“即诊即治”法与传统的“三阶梯”模式诊治宫颈高度鳞状上皮内病变的对照分析

"See and treat" versus three-step approach in treatment of high-grade squamous intraepithelial lesions

目的比较"即诊即治"法(see and treat)与传统"三阶梯"模式(three-step diagnosis)对宫颈高度鳞状上皮内病变(HSIL)的诊疗价值。方法 129例经液基薄层细胞学技术检测证实为HSIL的患者,其中59例患者接受即诊即治(ST组),70例患者接受传统"三阶梯"模式诊治(TD组),比较两组的治疗结果。结果两组间HSIL的诊断符合率以及过度治疗率的差异均无统计学意义(P值均>0.05),但ST组就诊次数显著少于TD组(P<0.05)。结论对宫颈细胞学检查为HISL的患者予"即诊即治"能减少患者的就诊次数,缩短诊疗时间,节省财力及物力,且同时治疗相对更及时。

Objective To compare the differences in the diagnosis and treatment of high-grade squamous intraepithelial lesions（HSIL） in women undergoing loop electrosurgical excision procedure（LEEP） with or without prior colposcopy-guided biopsy.Methods A total of 129 women diagnosed as having HSIL by cytology were randomly assigned to two treatment groups;with 59 treated by LEEP surgery using the ＂see-and-treat＂ approach （ST group） and 70 treated using the three-step approach（TD group）.The results of the two groups were analyzed.Results There were no significant differences in the detection rates of lesions of CINII or above and overtreatment rates between the two approaches（all P0.05）.However,the ST group had a significantly reduced number of doctor visits compared with the TD group（P0.05）.Conclusion In comparison to ＂threestep＂ approach,the ＂see-and-treat＂ approach can reduce the number of doctor visits and save time for cytologically indicated HSIL patients,and it also allows for timely treatment.