子宫颈高级别上皮内病变患者宫颈锥切术后腹腔镜下全子宫切除术的效果观察

Effect of Laparoscopic Total Hysterectomy after Cervical Conization in Patients with High-grade Intraepithelial Lesions

目的分析子宫颈高级别上皮内病变患者宫颈锥切术后腹腔镜下全子宫切除术的效果。方法选择我院2019年1月至2022年1月接收的88例子宫颈高级别上皮内病变患者为研究对象,入院先进行宫颈椎切术后行腹腔镜全子宫切除手术的44例患者作为观察组,阴道镜活检术后病理示高级别病变直接行腹腔镜全子宫切除手术的44例作为对照组,分析两组效果。并将观察组按照两次手术间隔时间分为3组,分别为宫颈锥切术后7 d内、宫颈锥切术后7~28 d,宫颈锥切术后28 d外,分析3组并发症情况。结果观察组患者和对照组患者手术时间、术中出血量、术后住院时间、术后发热时间无明显差异(P>0.05)。观察组患者和对照组患者手术后血红蛋白下降无明显差异(P>0.05)。观察组患者和对照组患者手术后半年HPV转阴率无明显差异(P>0.05)。宫颈锥切术后7 d内并发症发生率明显低于宫颈锥切术后7~28 d、宫颈锥切术后28 d后的并发症发生率,差异显著,有统计学意义(P<0.05)。结论子宫颈高级别上皮内病变患者宫颈锥切术后腹腔镜下全子宫切除术效果肯定,其手术风险较低,并发症发生率较低。宫颈锥切术后腹腔镜下全子宫切除术间隔时间应选择7 d内更安全,效果更佳。

Objective To analyze the effect of laparoscopic total hysterectomy after cervical conization in patients with high-grade intraepithelial lesions.Methods Select 88 patients from January 2019 to January 2022 as the study object,44 patients with laparoscopic total hysterectomy after uterine cervical resection were admitted as the observation group,and 44 patients with total laparoscopic high-grade lesions of colposcopy biopsy were used as the control group,and the effects of the two groups were analyzed.The observation group was divided into three groups according to the interval between the two operations,within 7 days after cervical conization,7-28 days after cervical conization,and 28 days after cervical conization.Analyze the complications in three groups.Results There were no significant differences in operation time,intraoperative blood loss,postoperative hospitalization time,and postoperative fever time between the observation group and the control group(P>0.05).There was no significant difference in the decrease of hemoglobin after surgery between the observation group and the control group(P>0.05).There was no significant difference in the negative rate of HPV in the observation group and the control group half a year after surgery(P>0.05).The complication rate within 7 days after cervical conization was significantly lower than that after 7-28 days after cervical conization and 28 days after cervical conization,which was significantly different and statistically significant(P<0.05).Conclusion Patients with cervical resection have low surgical risk and low rate of complications.The interval between laparoscopic total hysterectomy after cervical conization should be safer within 7 days and have better results.