探讨阴道镜指引下LEEP刀诊治宫颈上皮内瘤变的临床疗效

Investigation of the Clinical Efficacy of LEEP Knife in the Diagnosis and Treatment of Cervical Intraepithelial Neoplasia under the Guidance of Colposcopy

目的探讨阴道镜指引下LEEP刀诊治宫颈上皮内瘤变(CIN)的临床疗效。方法方便选择2014年4月—2019年3月就诊于该院70例宫颈上皮内瘤变患者,均行阴道镜指引下LEEP刀术治疗,并实施病理组织学诊断。记录术中出血量、手术操作时间、创面愈合时间、LEEP临床治疗效果,比较LEEP术取材的病理组织学与阴道镜下多点活检诊断的结果。结果70例患者顺利完成手术,术中出血量为(8.05±0.98)mL;手术时间为(4.86±1.47)min;创面愈合时间为(6.92±0.21)周;术后2个月复诊,宫颈形态异常者9例(12.86%),二次手术后治愈,宫颈光滑、外形恢复正常者61例(87.14%);阴道镜下多点活检病理诊断慢性宫颈炎为80.00%高于LEEP术的44.29%,差异有统计学意义(χ^2=4.301,P=0.038);阴道镜下多点活检病理诊断CINⅠ、CINⅡ、CINⅢ比例分别为11.43%、7.14%、1.43%,LEEP术分别为17.14%、12.86%、5.71%,差异无统计学意义(χ^2=0.933、1.270、0.830,P=0.334、0.260、0.172)。结论宫颈上皮内瘤变患者行阴道镜指引下LEEP刀术治疗效果较好,可更准确切除病变,能有效避免诊治不足与过度治疗现象,值得临床推广。

Objective To investigate the clinical efficacy of LEEP knife in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN) under the guidance of colposcopy. Methods From April 2014 to March 2019, Convenient select 70 patients with cervical intraepithelial neoplasia were enrolled in our hospital. All patients underwent laparoscopic LEEP knife surgery and histopathological diagnosis was performed. The intraoperative blood loss, operation time, wound healing time, and LEEP clinical treatment effect were recorded. The results of pathological histology and multi-point biopsy diagnosis under colposcopy were compared. Results Seventy patients completed the operation successfully. The intraoperative blood loss was (8.05±0.98)mL;the operation time was (4.86±1.47) min;the wound healing time was (6.92±0.21) weeks;the postoperative 2 months follow-up, cervical morphology 9 cases (12.86%) were abnormal, 61 cases (87.14%) were cured after the second operation, and the cervix was smooth and the shape returned to normal. The pathological diagnosis of chronic cervicitis by colposcopy was 80.00% higher than that of LEEP of 44.29%. The difference was statistically significant (χ^2=4.301, P=0.038). The proportions of CINⅠ, CINⅡ, and CIN Ⅲ in the pathological diagnosis of multi-point biopsy under colposcopy were 11.43%, 7.14%, and 1.43%, respectively, and LEEP was 17.14%. 12.86%, 5.71%, the difference was not statistically significant (χ^2=0.933, 1.270, 0.830, P=0.334, 0.260, 0.172). Conclusion The patients with cervical intraepithelial neoplasia underwent laparoscopic LEEP scalpel surgery, which can better remove the lesions, which can effectively avoid the diagnosis and treatment and over-treatment. It is worthy of clinical promotion.