冷刀锥切术在绝经后妇女宫颈上皮内瘤变Ⅲ级诊治中的应用

Application of cold knife conization in the diagnosis and treatment of CIN Ⅲ in postmenopausal women

目的讨论冷刀锥切在绝经后妇女宫颈上皮内瘤变(CIN)Ⅲ级诊治中的效果。方法回顾性分析因CINⅢ行冷刀锥切的患者259例,分为绝经组78例,未绝经组181例,将阴道镜活检与锥切术后病理以及再次手术后的病理进行比较。结果阴道镜活检病理结果与宫颈冷刀锥切术后病理相符率比较:绝经组相符率为66.66%,未绝经组相符率为70.16%;切缘情况比较:绝经组切缘阳性率为14.10%,未绝经组切缘阳性率为10.49%;追加手术后病灶残留率比较:绝经组残留率为10.25%,未绝经组残留率为8.33%。两组比较均差异无统计学意义(P>0.05)。结论冷刀锥切适用于绝经后妇女CINⅢ级,可避免漏诊和过度治疗,对于想保留子宫的绝经后患者是首选方法。

Objective To investigate the effect of cervical cold knife conization in postmenopausal women with CINⅢ.Methods A retrospective analysis was made of 259 cases of CINⅢ,including 78 postmenopausal women and 181 premenopausal women,who were treated with cervical cold knife conization.The biopsy under colposcopy,postoperative pathology and the extent of surgery were compared.Results The agreement rate between the colposcopy biopsy and the cervical cold knife conization pathology was 66.66%in postmenopausal group,while 70.16%in the premenopausal group.The positive margin rate of the postmenopausal group was 14.10%,while the rate of the premenopausal group was 10.49%.The additional postoperative residual positive rate of the postmenopausal group was 10.25%,while the rate of the premenopausal group was 8.33%.And the difference was not significant(P>0.05).Conclusions Cold knife conization is suitable for postmenopausal women with CINⅢ,which can avoid missed diagnosis and over treatment,and is the firstpreferred method for postmenopausal patients who want to retain their uterus.