冷刀锥切对绝经后妇女高级别宫颈上皮内瘤变的诊治

Diagnosis and treatment conization of high-grade cervical squamous intraepithelial lesions in postmenopausal women

目的：分析宫颈冷刀锥切术治疗绝经后妇女高级别宫颈上皮内瘤变的手术疗效。方法：回顾性分析2008年1月~2012年6月行宫颈冷刀锥切的绝经后高级别宫颈上皮内瘤变的患者39例,随机抽取的同期月经规律的未绝经高级别宫颈上皮内瘤变的患者78例,对患者病变范围及术后病理切缘的情况进行分析。结果：绝经组锥切术锥体的高和宽均显著小于未绝经组（均P〈0.05）;而绝经组的切缘阳性率大于未绝经组,差异无统计学意义（P〉0.05）。结论：对绝经后高级别宫颈上皮内瘤变患者,建议先行诊断性宫颈锥切术,如切缘阳性再选择全子宫切除,避免对宫颈病变的治疗不足及过度治疗。

Objective：To investigate the effect of cervical cold knife conization of postmenopausal women in high-grade cervical squamous intraepithelial lesions surgical treatment.Methods：A retrospective analysis of 39 postmenopausal women and 78 premenopausal women with high-grade cervical squamous intraepithelial lesions were treated with cervical cold knife conization between January 2008 and June 2012.The extent of surgery and pathological margin of conization were evaluated.Results：In postmenopausal group,the average height and width of the cone were significantly smaller than the premenopausal group （both P〈0.05）.The positive margin rate of the postmenopausal group was greater than the premenopausal group,the difference was not significant （P〉0.05）.Conelusion：To avoid over-or under-treatment of cervical squamous intraepithelial lesions,the post-menopausal women with high-grade cervical squamous intraepithelial lesions recommended the diagnostic conization at first.If the margin is positive,further complete hysterectomy can be applied.