阴道镜联合LEEP术在子宫颈癌前病变患者中的应用及对局部创伤的控制效果观察

Application of Colposcopy Combined with LEEP in Patients with Cervical Precancerous Lesion and Control Effect for Local Trauma

目的:探究及观察阴道镜联合子宫颈环形电切(LEEP)术在子宫颈癌前病变患者中的应用效果及对局部创伤的控制效果。方法:选择福州市长乐区医院2019年10月—2021年12月收治的90例子宫颈癌前病变患者,按照随机数表法分为对照组和观察组,各45例。对照组进行微波治疗,观察组则进行阴道镜联合LEEP术治疗。比较两组的治疗总有效率、手术时间、术中出血量、术后出血时间、手术前后的分泌物炎症指标[降钙素原(PCT)与C反应蛋白(CRP)]及宫颈局部微循环指标(局部血流灌注、微血管管径及红细胞聚集率)。结果:观察组的治疗总有效率显著高于对照组,手术时间及术后出血时间显著短于对照组,术中出血量显著少于对照组,差异均有统计学意义(P<0.05)。术前,两组的分泌物炎症指标及宫颈局部微循环指标比较,差异无统计学意义(P>0.05);术后2周,观察组的CRP及PCT显著低于对照组(P<0.05)。术后1、2周,观察组的宫颈局部微循环指标显著优于对照组,差异有统计学意义(P<0.05)。结论:阴道镜联合LEEP术在子宫颈癌前病变患者中的应用效果相对较好,且对局部创伤的控制效果更好,因此在子宫颈癌前病变患者中的应用价值较高。

Objective: To investigate and observe the application effect of colposcopy combined with loop electrosurgical excision procedure(LEEP) in patients with cervical precancerous lesion and control effect for local trauma. Method: A total of 90 patients with cervical precancerous lesion admitted to Fuzhou Changle District Hospital from October 2019 to December 2021 were selected and divided into control group and observation group according to random number table method, with 45 cases in each group. The control group was treated with microwave, and the observation group was treated with colposcopy combined with LEEP. The total effective rate, operation time, intraoperative bleeding volume, postoperative bleeding time, pre and post operation secretion inflammatory indicators [procalcitonin(PCT) and C-reactive protein(CRP)] and local cervical microcirculation indicators(local blood flow perfusion, microvascular diameter and erythrocyte aggregation rate) were compared between the two groups. Result: The total effective rate in observation group was significantly higher than that in control group, the operation time and postoperative bleeding time were significantly shorter than those in control group,the intraoperative blood loss was significantly less than that in control group, the differences were statistically significant(P<0.05). Before operation, there were no significant differences between the two groups in the indexes of secretion inflammation and local microcirculation of the cervix(P>0.05). Two weeks after operation, the CRP and PCT in the observation group were significantly lower than those in the control group(P<0.05). One week and two weeks after operation, the indexes of local cervical microcirculation in the observation group were significantly better than those in the control group(P<0.05). Conclusion: The application effect of colposcopy combined with LEEP in patients with cervical precancerous lesion is relatively better, and its control effect for local trauma is better too, so its application value in the patients with cervical intraepithelial neoplasia is higher.