射频热凝固治疗不同程度宫颈上皮内瘤样病变临床观察

The Use of Radio Frequency Heat Coagulation as a Minimally Invasive Method for Treating Different Degrees of Cervical Intraepithelial Neoplasia

目的探讨射频热凝固(RFHC)疗法对不同程度宫颈上皮内瘤样病变(CIN)保留宫颈治疗的效果,建立规范化诊疗和随访程序。方法对113例经宫颈刮片细胞学检查和电子阴道镜下活检病理证实的不同程度CIN(其中CINⅠ级52例,CINⅡ级47例,CINⅢ级14例)进行RFHC保留宫颈治疗。结果本组在应用RFHC和辅助治疗后4～7周各级CIN病变的宫颈治疗面全部愈合。本组随访6～47个月,平均32个月。随访期间共进行了586次宫颈细胞学检查,均提示未见异型细胞;阴道镜下宫颈取活组织病理学检查256次,均未见异型细胞。结论 RFHC是一种简单、快速和安全的微创治疗方法,对不同程度CIN有明确疗效,但患者应符合如下适应证:CIN诊断明确、适合个体化治疗方案及规范化随访。

Objective To standardize the treatment of cervical intraepithelial neoplasia（CIN） using radio frequency heat coagulation（RFHC） without the removal of cervix,and to investigate its efficacy.Methods One hundred and thirteen patients with different degrees of CIN（fifty two patients with CIN I,forty seven ones with CIN Ⅱ and fourteen ones with CIN Ⅲ）,who were all confirmed by thinprep cytology test（TCT）,electric colposcopy and cervical biopsy pathology,were treated by the RFHC method in order to maintain cervical integrity.All patients were strictly followed up from six months to 47 months,with an average of 32 months.Results All patients with different degrees of CIN in this group were fully recovered in 4-7 weeks after the RFHC and supplementary treatment.During this following up stage,no cellular atypicality was observed in five hundred and eighty six times of TCT or two hundred fifty six times of cervical biopsy under electric colposcopy.Conclusion RFHC is a simple,safe,fast,effective,repeatable and minimally-invasive method to treat different degrees of CIN.The use of RFHC for CIN treatment is based on definite diagnosis,standardized plan,personalized treatment schemes and strict following up programmes.