宫腔镜辅助冷刀锥切术与传统冷刀锥切术治疗子宫颈上皮内瘤变III期的临床疗效比较

Comparison of clinical efficiency between hysteroscopic assisted cold knife conization and traditional cold knife conization in the treatment of CIN Ⅲ

目的 探讨宫腔镜辅助冷刀锥切术治疗子宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN）III期的临床疗效及可行性。方法 我科2014年1~12月收治CINIII患者120例,分为观察组和对照组各60例,观察组行宫腔镜辅助下的宫颈冷刀锥切术,对照组行传统的宫颈冷刀锥切术,比较两组的手术时间、术中出血量、术后出血率、术后高危型HPV转阴率等。结果 观察组手术时间、术中出血量及术后出血率均明显低于对照组,差异有统计学意义（P〈0.05）;两组术后3月、6月HPV转阴率比较差异无统计学意义（P〉0.05）,术后1年观察组HPV转阴率明显高于对照组,差异有统计学意义（P〈0.05）。结论 与传统的宫颈冷刀锥切术对比,宫腔镜辅助下的宫颈冷刀锥切术治疗CINIII止血效果确切,可明显缩短手术时间、减少术中出血量、降低术后出血率、提高高危型HPV转阴率。

Objective To compare the efficacy and feasibility between hysteroscopic cold knife conization and traditional cold knife conization in the treatment of CINⅢ.Methods One hundred and twenty hospitalized patients with CINⅢat our department from January 2014 to December 2014 were divided into observation or control group ,60 in each group .The observation group was treated with hysteroscopic assisted cervical cold knife conization while the control group was treated with traditional cervical cold knife conization . Operative time,blood loss,postoperative bleeding and postoperative high-risk HPV negative rate were compared between the two groups . Results The mean operating time ,average blood loss ,postoperative bleeding rate in the observation group were all significantly lower than that in the control group （ P 〈0.05 ） .The differences in HPV negative rate after 3 and 6 months of operation were not statistically significant （P〉0.05）.However,high-risk HPV negative rate in the observation group was higher than that in the control group after one year of operation （P 〈0.05）.Conclusion Compared to the traditional cervix cold knife conization ,hysteroscopic assisted cold knife conization can make the exact hemostasis during the operation ,significantly shorten the operation time ,reduce the blood loss ,re-duced the postoperative bleeding rate and improve the high-risk HPV negative rate .