235例宫颈上皮内瘤变Ⅲ级术后患者临床结局的影响因素分析

Analysis of the influencing factors of clinical outcome of 235 patients with cervical intraepithelial neoplasia

目的:探讨235例宫颈上皮内瘤变Ⅲ级患者术后预后情况及不良预后的影响因素。方法:选择2015年1月-2016年6月我院妇瘤科收治的235例宫颈上皮内瘤变Ⅲ级患者,均予宫颈环状电切术治疗,观察患者预后,并对影响预后的因素进行分析。结果:235宫颈上皮内瘤变Ⅲ级患者中,166例患者预后良好,良好率为70.64%,69例患者预后不良,不良率为29.36%,其中,复发患者64例,复发率为27.23%,并发症患者主要包括术后晚期出血1例,宫颈管狭窄3例,痛经1例,并发症发病率为2.13%。统计分析发现,年龄超过55岁、吸烟、切缘阳性、HPV感染高危、绝经、重度宫颈糜烂、有流产史、性生活初始年龄小于16岁是宫颈上皮内瘤变Ⅲ级患者不良预后的独立危险因素(P<0.05)。结论:超过55岁、吸烟、切缘阳性、HPV感染高危、绝经、重度宫颈糜烂、有流产史、性生活初始年龄小于16岁是宫颈上皮内瘤变Ⅲ级患者不良预后的独立危险因素,对有上述症状患者应密切注意预后情况,防止复发。

Objective:To investigate the prognosis of 235 patients with cervical intraepithelial neoplasia grade III after operation and the influencing factors of adverse prognosis.Methods:From January 2015 to June 2016,235 patients with grade III cervical intraepithelial neoplasia admitted to gynecologic oncology department of our hospital were treated with cervical circumferential electrotomy.The prognosis of the patients was observed and the factors affecting the prognosis were analyzed.Results:Among 235 patients with cervical intraepithelial neoplasia grade III,166 had good prognosis,and the good rate was 70.64%.69 had poor prognosis,and the bad rate was 29.36%.Among them,64 had recurrence,and the recurrence rate was 27.23%.The main complications included late bleeding in 1 case,cervical stenosis in 3 cases,dysmenorrhea in 1 case,and the incidence of complications was 2.13%.Statistical analysis showed that age over 55,smoking,positive source of excision,high risk of HPV infection,menopause,severe cervical erosion,history of abortion,and initial age of sexual life less than 16 years were independent risk factors for poor prognosis of patients with cervical intraepithelial neoplasia grade III(P<0.05).Conclusion:Over 55 years old,smoking,positive source of incision,high risk of HPV infection,menopause,severe cervical erosion,abortion history,and the initial age of sexual life less than 16 years old are independent risk factors for poor prognosis of patients with cervical intraepithelial neoplasia grade III.Patients with these symptoms should pay close attention to the prognosis and prevent recurrence.