LEEP与冷刀锥切治疗宫颈上皮内瘤变Ⅲ的效果以及对患者出血量、手术时间的影响

The Effect of LEEP and Cold Knife Conization in the Treatment of Cervical Intraepithelial NeoplasiaⅢand Its Effect on the Amount of Blood Loss and Operation Time

目的评定宫颈上皮内瘤变Ⅲ患者应用宫颈环形电切术(loop electrosurgical ercisional procedure,LEEP与冷刀锥切治疗对于患者出血情况和手术时间等治疗效果的影响。方法随机选择2018年10月—2021年10月青阳县人民医院就诊的60例宫颈上皮内瘤变Ⅲ患者为研究对象,根据随机数字表法分为对照组与观察组,各30例。对照组给予冷刀锥切治疗,观察组给予LEEP治疗,比较两组宫颈上皮内瘤变Ⅲ患者的临床效果。结果观察组术中出血量(7.85±2.32)mL低于对照组,观察组手术时间(17.65±2.52)min、切口愈合时间(29.56±2.33)d、住院时间(5.28±1.52)d短于对照组,差异有统计学意义(P<0.05)。观察组的病灶切除深度(19.52±2.05)mm、切除高度(1.35±0.33)cm、切除面积(4.11±1.23)cm^(2)均小于对照组,差异有统计学意义(P<0.05)。观察组并发症(宫腔出血、宫颈感染、宫颈管粘连、宫颈机能不全)发生率(3.33%)小于对照组,差异有统计学意义(χ^(2)=10.416,P<0.05)。结论与冷刀锥切治疗相比较,应用LEEP治疗宫颈上皮内瘤变Ⅲ的效果突出,可以更好地降低患者术中的出血量,降低对患者的创伤。

Objective To evaluate the effect of loop electrosurgery excisional procedure(LEEP)and cold-knife conization on the bleeding and operation time of patients with cervical intraepithelial neoplasiaⅢ.Methods A total of 60patients with cervical intraepithelial neoplasiaⅲtreated in Qingyang County People’s Hospital from October 2018 to October 2021 were randomly selected as the study objects and divided into control group and observation group according to the random number table method,with 30 cases in each group.The control group was treated with cold knife conization,and the observation group was treated with LEEP.The clinical effects of cervical intraepithelial neoplasiaⅲwere compared between the two groups.Results The intraoperative blood loss in the observation group was(7.85±2.32)mL,which was lower than that in the control group,and the operation time,incision healing time and hospital stay in the observation group were(17.65±2.52)min,(29.56±2.33)d and(5.28±1.52)d,which were shorter than those in the control group,and the differences were statistically significant(P<0.05).The depth of lesion resection,height of lesion resection and area of lesion resection in the observation group were(19.52±2.05)mm,(1.35±0.33)cm and(4.11±1.23)cm^(2),unich were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of complications(uterine hemorrhage,cervical infection,cervical canal adhesion,cervical insufficiency)in the observation group(3.33%)was lower than that in the control group,and the difference was statistically significant(χ^(2)=10.416,P<0.05).Conclusion Compared with cold-knife conization,the application of LEEP in the treatment of cervical intraepithelial neoplasia III is more effective,can better reduce the amount of intraoperative blood loss,and reduce the trauma to the patient.