宫颈环形电切术与宫颈冷刀锥切术治疗宫颈上皮内瘤变Ⅲ级的临床研究

Clinical study of loop electrosurgical excision procedure and cervical cold knife conization in treatment of cervical intraepithelial neoplasia Ⅲ

目的研究比较宫颈环形电切术(LEEP)及宫颈冷刀锥切术(CKC)治疗宫颈上皮内瘤变(CIN)Ⅲ级的临床效果。方法将2012年1月-2014年8月在该院接受治疗的96例CINⅢ级患者作为研究对象,根据数字随机表法将其分为LEEP组和CKC组,各48例。两组患者术后随访1年,对比两组患者手术指标水平、术后不同时期的复发率及感染率、并发症及妊娠情况。结果 LEEP组的手术时长、出血量、锥切组织面积及锥高均显著低于CKC组,差异均有统计学意义(均P<0.05)。随访1年,LEEP组术后的总复发率(20.83%)与总感染率(25.00%)均显著高于CKC组的6.25%及6.25%,差异均有统计学意义(均P<0.05)。两组术后并发症发生率及妊娠情况相比,差异均无统计学意义(均P>0.05)。结论 CKC术式与LEEP术式均可治疗CINⅢ级患者,二者疗效均较好,但LEEP术式出血量较少,且手术耗时短,CKC术式在降低复发率及感染率方面更具优势。

Objective To research the clinical effects of loop electrosurgieal excision procedure（LEEP） and cervical cold knife conization（CKC） in treatment of cervical intraepithelial neoplasia（CIN） Ⅲ.Methods Ninety-six CIN Ⅲ patients treated in the hospital from January 2012 to August 2014 were selected as research object,then they were divided into LEEP group and CKC group according to random number table,48 patients in each group.The patients in the two groups were followed up for one year after surgery.The levels of surgical indexes,postoperative recurrence rates and infection rates,incidence rates of complications and pregnancy rates in the two groups were compared.Results The operation time,bleeding volume,the area of the cone,and cone height in LEEP group were statistically significantly lower than those in CKC group（P〈0.05）.The total recurrence rate and total infection rate after one year in LEEP group were20.83% and 25.00%,respectively,which were statistically significantly higher than those in CKC group（6.25% and 6.25%）（P〈0.05）.There was no statistically significant difference in the incidence rate of complications and pregnancy rate between the two groups（P〉0.05）.Conclusion Both CKC and LEEP can treat patients with CIN Ⅲ,the curative effects of the two methods are good,but the amount of LEEP is less,and the operation time is shorter,CKC has more advantages in reducing recurrence rate and infection rate.