柯凝卡冷刀自动锥切后射频热凝固和CKC治疗育龄妇女CINⅡ～Ⅲ的临床效果比较

Comparison of clinical effects of radio-frequency thermocoagulation after Cooling Cut cold knife conization and simple cold knife conization in treatment of CINⅡ-Ⅲ in women of childbearing age

目的对比柯凝卡冷刀自动锥切后射频热凝固与传统冷刀锥切术(CKC)治疗育龄妇女高级别宫颈上皮内瘤变的临床效果。方法选择2012年1月-2015年12月在该院确诊并接受治疗的有生育要求的高级别宫颈上皮内瘤变患者47例,按治疗方法的不同,分为柯凝卡冷刀组(25例)及CKC组(22例)。比较两组患者术中出血量、手术时间、住院时间及术后恢复情况,追踪术后妊娠和分娩情况。结果柯凝卡冷刀组手术、住院时间以及出血量均少于CKC组(P<0.05);两组患者术后并发症发生率比较差异无统计学意义(P>0.05),术后3个月,接受柯凝卡冷刀治疗者的TCT、HPV、阴道镜结果与CKC组相似,差异无统计学意义(P>0.05);柯凝卡冷刀治疗组术后不良妊娠发生率明显低于CKC组(P<0.05)。结论柯凝卡冷刀组治疗育龄妇女高级别宫颈上皮内瘤变较CKC术中出血少、手术时间短、恢复快且对妊娠结局影响小。

Objective To compare the clinical effects of radio-frequency thermocoagulation after Cooling Cut cold knife conization（ CKC） and simple CKC in treatment of cervical intraepithelial neoplasia（ CIN） Ⅱ-Ⅲ in women of childbearing age. Methods Fortyseven CIN patients having fertility requirement who were diagnosed definitely and treated in Changsha Maternal and Child Health Care Hospital from January 2012 to December 2015 were selected and divided into modified CKC group（ 25 patients） and simple CKC group（ 22 patients）. The amounts of intraoperative blood loss,operation time,hospitalization time,and postoperative recovery in the two groups were compared. Postoperative pregnancy and delivery were followed up. Results The operation time,hospitalization time,and the amount of intraoperative blood loss in modified CKC group were statistically significantly less than those in simple CKC group（ P〈0. 05）. There was no statistically significant difference in the incidence rate of postoperative complications between the two groups（ P〈0. 05）. At three months after operation,there was no statistically significant difference in the results of TCT,HPV detection,and colposcopy between the two groups（ P〈0. 05）. The incidence rate of postoperative adverse pregnancy in modified CKC group was statistically significantly lower than that in simple CKC group（ P〈0. 05）. Conclusion Compared with simple CKC,modified CKC has the advantages of less bleeding,shorter operation time,quicker recovery,and less effect on pregnancy outcome in treatment of CIN among the women of childbearing age.