宫颈电热圈环切术治疗宫颈上皮内瘤变的价值

Evaluation of loop electrosurgical excision procedure for the treatment of cervical intraepithelial neoplasia

目的讨论宫颈电热圈环切术在宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)诊治中的可靠性。方法将同济大学附属第十人民医院妇科就诊的146例阴道镜下宫颈活检病理,诊断CIN的患者进行子宫颈电热圈环切术(loop electrosurgical excision procedure,LEEP)治疗,其中112例患者完成了6～25个月的随访,对术后病变持续存在率及复发率进行总结。结果 LEEP术后病理结果与术前阴道镜下活检病理结果比较,CINⅠ的诊断符合率为59.70%,高度病变(CINⅡ,CINⅢ)的诊断符合率84.81%。治疗后6个月治愈率为98.21%,病变持续存在率为1.79%,复发率为2.68%,其中高度CIN病变持续存在及复发率为6.78%。结论 LEEP对于各级CIN患者的治疗是安全可靠的,但术后需要严密随访。

Objective To evaluate the loop electrosurgical excision procedure for the diagnosis and treatment of different grades of cervical intraepithelial neoplasia. Methods One hundred and forty-six patients with CIN treated by LEEP during January 2008 to August 2009 were selected for the study. 112 patients were followed up for 6-25 months. The incidences of residual and recurrence were reviewed respectively. Results By comparing the diagnosis with the biopsy results from LEEP and colposcope, the confirmed diagnosis for CIN I was 59. 70%, high-grade CIN was 84. 81% respectively. First 6 month after LEEP treatment, the overall cure rate was 98.21%, the residual CIN was identified in 1.79%. However, the recurrent CIN was occurred in 2.68% and followed by LEEP again. 6.78% of them were patients with high-grade CIN due to either residual or recurrent disease. Conclusion LEEP is a kind of safe and effective method for the treatment of CIN. It is necessary for patients to be followed up for a long time.