宫颈环形电切术与冷刀锥切术治疗宫颈上皮内瘤变疗效比较的Meta分析

Meta-analysis of the Effectiveness of LEEP and CKC in the Treatment of Cervical Intraepithelium Neoplasma

目的:比较宫颈环形电切术(LEEP)与冷刀锥切术(CKC)治疗宫颈上皮内瘤变(CIN)的疗效。方法:通过计算机检索中国知网、维普、万方、PUBMED、EBSCO和Cochrane图书馆从1990年1月至2010年7月国内外公开发表的有关LEEP与CKC治疗CIN疗效比较的有关文献。按Cochrane系统评价方法,采用Revman 5.0进行Meta分析。结果:共纳入17项研究,2234例患者。Meta分析结果显示:LEEP与CKC相比,手术时间、术中出血量、愈合时间、住院天数、治疗费用和病灶切除的深度,差异均有统计学意义(P<0.05),而治愈率、复发率、持续存在率、残留率、术后出血、术后宫颈狭窄、手术切除的宽度及体积的比较,差异均无统计学意义(P>0.05)。结论:LEEP治疗CIN的疗效与CKC相似,但LEEP具有手术时间短、术中出血量少、愈合时间快、住院天数少和治疗费用低的优点,值得临床推荐。

Objective: To compare the effectiveness of loop electrosurgical excision procedure(LEEP) and cold knife conization(CKC) in the treatment of cervical intraepithelium neoplasma(CIN).Methods: A search for relevant articles of patients with CIN treated by LEEP or CKC was done on CNKI,WeiPu,WanFang,Pubmed,EBSCO and cochrane library from January,1990 to July 2010.The Revman 5.0 software was used for Meta-analysis according to cochrane system evaluation method.Results:17 studies involving 2234 patients were included.Meta-analysis showed that there were statistical differences in operation time,amount of blood loss,healing time,hospitalization time,treatment expenses and depth of excision between LEEP and CKC procedure.However,there were no significant differences in cure rate,recurrence rate,disease persisting rate,residual rate,postoperative bleeding,width and volume of excision,and postoperative cervical stenosis between the two procedures.Conclusions: The effectiveness of LEEP is similar to CKC in the treatment of CIN,but LEEP has the priority in operation time,amount of blood loss,healing time,hospitalization time and treatment expenses,so it's worth to be recommended.