LEEP锥切术联合雌激素补充治疗围绝经期HPV阳性低度宫颈上皮内瘤变临床效果

Clinical effect of loop electrosurgical excision procedure combined with estrogen supplementary therapy for treating perimenopausal women with human papillomavirus positive and low-grade cervical intraepithelial neoplasia

目的:探讨宫颈环形电切(LEEP)联合雌激素补充治疗围绝经期人乳头瘤病毒(HPV)持续感染的低度宫颈上皮内瘤变(CIN)疗效及对患者性激素水平的影响。方法:选取2018年1月-2019年1月本院收治的144例持续HPV感染的围绝经期低度CIN患者,随机数字表法分为观察组和对照组各72例。两组均行LEEP手术治疗,观察组术后辅以口服戊酸雌二醇(2~3mg/次,每日2次)连续治疗3个月。观察两组围术期指标及并发症情况,记录两组术后24~36个月HPV核酸定量及转阴率,比较两组治疗3个月后性激素水平。结果:观察组与对照组术后阴道出血时间(5.1±0.8d、7.6±0.9d)、阴道流液时间(6.1±1.0d、8.3±1.1d)、切面愈合时间(28.7±5.8d、36.4±6.9d),观察组均低于对照组(均P<0.05)。术后HPV阴性率观察组(81.9%)与对照组(79.2%)无差异(P>0.05)。观察组术后LH、FSH水平低于对照组,E_(2)、P水平高于对照组,术后并发症发生率(7.0%)低于对照组(18.1%)(均P<0.05)。结论:LEEP锥切术联合雌激素补充治疗可促进术后恢复,降低术后并发症发生,调节患者性激素水平,有助于HPV阳性低度CIN的治疗。

Objective:To study the effect of loop electrosurgical excision procedure(LEEP)combined with estrogen supplementary therapy for treating perimenopausal women with positive human papillomavirus(HPV)and low-grade cervical intraepithelial neoplasia(CIN),and to explore its influence on the sex hormone level of these women.Methods:A total of 144 perimenopausal women with persistent HPV infection and low-grade CIN were selected and were randomly divided into two groups(72 cases in each group)according to the random number table from January 2018 to January 2019.The women in the two groups were given LEEP treatment.The women in the observation group were also given oral estradiol valerate(2-3 mg/time,twice a day)for three months after surgery additionally.The perioperative indicators and complications situation of the women in the two groups were observed.The HPV nucleic acid quantification and the HPV negative conversion rate of the women in the two groups were recorded.Results:The postoperative vaginal bleeding time(5.1±0.8d),the vaginal discharge time(6.1±1.0d),and the section healing time(28.7±5.8d)of the women in the observation group were significantly lower than those(7.6±0.9d,8.3±1.1d,and 36.4±6.9d)of the women in the control group(all P<0.05).There was no significant difference in the HPV negative rate(81.9%vs.79.2%)of the women after surgery between the two groups(P>0.05).The levels of LH and FSH of the women in the observation group were significantly lower than those of the women in the control group,the levels of E2 and P of the women in the observation group were significantly higher.The incidence of postoperative complications(7.0%)of the women in the observation group was significantly lower than that(18.1%)of the women in the control group(all P<0.05).Conclusion:LEEP conization combined with estrogen supplementary therapy for treating perimenopausal women with HPV infection and low-grade CIN can effectively promote their postoperative recovery,reduce the occurrence of their postoperative complications,regulate the level of their sex hormones,and which help to treat the HPV infection and low-grade CIN of the women.