宫颈冷刀锥切术和宫颈环形电切术治疗宫颈上皮内瘤变Ⅲ级的效果对比

Comparison of the effect of cervical cold knife conization and cervical resection for cervical intraepithelial neoplasia

目的探讨比较宫颈冷刀锥切术(CKC)和宫颈环形电切术(LEEP)治疗宫颈上皮内瘤变(CIN)Ⅲ级的效果。方法选取2014年4月~2015年7月在我院接受治疗的CINⅢ级患者82例作为研究对象,按照随机数字法分为CKC组和LEEP组,每组各41例。CKC组患者采用CKC治疗,LEEP组患者采用LEEP治疗,观察记录两组患者相关临床指标数据。结果比较两组患者的手术时间、术中出血量和术后宫颈愈合时间,LEEP组的各项指标均较CKC组要低,差异有统计学意义(P<0.05);比较两组患者在术后3、6、12、22个月的复发情况,CKC组均较LEEP组低,差异有统计学意义(P<0.05);比较两组患者的术后并发症情况,CKC组患者明显较LEEP组高,差异有统计学意义(P<0.05);比较两组患者的HPV感染情况,CKC组患者明显较LEEP组低,差异有统计学意义(P<0.05)。结论传统的CKC手术和LEEP手术各有特点,LEEP的优势体现在操作快速简便,创伤小、患者恢复时间短,但存在治疗不彻底、切割范围小和切缘易复发等劣势,因而对CINⅢ级患者的治疗,需综合患者本身的具体病情和生育要求进行手术方案的合理选择。

Objective To explore contrast cervical cold knife cuts（CKC） and the cervical cone annular cutting （LEEP） treatment of cervical intraepithelial neoplasia（CIN）Ⅲ level effect.Methods 82 CIN UI patients who treated in our hospital from April 2014 to July 2015 were selected for this study.They were divided into two groups according to the random number table method,41 cases in each group.One group patients were treated with CKC,referred to as CKC group. The other were treated with LEEP,referred to as LEEP group.The clinical data of the two groups were observed and recorded.Results The operation time,intraoperative blood loss and postoperative cervical healing time of the two groups of patients was compared,LEEP group were lower than the CKC group,the difference between the two groups was statistically significant（P〈0.05）.The recurrence of the two groups of patients at 3,6,12 and 22 months after surgery was compared,CKC group was lower than LEEP group, the difference between the two was statistically significant （P〈0.05）.HPV infection between the two groups of patients was compared,patients in the CKC group were significantly lower than those in the LEEP group,the difference was statistically significant （P〈0.05）.Conclusion Traditional CKC and LEEP surgery have their own characteristics.The advantages of LEEP is quick and easy operation.Its trauma is small and patients＇recovery time is short.But there is also disadvantage,like small range of cutting and cutting edge relapsing easily. Therefore for the treatment of patients with cervical intraepithelial neoplasia, the decision should be made according to their concrete condition and need.