宫颈环形电切术与根治性宫颈切除术对子宫上皮内瘤变的疗效观察

Observation of Curative Effect of Cervical Loop Excision and Radical Hysterectomy in the Treatment of Uterine Intraepithelial Neoplasia

目的观察宫颈环形电切术与根治性宫颈切除术治疗子宫上皮内瘤变的疗效。方法选择子宫上皮内瘤变(CIN)患者160例,按照随机数字表法分为观察组和对照组。对照组采用宫颈环形电切术,观察组采用根治性宫颈切除术,观察两组手术效果。结果 CINⅡ患者观察组治愈率和复发率分别为100%和0,对照组治愈率和复发率分别为94.0%和4.0%;CINⅢ患者观察组治愈率和复发率分别为96.4%和0,对照组治愈率和复发率分别为90.0%和3.3%,观察组略优于对照组,但组间比较,差异不显著,P>0.05。观察组手术时间、术中出血量均明显优于对照组,观察组切除多个淋巴结,对照组未切除淋巴结,组间比较,均差异有显著性,P<0.05或P<0.01。对照组术后镇痛药使用例数明显多于观察组,组间比较,差异有显著性,P<0.05;观察组术后并发症发生率为11.3%,对照组术后并发症发生率为15.0%,组间比较,差异不显著,P>0.05。结论宫颈环形电切术和根治性宫颈切除术治疗CIN均有一定疗效,但根治性宫颈切除术在术中出血量、手术时间、切除淋巴结方面更有优势。

Objective To investigate the effects of loop electrosurgical excision（ LEEP） and radical resection in the treatment of cervical intraepithelial neoplasia（ CIN）. Methods 160 cases of CIN were randomly divided into the observation group and the control group. The control group received LEEP,and the observation group were treated with radical resection of the cervix,the effect of the 2 groups were observed. Results Cure rate and recurrence rate of CIN Ⅱ patients in the observation group were 100% and 0%,cure rate and recurrence rate of the control group were 94. 0% and 4. 0%; cure rate and recurrence rate of CIN Ⅲ patients in the observation group was 96. 4% and 0,respectively,cure rate and recurrence rate of the control group were 90. 0% and 3. 3%,observation group was slightly better than that of the control group,there had no significant difference（ P〈0. 05）. Operation time,intraoperative blood loss of the observation group were significantly better than those of the control group,the observation group removed multiple lymph nodes,the control group did not remove lymph nodes,there had significant differences,P〈0. 05 or P〈0. 01. Postoperative analgesic use number of the control group was significantly more than that of the observation group（ P〈0. 05）. Postoperative complication rate of the observation group was 11. 3%,postoperative complication rate of the control group was 15. 0%,there had no significant difference（ P〉0. 05）. Conclusion LEEP and radical resection in the treatment of cervical CIN have certain effect,but the radical resection of cervical bleeding volume,operation time,lymph node resection has more advantages in operation.