宫颈环形电切术与宫颈冷刀锥切术治疗HSIL疗效及术后1年预后比较

Comparison of clinical efficacy and postoperative prognosis within 1 year after operation of loop electrosurgical excision procedure and cervical cold knife conization for treating high-grade squamous intraepithelial lesion of the cervix

目的:比较宫颈环形电切术(LEEP)与宫颈冷刀锥切术(CKC)治疗高级别宫颈鳞状上皮内病变(HSIL)疗效及术后1年预后。方法:选取本院在2017年1月-2019年12月收治的80例HSIL患者,根据治疗方法的不同分为LEEP组和CKC组各40例。比较两组围术期指标、并发症及短期预后情况。结果:LEEP组手术时间(7.87±2.14min)、术中出血量(8.34±1.85ml)低于CKC组(31.85±5.77min、26.57±4.37ml)(P<0.05)。术后并发症LEEP组(7.5%)与CKC组(12.5%)无差异,术后切缘阳性率LEEP组(7.50%)与CKC组(2.5%)无差异(均P>0.05)。术后12个月LEEP组TCT/HPV筛查阳性率(32.5%)、病变残留率(25.0%)均高于CKC组(10.0%、5.0%)(P<0.05)。术后12个月复发率LEEP组(7.5%)与CKC组(5.0%)无差异(P>0.05)。结论:在手术时间、术中出血量方面LEEP优于CKC,但术后短期预后方面CKC优于LEEP。临床上可根据患者病情需求合理选择术型,从而提高HSIL治疗及预后效果。

Objective:To compare the clinical efficacy and postoperative prognosis within 1 year after operation of loop electrosurgical excision procedure(LEEP)and cervical cold knife conization(CKC)for treating high-grade squamous intraepithelial lesion(HSIL)of the cervix.Methods:A total of 80 patients with HSIL were selected and were divided into group A(40 women given LEEP treatment)and group B(40 women given CKC treatment)according to the different treatment methods from January 2017 to December 2019.The perioperative indicators,complications,and short-term prognosis of the patients were compared between the two groups.Results:The operation time(7.87±2.14min)and the intraoperative blood loss(8.34±1.85ml)of the patients in group A were significantly lower than those(31.85±5.77min and 26.57±4.37ml)of the patients in group B(P<0.05).There were no significant differences in the postoperative complications rate(7.5%vs.12.5%)and the postoperative margin positive rate(7.50%vs.2.5%)of the patients between the two groups(all P>0.05).12 months after operation,the positive rate of TCT/HPV screening(32.5%)and residual rate of lesions(25.0%)of the patients in group A were significantly higher than those(10.0%and 5.0%)of the patients in group B(P<0.05).There was no significant difference in the recurrence rate(7.5%vs.5.0%)of the patients at 12 months after operation between the two groups(P>0.05).Conclusion:Compared with those of CKC,LEEP has the advantages of shorter operation time and less intraoperative bleeding,but the short-term prognosis after operation of the patients after CKC treatment is better than that of the patients after LEEP treatment.In clinic,the surgical method can be reasonably selected according to the needs of patients'conditions,so as to improve the treating effect of HSIL and its prognosis.