宫颈冷刀锥切术与全子宫切除术对CINⅢ合并高危型HPV阳性患者治疗结局的影响

Effect of cervical cold taaper and total hysterectomy on treatment outcomes of patients with CIN with high-risk HPV positive

目的探讨对宫颈上皮内瘤变(CIN)Ⅲ合并高危型人乳头瘤病毒(HR-HPV)阳性患者分别采用宫颈冷刀锥切术与全子宫切除术治疗的效果。方法选取47例CINⅢ合并高危型HPV阳性患者,根据随机数字表法分为对照组(23例)与研究组(24例)。对照组予以全子宫切除术治疗,研究组予以宫颈冷刀锥切术治疗。比较两组手术效果、手术治疗指标以及术后高危型HPV转阴率。结果研究组患者手术治愈率为91.67%,对照组手术治愈率为95.65%,比较差异无统计学意义(P>0.05)。研究组患者术中出血量少于对照组,住院时间短于对照组(P<0.05)。研究组术后高危型HPV转阴率为83.33%,对照组术后高危型HPV转阴率为78.26%,比较差异无统计学意义(P>0.05)。结论对CINⅢ合并高危型HPV阳性患者采取宫颈冷刀锥切术与全子宫切除术治疗的效果相当,术后高危型HPV转阴率亦无显著差异,但是宫颈冷刀锥切术治疗的术中出血量更少,术后康复较快,故临床治疗中需结合患者的实际病情选择合适的手术进行治疗。

Objective To investigate the efficacy of cold knife coning and total hysterectomy for cervical intraepithelial neoplasia(CIN)Ⅲ combined with human papillomavirus(HR-HPV)positive.Methods 47 patients with CINⅢ combined with high-risk HPV positive were selected and divided into control group(23 cases)and study group(24 cases)according to random number table method.The control group was treated with total hysterectomy,while the study group was treated with cold knife coning of the cervix.The surgical effect,surgical treatment indexes and postoperative negative conversion rate of high-risk HPV were compared between the two groups.Results The operative cure rate was 91.67%in the study group and 95.65%in the control group,with no statistical significance(P>0.05).The intraoperative blood loss in the study group was less than that in the control group,and the length of hospitalization was shorter than that in the control group(P<0.05).The negative conversion rate of high-risk HPV was 83.33%in the study group and 78.26%in the control group,with no statistical significance(P>0.05).Conclusion CIN patients with high-risk HPV There is no significant difference in the rate of high-risk HPV conversion,but the intraoperative bleeding amount treated by cervical cold knife conization is less and the postoperative recovery is faster.Therefore,in clinical treatment,appropriate surgery should be selected based on the actual condition of the patient for treatment.