宫颈上皮内瘤变LEEP术后HPV病毒感染的消退情况分析

Analysis on Regression of HPV Virus Infection after Cervical Intraepithelial Neoplasia Operation

目的检测术后HPV病毒感染的消退情况。方法应用LEEP术对77例宫颈上皮内瘤变患者、35例宫颈炎患者进行治疗,分析术前宫颈活检与及术后宫颈病理的符合情况,于术后1个月随访创面修复、阴道流血及分泌物情况,术后3、6、12个月复查宫颈修复情况、液基细胞学检查、HPV病毒检测、阴道镜检查,必要时取宫颈活检。结果 1)宫颈LEEP术前及术后1、3、6、9个月阴道分泌物HPV阳性表达率依次下降(χ21月与术前=7.12,χ23月与1月=4.78,χ26月与3月=22.22,χ212月与6月=6.51,P均<0.05),差别均有显著性。2)术前HPV感染阳性组与HPV感染阴性组比较,术后病变残留率和复发率间比较均无显著性差异(P均>0.05),但是术后6个月HPV仍然持续感染阳性组较HPV感染阴性组残留和复发率均明显增高,有显著性差异(P均<0.05)。结论 LEEP治疗宫颈上皮内瘤变是一种安全而且有效的方法,在治疗的同时不仅可以明确诊断,而且有利于HR-HPV感染的清除。但是LEEP治疗术后有一定的病变残留和复发率。术后HPV持续阳性患者复发风险高,应密切随访。HPV病毒检测预示治疗后病变残留和复发有较高的灵敏度,是一种有效的随诊方法。对于HPV感染、TCT阴性的不满意的阴道镜患者,即使阴道镜下活检为炎症,也应高度重视,对持续感染的高危患者行LEEP术既可达到诊断目的又可达到治疗作用,防止宫颈癌前病变及癌变的漏检。

Objective To detect postoperative regression of HPV virus infection. Methods LEEP was performed on 77 pa- tients with CIN （ including CINI 19 cases, CINII 53 cases, CINIII 5 cases ）, 35 cases of Cervicitis Patients （ colposcopy as unsatis- factory colposcopy, normal TCT. HPV virus positive ） treatment, analysis of preoperative cervical biopsy and postoperative cervical pathology compliance, after 1 months of follow-up in wound repair, vaginal bleeding and discharge, after March. June. December review of cervical repair, liquid based cytology, HPV virus detection, colposcopy, cervical biopsy necessary for. Results 1 ） The cervix of the uterus LEEP before and after operation in January, March. June. September, vaginal secretions of the positive expres- sion rate of HPV decreased t 21 months before operation and =7.12.23 month and January =4.78.26 month and March =22.22. 212 month and June --6.51. all P 〈0.05 ）. The differences were statistically significant meaning of. 2） Preoperative HPV infection group and the infection of HPV negative group. Postoperative neuropathy residual rate and recurrence rate between the was no significant dif- ference （ P all 〉0.05 ）. but after June HPV continued infection group than the HPV group without infection residue and recurrence rate were increased. There was a significant difference in sex （ P 〈0.05 ）. Conclusion The therapy of LEEP CIN is a safe and effec- tive method in the treatment of at the same time, not only can clarify the diagnosis, but also conducive to HR-HPV infection clear- ance. But LEEP therapy has certain lesions of residual and recurrent rate. Postoperative recurrence in patients with persisting positive HPV high risk. should be followed up closely. Detection of HPV virus that after treatment of residual and recurrent lesions with high sensitivity, is an effective diagnosis method. For HPV infection. TCT negative unsatisfactory colposcopy with biopsy under colposcopy, even for inflammation, should also attach, on persistent infection of high risk patients undergoing LEEP operation to be used for diagnostic purposes and can achieve therapeutic effect, prevent cervical precancerous lesions and cancer detection..