宫颈冷刀锥切术中氩气刀应用研究

Application of Argon Knife in Cold Knife Conization of Cervix

目的:分析宫颈冷刀锥切术中应用氩气刀的临床效果。方法:选择2022年1-6月邳州市人民医院妇科收治的60例高级别子宫颈上皮内瘤变(CINⅢ)患者为研究对象,依据随机数字表法分为对照组(30例,使用宫颈冷刀锥切加缝合止血治疗)和观察组(30例,使用宫颈冷刀锥切加氩气刀止血治疗)。比较两组手术时间、术中及术后96 h出血量、术后阴道分泌物线索细胞阳性率、再出血率、宫颈管狭窄率、人乳头瘤病毒(HPV)阳性率。结果:观察组手术时间、术中及术后96 h出血量分别为(25.42±5.31)min、(31.55±7.62)mL、(23.56±4.61)mL,均短/少于对照组的(28.35±4.12)min、(39.56±9.12)mL、(29.45±6.57)mL,差异有统计学意义(P<0.05);观察组术后阴道分泌物线索细胞阳性率、再出血率、宫颈管狭窄率及术后6个月HPV阳性率均低于对照组,差异有统计学意义(P<0.05)。结论:在CINⅢ患者宫颈冷刀锥切术治疗中,采取氩气刀进行止血治疗效果确切,可显著缩短手术时间,减少术中术后出血量,降低术后HPV病毒阳性率,促进预后。

Objective:To analyze the clinical effect of argon knife in cervical cold knife conization.Methods:Sixty patients with high-grade cervical intraepithelial neoplasia(CIN Ⅲ) who were treated in the Department of Gynecology of Pizhou People’s Hospital from January 2022 to June 2022 were selected as the study objects.According to the random number table,they were divided into the control group(30 patients,who were treated with cold knife conization and suture hemostasis) and the observation group(30 patients,who were treated with cold knife conization and argon knife hemostasis).The operation time,the intraoperative and 96 h postoperative bleeding volume,the positive rate of vaginal secretions clue cells,the rate of rebleeding,the rate of cervical stenosis,and the positive rate of human papilloma virus(HPV) were compared between the two groups.Results:The operation time,intraoperative and 96h postoperative bleeding volume in the observation group were(25.42±5.31) min,(31.55±7.62) mL and(23.56±4.61) mL,respectively,which were shorter/less than the control group(28.35±4.12) min,(39.56±9.12) mL and(29.45±6.57) mL(P<0.05).The positive rate of clue cells in vaginal secretions,the rate of rebleeding,the rate of cervical stenosis and the positive rate of HPV at 6 months after operation in the observation group were lower than the control group(P<0.05).Conclusion:In the cervical cold knife conization treatment of CIN Ⅲ patients,the argon knife used for hemostasis treatment has a definite effect,can shorten the operation time,reduce the intraoperative and postoperative bleeding volume,reduce the positive rate of HPV after surgery,and promote the prognosis.