冷刀锥切在高级宫颈上皮内瘤变治疗中的应用

Application of Cone of Cold Knife Cut in the treatment of Advanced Cervical Intraepithelial Neoplasia

目的探讨宫颈冷刀锥形切除术在高级别宫颈上皮内瘤变治疗中的诊断价值。方法回顾我院妇科因阴道镜下活检病理诊断为CINⅢ的89例患者,采用前后对照法,对术前阴道镜下多点活检,术后组织学结果进行对比研究。结果 89例CINⅢ患者60例入院后拟行子宫全切术,全子宫切除术前均行诊断性宫颈锥形切除术,39例直接行宫颈锥形切除术,术后患者病理较术前活检组织病理升级占8.99%,8例术后病理结果为宫颈早期浸润癌其中6例Ⅰa1期,2例Ⅰa2期。结论阴道镜下多点活检具有一定的局限性,拟行子宫全切除术前行宫颈冷刀锥形切除术进一步明确诊断是必要的。

Objective To investigate the cervical cold knife conization in high level diagnostic value in the treatment of cervical intraepithelial neoplasia. Methods Review our hospital department of gynaecology because of biopsy under colposcope pathological diagnosis of CIN Ⅲ, 89 patients before and after using contrast method, the preoperative multi-point biopsy under colposcope, comparing with the results the postoperative histological study. Results 60 patients with 89 cases of CIN Ⅲ after admission to line the uterus cut method, total hysterectomy were performed before diagnostic cervical conization, 39 cases of direct line of cervical conization, postoperative pathology in patients with a preoperative biopsy tissue pathology upgrade（8.99%）, 8 cases of early postoperative pathologic results for cervical invasive cancer among them 6 cases Ⅰa1 period, 2 cases of group. Conclusion The multi-point biopsy under colposcope has certain limitations, quasi uterus total resection on cervical cold knife conization further diagnosis is necessary.