治疗宫颈病变而不影响生殖的新方法:宫颈环形电切术

The New Method Both Treating Cervical Lesions and Reserving Genital Function: LEEP.

目的:探讨宫颈环形电切术(LEEP)与阴道镜下多点活检在宫颈病变的诊断中互补,及其LEEP在宫颈病变治疗中的价值。方法:回顾分析因宫颈病变同时行宫颈细胞学检查、阴道镜下多点活检和LEEP的患者109例,采用自身对照法,对比LEEP和阴道镜下多点活检病理结果。结果:LEEP和阴道镜下多点活检的病理结果完全符合者86例(78.9％),不符合者23例(21.1％)。LEEP后,因发现原位癌2例(1.9％)行全子宫切除术1例,行较大的宫颈锥形切除术1例。术后3个月随诊,无一例出现宫颈细胞学检查异常。LEEP的并发症为出血46例(42.2％)。 结论:LEEP在宫颈病变的诊断和治疗中具有极其重要的价值。对于宫颈病变的明确诊断与阴道镜下多点活检互为补充;对宫颈炎症、CINⅠ、CINⅡ、CINⅢ可提供操作简单,安全有效的治疗,并可保留生育功能;患者有宫颈细胞学检查结果再到门诊做阴道镜检查时,既可用LEEP进一步诊断和同时治疗,术后必须定期随访;本文中介绍几种处理并发症的经验。

Objective:To evaluate the feasibility of Loop Electro - surgical Excisional Procedure(LEEP) in cervical lesions replaces multipoint biopsy by colposcopy, and the diagnostic and therapeutic value in cervical lesions. Methods; Data of 109 patients with cervical lesions were reviewed, cervical cytology, biopsy by colposcopy and LEEP in cervical lesions were performed in every patient. With auto - control, their pathologic diagnosis after multipoint biopsy by colposcopy and LEEP were compared. Results; Pathologic diagnosis after LEEP accorded with that after multipoint biopsy by colposcopy in 86 patients (78. 9% ) ,and differed in 23 patients(21. 1% ). After cervical LEEP,2 patients were diagnosed carcinoma in situ,total hysterectomy was performed in one patient, and more extensive cervical conization in the other patient. No cervical cytology abnormity was found in follow- up 3 month after LEEP. Complication of LEEP we found was bleeding,it happened in 46 patients (42. 2% ). Conclusions:Cervical LEEP was the most important method in the diagnosis and treatment of the cervical lesions,it could replace the multipoint biopsy by colposcopy. It could provide easy handling, safe and effective treatment in cervical in flammations and GIN ( from Ⅰ to Ⅲ) . Both diagnosis and treatment could be done at the same time during the primary colposcopy in clinic. The treatment of the complications was introduced in the article.