宫颈环形电切术诊治宫颈上皮内瘤变的临床研究

Clinical research of loop electrosurgical excision procedure for diagnosis and treatment of cervical intraepithelial neoplasia

目的:探讨使用高频电波刀作宫颈环形电切术(LEEP)治疗宫颈上皮内瘤变(CIN)的临床价值。方法:经宫颈液基薄片细胞学检查(TCT)和阴道镜下活检,病理诊断为CIN 232例,行LEEP治疗。术后3个月、6个月～2年常规行TCT追踪随访,异常者再行阴道镜检查及活检。结果:术后3个月复查232例,TCT正常者220例(94.83%),异常者12例(5.17%),阴道镜检查宫颈表面出现红斑,活检均为炎症或正常宫颈组织;术后6个月复查228例,TCT正常者222例(97.37%),异常者4例(2.63%),阴道镜检查及活检均为炎症;术后2年复查172例,TCT阴性170例(98.84%),异常者2例(1.16%),阴道镜检查及活检1例为炎症,1例为CINⅠ。结论:宫颈环形电切术治疗宫颈上皮内瘤样病变操作简单、安全、成功率高,但要注意病变切除的范围及随访,宫颈环形电切术是治疗CIN有效手段。

Objective：To explore the clinical value of loop electrosurgical excision procedure（LEEP） in treatment of cervical intraepithelial neoplasia（CIN）.Methods：232 cases diagnosed as CIN definitely after Thin prep cytologic test（TCT） and biopsy under colposcope were treated by LEEP.TCT was used for follow-up at 3 months,6 months and 2 years after surgery routinely,the cases with abnormal results underwent colposcopy and biopsy.Results：232 cases were followed up at 3 months after surgery,220 cases（94.83%） were found with normal results,12 cases（5.17%） were found with abnormal results,erythema appeared on the surface of cervix under colposcope,the results of biopsy were inflammation or normal cervical tissues;228 cases were followed up at 6 months after surgery,222 cases（97.37%） were found with normal results,4 cases（2.63%） were found with abnormal results,the results of colposcopy and biopsy both were inflammation;172 cases were followed up at 2 years after surgery,170 cases（98.84%） were found with normal results,2 cases（1.16%） were found with abnormal results,the results of colposcopy and biopsy were inflammation（one case） and CIN Ⅰ（one case）.Conclusion：LEEP is simple and safe in treatment of CIN with high success rate,but more attention should be paid to the range of excision and follow-up,LEEP is an effective method to treat CIN.