电热圈环切术治疗宫颈上皮内瘤变的临床价值探讨

目的：研究宫颈电热圈环切术（Loop Eelectrosurgical Excision Procedure，LEEP）治疗宫颈上皮内瘤变的临床价值。方法选择2009年3月～2012年3月广东省佛山市顺德区第一人民医院收治的139例经阴道镜活检显示为宫颈上皮内瘤变的患者进行研究。分别采用环状浅凹形切除和环状深凹形切除两种LEEP的手术对患者进行治疗，对LEEP术后病理诊断与术前阴道镜活检诊断结果进行比较分析，并且记录分析手术情况及术后的情况。结果术后发现，LEEP术后病理结果与术前阴道镜活检完全符合的病例数为43例，不符合的有96例，其中病情加重为10例，病情减轻为86例。阴道镜活检对CIN的诊断率为99.3%。对于宫颈上皮内瘤变的诊断，LEEP术后病理结果与术前阴道镜诊断的结果差异无统计学意义。采用环状浅凹形切除的LEEP术患者的手术时间为5～39 min，平均为（10.1＆#177;2.4）min，术中出血量为7～59 ml，平均为（12.1＆#177;2.2）ml。采用环状深凹形切除的LEEP术患者的手术时间为6～35 min，平均为（9.2＆#177;2.1）min，术中出血量为4～55 ml，平均为（12.1＆#177;2.2）ml。术后，患者中治愈的有135例，治愈率为97.1%。结论 LEEP治疗宫颈上皮内瘤变的临床价值较高。

Objective To study the clinical value of the loop electrosurgical excision procedure （LEEP） in cervical intraepithelial neoplasia. Method 139 cases of colposcopy biopsy showed the patients with cervical intraepithelial neoplasia from March 2009 to March 2012 in the hospital were studied.The patients were treated with annular shallow concave resection and deep concave annular with two kinds of LEEP surgery, pathological diagnosis and preoperative colposcopy biopsy results were compared, and surgical and postoperative case were recorded and analyzed. Results After the postoperation, the pathological and the preoperative colposcopy biopsy in full compliance with the number of cases was 43 cases, 96 cases did not meet, 10 cases aggravated, 86 cases improved. Colposcopy biopsy diagnosis of cervical intraepithelial neoplasia was 99.3%. For the diagnosis of cervical intraepithelial neoplasia results with the preoperative colposcopy LEEP postoperative pathological diagnosis was no signiifcant difference. LEEP surgery patients using annular shallow concave resection operation time was 5-39 min, with an average （10.1＆#177;2.4） min, intraoperative blood loss was 7-59 ml, on average, （12.1＆#177;2.2） ml. LEEP surgery patients using deep concave annular resection operation time was 6-35 min, with an average （9.2＆#177;2.1） min, intraoperative blood loss in 4-55 ml, on average, （12.1＆#177;2.2） ml. After surgery, patients with 135 cases of healing, the cure rate was 97.1%. Conclusion The clinical value of the LEEP in treatment to cervical intraepithelial neoplasia has higher value.