阴道镜联合高频电波环切术治疗宫颈癌前病变的临床效果观察

Observation of clinical effect of LEEP combined with vaginal cytology in the treatment of cervical precancerous lesions

目的 探讨阴道镜与高频电波环切术（LEEP）联合应用于宫颈癌前病变的临床治疗效果.方法 收集行术后病理检查确诊为宫颈癌前病变患者76例的病历资料,行阴道镜下病理活检,对具有LEEP手术指征的宫颈癌前病变患者进行阴道镜下LEEP手术治疗,分析阴道镜下病理活检的诊断准确率,并统计其手术时间、手术出血量及治疗效果.结果 阴道镜检查结果分为满意、不满意两类,其中满意阴道镜诊断分为高度鳞状上皮内瘤样病变（HSIL）、低度鳞状上皮内瘤样病变（LSIL）两类,满意率为82.89%（63/76）;阴道镜活检的诊断准确率为90.79%;平均手术时间为（6.42±1.21）min,平均手术出血量为（10.45±2.31）mL,术后3个月液基薄层细胞检测（TCT）转阴率为95.83%（92/96）,术后6个月液基薄层细胞检测（TCT）转阴率为100.00%（76/76）.结论 对宫颈癌前病变患者采取阴道镜联合LEEP手术治疗具有创伤小、手术出血量少、住院时间短的优点,同时能有效切除病变部位,值得推荐.

Objective To explore the clinical efficacy of the combination of the vaginal and high frequency electric wave loop（LEEP） in the treatment of cervical precancerous lesions.Methods The clinical data of 76 cases with cervical precancerous lesions confirmed by postoperative pathological examination were collected,Pathologic biopsy was conducted under colposcope.For patients with operative indication, LEEP operation was carried out under colposcope and analyzed vaginal microscopic pathological biopsy diagnosis accurate rate.The operation time,bleeding volume and treatment were observed.Results Satisfactory colposcopy and biopsy results difference had statistical significance;colposcopy with biopsy diagnosis accurate rate was 90.79%.The average operation time was （6.42±1.21）min.The mean operative bleeding was （10.45±2.31）mL.Postoperative 3 months, TCT negative rate was 95.83%（92/96）.After 6 months of TCT negative rate was 100.00%（76/76）.Conclusion LEEP combined with vaginal cytology in the treatment of cervical precancerous lesions has less invasion,less bleeding,shorter hospitalization time,and can effectively remove the lesion site,it is worthy of recommending.