宫颈环形电切术与宫颈冷刀锥切术治疗宫颈上皮内瘤变Ⅲ级临床分析

Clinical analysis on treatment of CIN Ⅲ by LEEP and CKC

目的：比较宫颈环形电切术（LEEP）与宫颈冷刀锥形切除术（CKC）治疗宫颈上皮内瘤变Ⅲ级的临床疗效及预后观察。方法：回顾性分析2009年1月～2012年12月武汉市中心医院行阴道镜活检确诊的宫颈上皮内瘤变Ⅲ级患者352例患者的临床资料，比较两种治疗方式对患者术中及术后的影响。结果：两组行LEEP术及CKC术患者平均年龄分别为35．4岁和38．8岁，差异无统计学意义（P〉0．05）。LEEP组手术时间、术中出血、平均住院日、住院费用均低于CKC组（P〈0．05）。术后并发症方面，CKC组优于LEEP组（P〈0．05）。在术后随访方面，LEEP组治愈率、切缘阳性率、术后复发率均优于CKC组（P〈0．05）。结论：LEEP术治疗CINⅢ级具有手术时间短，出血少的优势，但宫颈锥形切除术具有治愈率高、复发率低、术后并发症少的优势，是治疗CINIII级的首选方法。

Objective： To compare the clinical efficacies and observe the prognosis of cervical loop electrosurgical excision proce- dure （LEEP） and cold knife conization （CKC） in treatment of cervical intraepithelial neoplasia （CIN） m. Methods： The clinical data of 352 patients diagnosed as CIN III definitely by colposcopic biopsy in the hospital from January 2009 to December 2012 were analyzed retro- spectively, the intraoperative and postoperative effects of two therapeutic methods were compared. Results： The mean ages in LEEP group and CKC group were 35.4 years and 38.8 years, there was no statistically significant difference between the two groups （ P 〉 0. 05 ） . The operation time, the amount of blood loss during operation, the average hospitalization time and the average hospitalization cost in LEEP group were statistically significantly lower than those in CKC group （ P 〈 0. 05 ） . The incidence rate of postoperative complications in CKC group was statistically significantly lower than that in LEEP group （ P 〈 0. 05 ） . During postoperative follow - up, the cure rate, marginal positive rate and postoperative recurrence rate in LEEP group were better than those in CKC group （ P 〈 0. 05 ） . Conclusion： LEEP has the advan- tages of less operation time and less blood loss in treatment of CIN III, but CKC has the advantages of higher cure rate, lower recurrence rate and less postoperative complications, the latter is the first choice in treatment of CIN III.