189例宫颈上皮内瘤变Ⅲ级术后患者临床结局的危险因素及对策研究

Risk factors and countermeasures of clinical outcomes of 189 patients after the surgery of grade Ⅲ cervical intraepithelial neoplasia after

目的研究189例宫颈上皮内瘤变Ⅲ级术后患者临床结局的危险因素及对策。方法选择2015年1月~2016年1月本院收治的宫颈上皮内瘤变Ⅲ级患者189例,观察宫颈上皮内瘤变Ⅲ级术后患者临床结局的危险因素,并讨论相应预防对策。结果在189例宫颈上皮内瘤变Ⅲ级患者中,术后2年出现肿瘤复发34例,发生率为17.99%,其中术后第1年内复发22例,术后第2年复发12例。患者的年龄超过45岁、高危型HPV感染阳性、已绝经、伴切缘阳性、累及腺体、产次超过2次、性生活开始年龄<18岁、吸烟均是影响宫颈上皮内瘤变Ⅲ级术后临床结局的独立危险因素(P<0.05)。结论宫颈上皮内瘤变Ⅲ级术后临床结局受多因素综合影响,复发率仍较高,需要警惕高危人群,并加大随访力度,提高复发检出率,采取合理的对策预防、治疗。

Objective To study the risk factors and countermeasures of clinical outcomes in 189 patients after the surgery of grade m cervical intraepithelial neoplasia. Methods A total of 189 patients with grade Ⅲ cervical intraepithelial neoplasia who were admitted to our hospital from January 2015 to January 2016 were selected. The risk factors for clinical outcomes of patients after the surgery of grade Ⅲ cervical intraepithelial neoplasia were observed, and the corresponding preventive measures were discussed. Results Of the 189 patients with grade Ⅲ cervical intraepithelial neoplasia, 34 cases had tumor recurrence 2 years after surgery, with an incidence rate of 17.99%. Among them, 22 casimcees relapsed within the first year after surgery, and in the second year after surgery, there were 12 cases who relapsed. The patient＇s age being more than 45 years old, positive high-risk HPV infection, post-menopausal, complication with positive margins, glands being involved, more than 2 times of childbirth, sexual life starting age less than 18 years, and smoking were all independent risk factors affecting the clinical outcomes after the surgery of grade Ⅲ cervical intraepithelial neoplasia （P〈0.05）. Conclusion The clinical outcome after the surgery of grade Ⅲ postoperative cervical intraepithelial neoplasia is affected by multiple factors, and the recurrence rate still remains high. Alerts should be given to high-risk groups, and follow-up efforts should be strengthened to improve the detection rate of relapse, and reasonable measures should be taken for prevention and treatment.