocautery Hemostasis by Hysteroscope:193 Cases Analysis

目的:评价宫颈冷刀锥切加宫腔镜下电凝止血术在宫颈上皮内瘤变(CIN)诊断和治疗中的价值。方法:回顾性分析2005年1月至2008年11月行宫颈冷刀锥切加宫腔镜下电凝止血术治疗,且阴道镜下活检结果为CIN的患者193例的临床资料。结果:手术时间15～40分钟,术中出血量5～25ml,131例锥切术前后病理检查结果相同,符合率为67.88%,术后9例CINⅢ级切缘阳性,18例发生宫颈创面脱痂出血,术后无一例发生术后感染及宫颈粘连或狭窄。结论:宫颈冷刀锥切加宫腔镜下电凝止血术是诊断和治疗CIN的有效方法。

Objective：To evaluate the value of diagnosis and therapy of cold knife conization with electrocautery hemostasis by hysteroscope in the treatment of cervical intraepithelial neoplasia（CIN）.Methods：A retrospective analysis of the clinical data was carried out in 193 cases with CIN underwent cold knife coniza-tion with electrocautery hemostasis by hysteroscope from January 2005 to November 2008,and all patients had pathological diagnosis under colposcopic biopsy.Results：The operative time was from 15 to 40 minutes,and the blood loss during operation was from 5 to 25 milliliters.The coincidence rate of histopathology before and after conization was 67.88% in 131 cases.9 CIN Ⅲ patients had positive margins after operation,owing to scab break off bleeding of cervical wound was encountered in 18 cases.No infection and cervical adhesion or stenosis occurred.Conclusions：Cold knife conization with electrocautery hemostasis by hysteroscope is an effective diagnosis and treatment for CIN.