宫颈环形电切术治疗CIN Ⅲ的临床疗效分析

Clinically therapeutic effect analysis of loop electrosurgical excision procedure for CIN Ⅲ

目的探讨宫颈环形电切术(LEEP)治疗宫颈上皮内瘤变Ⅲ级(CIN Ⅲ)的临床疗效,与传统的冷刀锥切(CKC)相比是否更具有优势。方法将120例经过病理诊断为CINⅢ的患者按治疗方式的不同分为CKC组61例及LEEP组59例,即分别采用CKC及LEEP,对比两组的术后残留率及术后复发率。锥切术后半年内无CIN病变存在为治愈;锥切术后1年内仍有CIN病变存在定为病变残留;术后无CIN病变存在,但1年后发现病变定为CIN复发。结果术后半年内LEEP组治愈56例,治愈率为94.9%,有1例于术后1年复发,为CINⅠ,经再次LEEP术后治愈。CKC组治愈率为93.4%(57/61),无复发。两组患者治愈率相比,差异无统计学意义(P=0.149)。采用LEEP的患者复发率与CKC的患者无明显差异。结论 LEEP治疗时间短,出血少,与传统的冷刀锥切相比更具有优势,值得推广应用。

Objective To investigate the clinical therapeutic effect of loop electrosurgical excision procedure （LEEP） for cervical intraepithelial neoplasias grade Ⅲ （CIN Ⅲ ） and whether LEEP has superiority compared to traditional cold-knife conization （CKC）.Methods According to the different treatment,120 patients with CIN Ⅲ confirmed by pathological diagnosis were assigned into CKC group 61 cases and LEEP group 59 cases,respectively treated by CKC and LEEP.The postoperative residual rate and recurrence rate of both groups were compared.The cure was defined as no CIN lesions within six months after CKC,the lesion residual as CIN lesions still existing within one year after CKC, the recurrence of CIN as no CIN lesions after surgery but presence after one year. Results Within half year after surgery,there were 56 cases cured in LEEP group with cure rate of 94.9%,one case of recurrence （CIN Ⅰ） at 1 year after surgery cured by LEEP again.The cure rate of CKC group was 93.4% （57/61）, with no recurrence.The comparison of cure rate of both groups showed no statistically significant difference （ P = 0.149）.There were no significant difference between the recurrence rates of patients respectively treated by LEEP and CKC. Conclusion LEEP has shorter time of treatment,less amount of bleeding,and more advantages compared to the traditional CKC,thus is worth promotion and applying.