不同术式治疗高级别宫颈上皮内瘤变伴高危型HPV感染的临床疗效

Clinical efficacy of different surgical methods in the treatment of advanced cervical intraepithelial neoplasia with high-risk HPV infection

目的 探讨不同术式治疗高级别宫颈上皮内瘤变伴高危型人乳头瘤病毒(HPV)感染的临床疗效。方法 选取294例高级别宫颈上皮内瘤变伴高危型HPV感染患者为研究对象,随机分为宫腔镜下宫颈锥切术组104例、宫颈冷刀锥切术组99例、宫颈环形电切术组91例,比较三组的治疗效果。结果 宫腔镜下宫颈锥切术组术中出血量少于宫颈冷刀锥切术组、宫颈环形电切术组,愈合时间短于宫颈冷刀锥切术组、宫颈环形电切术组,术后并发症发生率、复发率、术后液基薄层细胞检测阳性率及HPV持续感染率低于宫颈冷刀锥切术组、宫颈环形电切术组(P<0.05);宫腔镜下宫颈锥切术组术前、术后女性性功能调查表评分比较差异无统计学意义(P>0.05)。结论 宫腔镜下宫颈锥切术治疗高级别宫颈上皮内瘤变伴高危型HPV感染的临床疗效显著,对性生活质量无明显影响,值得推广应用。

Objective To explore the clinical efficacy of different surgical methods in the treatment of advanced cervical intraepithelial neoplasia with high-risk human papillomavirus(HPV) infection.Methods 294 patients with high-grade cervical intraepithelial neoplasia and high-risk HPV infection were selected as the study subjects.They were randomly divided into three groups:104 patients in the hysteroscopic cervical conization group,99 patients in the cervical cold knife conization group,and 91 patients in the cervical circular resection group.The treatment effects of the three groups were compared.Results The intraoperative blood loss in the hysteroscopic cervical conization group was less than that in the cervical cold knife conization group and cervical circular electrocautery group,and the healing time was shorter than that in the cervical cold knife conization group and cervical circular electrocautery group.The incidence of postoperative complications,recurrence rate,positive rate of postoperative liquid based thin-layer cytology examination,and persistent HPV infection rate were lower than those in the cervical cold knife conization group and cervical circular electrocautery group(P<0.05);There was no statistically significant difference in the scores of the preoperative and postoperative female sexual function questionnaire between the hysteroscopic cervical conization group(P>0.05).Conclusion Hysteroscopic cervical conization has a significant clinical efficacy in the treatment of advanced cervical intraepithelial neoplasia with high-risk HPV infection,and has no significant impact on sexual quality of life.It is worth promoting and applying.