高频电波刀治疗宫颈上皮内瘤样变伴人乳头瘤病毒感染的临床观察

Clinical observation of cervical intra-epithelial neoplasia with high risk HPV infection after LEEP treatment

目的 探讨宫颈上皮内瘤样变（CIN）伴人乳头瘤病毒（HR-HPV）采用高频电波刀行宫颈环形电切术（LEEP）治疗效果.方法 选择收治80例宫颈上皮内瘤变伴HPV感染患者行LEEP手术治疗并分别检测手术前及术后3个月HR-HPV DNA负荷量,同时行阴道检查及宫颈定点活检.结果 LEEP手术前不同级别CIN的HPV荷量之间差异不显著（F=0.45,P＞0.05）；术后3个月CIN Ⅰ级19（86.4％）转为慢性炎症、CINⅡ级36（83.7％）例转为慢性炎症；CINⅢ级13（86.6％）例转慢性炎症,宫颈HPV负荷量术后转阴率为85％且HPV负荷量低的患者较负荷量高的患者术后转阴的概率更高.结论 LEEP刀在治疗宫颈上皮内瘤变中效果显著,同时可有效降低宫颈HPV负荷量,值得临床大力推广应用.

Objective To explore the curative effect of loop electrosurgical excision procedure （LEEP） on cervical intra-epithelial neoplasia（CIN） infected with high risk human papilloma virus （HR-HPV）.Methods 80 CIN patients with HPV infection underwent LEEP were selected.HR-HPV DNA load was detected before operation and 3 months after operation,and at the same time,vaginal examination and cervical directed biopsy were conducted.Results Before LEEP operation,the differences between different levels of CIN HPV load were not significant（P ＞0.05,F =0.45）.3 months after operation,CIN Ⅰ grade 19 cases （86.4％） turned to chronic inflammation,CIN Ⅱgrade 36 cases （83.7％） turned to chronic inflammation,CINⅢ grade 13 patients （86.6％） were chronic inflammation.Cervical HPV load postoperatively negative rate was 85％ and the lower HPV load,the higher postoperatively negative rate.Conclusion LEEP is the effective treatment for cervical lesion and can significantly decrease the HPV-DNA loading at cervix.