LEEP刀治疗宫颈上皮内瘤变临床分析

Clinical Analysis of LEEP Knife Treatment of Cervical Intraepithelial Neoplasia

目的:分析宫颈环状电切术(LEEP)在宫颈上皮内瘤变(CIN)中的诊治价值。方法:选择本院2008年1月-2014年12月经阴道镜多点活检病理诊断为CIN及以上患者396例,其中312例实施宫颈LEEP术治疗(LEEP组),84例采用宫颈冷刀锥切术(CKC)治疗(CKC组),记录并比较两组的手术时间、术中出血量、术后并发症发生情况。切除组织均送病理检查,并与术前阴道镜下活组织病理检查结果进行比较。所有患者均随访6~24个月,评价疗效。结果:LEEP组平均手术时间短于CKC组,术中平均出血量少于CKC组(P<0.05)。LEEP组并发症发生率为0.96%,低于CKC组的7.14%(P<0.05)。LEEP组术后病理结果升级率为8.33%,符合率为48.40%,降级率为43.27%,CKC组升级率为22.62%,符合率为65.48%,降级率为11.90%,两组比较差异均有统计学意义(P<0.05)。LEEP组的临床治愈率为94.87%,CKC为96.43%,两组比较差异无统计学意义(X^2=1.042,P>0.05)。随访24个月,LEEP组总有效率为99.66%,CKC组为98.68%,两组比较差异无统计学意义(X^2=0.637,P>0.05)。结论:LEEP刀可完整切除宫颈病灶,近期和远期疗效与CKC相似,不仅可缩短手术时间短,减小创伤,降低并发症发生率,还可销毁切缘病灶。

Objective： To analyze the value of diagnosis and treatment of the cervical LEEP in cervical intraepithelial neoplasia （CIN） .Method： 396 colposcope multi-point biopsy pathologic diagnosis of CIN and over patients in our hospital from January 2008 to December 2014 were selected, including 312 cases were treated with cervical LEEP （ LEEP group ）, 84 cases were treated with cold knife conization （ CKC ） （ CKC group ） .The operation time, intraoperative blood loss, postoperative complications of the two groups were compared.Removing tissue pathologic examination, and with preoperative biopsy under colposcope pathologic examination results were compared.All patients were followed up for 6 to 24 months, evaluation of curative effect.Result： The LEEP the average operation time was short than that in CKC group, the average intraoperative blood loss was lessthan that in CKC group （ P〈0.05 ） .The complication rate of LEEP group was 0.96%, less than 7.14% of CKC group （ P〈0.05 ） . LEEP group of postoperative pathological results to progression rate was 8.33%, the coincidence rate was 48.40%, the degration rate was 43.27%, progression rate of CKC group was 22.62%, the coincidence rate was 65.48%, the degration rate was 11.90%, the differences between two groups were statistically significant （ P〈0.05 ） .The clinical cure rate of LEEP group was 94.87%, the clinical cure rate of CKC group was 96.43%, the difference between two groups was not statistically significant （ X2=1.042, P〉0.05 ） .Up to 24 months follow-up, the total effective rate of LEEP group was 99.66%, the total effective rate of CKC group was 98.68%, the difference between the two groups was not statistically significant （ X2=0.637, P〉0.05 ） .Conclusion： LEEP knife can complete removal of the cervical lesions, immediate and long-term curative effect is similar to CKC, not only can shorten the operation time is short, less trauma, reduce the incidence of complications, still can destroy cut edge lesions.