阴道上皮内瘤变的诊断及治疗

Diagnosis and Treatment of Vaginal Intraepithelial Neoplasia

目的：探讨阴道上皮内瘤变（VAIN）的诊断及治疗方法。方法：回顾性分析VAIN的72例患者的临床资料,72例患者VAINⅠ52例,VAINⅡ-Ⅲ20例。结果：患者年龄18-61岁,绝大多数无临床症状,少数表现为阴道分泌物增多,96%患者病变位于阴道穹窿或上1/3,其余4%位于阴道中1/3,30%患者合并宫颈上皮内瘤变（CIN）Ⅱ-Ⅲ。52例VAINⅠ中有18例合并CINⅡ-Ⅲ的患者行LEEP术,余予以观察;20例VAINⅡ-Ⅲ患者行病灶电灼术,其中6例合并CINⅡ-Ⅲ的患者同时行宫颈LEEP术。20例VAINⅡ-Ⅲ患者有1例高危型人乳头瘤病毒（HPV）阴性,19例高危型HPV阳性,均在术后3个月-1年内转为阴性。结论：VAIN常在宫颈筛查的第二阶梯阴道镜检查时偶然发现,常合并CIN,病灶电灼术能起到有效的治疗作用,创伤小,治愈率高。

Objective： To investigate the diagnosis and treatment of vaginal intraepithelial neoplasia（VAIN）. Methods： The clinical data of 72 patients with VAIN were retrospectively analyzed, 72 cases of VAIN I, 20 cases of VAIN. Results： Patients ranged in age from 18 to 61 years old, most without clinical symptoms, the performance of a small number of vaginal secretion grow in quantity, 96% of patients in the vaginal fornix or 1/3, the remaining 4% in the third of the vagina, 30% of patients with cervical intraepithelial neoplasia（CIN） II - III. 52 cases of VAIN I have 18 cases of patients with CIN II to III of the patients underwent LEEP, I was to observe; 20 cases of patients with VAIN II - III patients with lesions, 6 cases of patients with CIN. 20 cases of VAIN II to III patients with high-risk human papillomavirus（HPV） negative, 19 cases of high-risk HPV positive, 3 months to 1 years after the turn to negative. Conclusion： VAIN often in the second step of the cervical screening test for the occasional discovery, often combined with CIN, the lesion of electric burn can play an effective therapeutic effect, the wound is small, the cure rate is high.