改良式冷刀锥切术治疗高级别CIN的临床观察

Clinical observation of high-level cervical intraepithelial neoplasia treated by modified cold-knife conization

目的:探讨改良式冷刀锥切术在治疗高级别宫颈上皮内瘤变中的价值。方法:对辽宁医学院附属第一医院2007年1月～2008年12月接受宫颈锥切术的172例高级别宫颈上皮内瘤变患者的资料进行回顾性分析。根据手术方式分为改良组及传统组。比较两组的手术时间、术中出血量、术后宫颈狭窄或粘连发生率及宫颈鳞柱交界可见率等。结果:改良组平均手术时间28 min,对照组平均手术时间35 min,改良组手术时间明显缩短(P<0.05);改良组术中出血量平均33 ml,对照组平均45 ml,改良组明显少于对照组(P<0.05);两组宫颈狭窄或粘连发生率差异无统计学意义(P>0.05),而鳞柱交界可见率差异具有统计学意义(P<0.05)。结论:改良式冷刀锥切术可以有效减少术中出血量,缩短手术时间,同时具有术后宫颈鳞柱交界可见率高,有利于术后随访等优点。

Objective：To explore the value of modified cold-knife conization in treatment of high-level cervical intraepithelial neoplasia（CIN）. Methods：The data of 172 patients with high-level CIN who were treated by cervical conization in the first affiliated hospital of Liaoning medical college from January 2007 to December 2008 were analyzed retrospectively,then the patients were divided into modified conization group and routine conization group according to the surgical modes.The operation times,the amounts of blood loss during operation,the incidences of postoperative cervical stenosis or adhesion,the visible rates of squamocolumnar junction in the two groups were compared. Results：The average operation times in modified conization group and routine conization group were 28 minutes and 35 minutes,respectively,the operation time in modified conization group was significantly shorter than that in routine conization group（P0.05）;the average amounts of blood loss during operation in modified conization group and routine conization group were 33 ml and 45 ml,respectively,the average amount of blood loss during operation in modified conization group was less than that in routine conization group（P0.05）;there was no significant difference in the incidences of postoperative cervical stenosis or adhesion between the two groups（P0.05）,but there was significant difference in the visible rate of squamocolumnar junction between the two groups（P0.05）. Conclusion：Modified cold-knife conization can reduce the amount of blood loss during operation and shorten the operation time effectively,which has the advantages of high visible rate of squamocolumnar junction and easy to follow up.