改良宫颈锥切术临床效果研究

The clinical effect of a modified cervical conization

目的探讨一种改良宫颈锥切术的临床价值。方法 2008年1月至2011年1月在中山大学附属第五医院对87例患者实施改良宫颈锥切术的手术效果、并发症进行观察,随机选取同期62例行常规宫颈锥切术的患者资料进行比较。结果常规宫颈锥切术与改良宫颈锥切术手术时间分别是(40.08±9.16)min和(17.08±3.90)min,常规宫颈锥切术与改良宫颈锥切术术中出血量分别是(44.66±22.64)mL和(13.09±4.44)mL,两组手术时间及术中出血量差异均具有统计学意义(P<0.001)。常规宫颈锥切组和改良宫颈锥切组切除锥体高度分别为(21.94±2.34)mm、(22.04±2.29)mm,P>0.05。常规宫颈锥切术术后出血率29.03%,改良宫颈锥切组术后出血率3.45%,差异具有统计学性意义(P<0.05)。两组术后发热、切缘阳性率、宫颈狭窄发生率差异无统计学意义(P>0.05)。结论改良宫颈锥切术能达到常规宫颈锥切术的手术范围,不影响切缘病理诊断;比常规宫颈锥切术手术时间短,出血量少,并发症更少。

Objective To evaluate the clinical value and operative procedure of a modified cervical conization. Methods The surgery effect and complications were analyzed in 87case patients performed with a modified cervical conization in Department of Gynecology and Obstetrecs in The Fifth Affiliated Hospital of Sun Yat-Sen University. between January 2008 and Janua/ 2011. 62 case patients performed with conventional cervical couization were collected as control group during same study interval. Results Operative time for conventional cervical conization and modified cervical conization was （40. 08 ± 9.16）rain and （ 17.08 ± 3.90 ） rain, blood loss during operation for conventional cervical conization and modified cervical conization was （44. 66 ± 22. 64 ） mL and （ 13.09 ± 4.44 ） mL, respectively （ P 〈 0. 001 ）. The height of conization for conventional cervical conization and modified cervical conization was （ 21.94 ± 2. 34 ）mm and （ 22. 04 ± 2.29） mm（ P 〉 0. 05）. Postoperation blood loss rate for conventional cervical conization and modified cervical conization was 29. 03% and 3.45% （P 〈 0. 05）. Postoperative fever,positive margin and cervical stenosis between two group were not statistically significant. Conclusion Modified cervical conization obtains equivalent excision range to conventional cervical conization, does not affect pathological diagnosis of excision margin, with shorter operative time,less bleeding and complication.