LEEP与CKC治疗宫颈高级别鳞状上皮内病变的疗效及宫颈再生情况观察

Efficacy of LEEP and CKC on cervical high-grade squamous intraepithelial lesion and observation of cervical regeneration status

目的:观察宫颈环形电切术(Loop electrosurgical excision procedure,LEEP)与冷刀锥切术(Cold knife conization,CKC)治疗宫颈高级别鳞状上皮内病变(High-grade squamous intraepithelial lesion,HSIL)的疗效差异,并比较其术后宫颈再生情况。方法:选取本院2021年1月~2023年6月收治的60例HSIL患者作为研究对象,根据信封法分为两组,LEEP组和对照组,各30例。LEEP组采用LEEP治疗,对照组采用CKC治疗,比较两组患者治疗效果、手术指标、宫颈再生及并发症发生情况。结果:治疗6m后,LEEP组病情逆转率明显低于对照组(P<0.05);LEEP组手术时间、术中出血量、锥切组织体积和长度均明显低于对照组(P<0.05);术后3m、术后6 m,LEEP组宫颈体积、长度均明显高于对照组(P<0.05);两组并发症发生情况无明显差异(P>0.05)。结论:CKC治疗HSIL的效果优于LEEP,但LEEP手术操作更简单、出血更少,对宫颈损伤更小,更有利于术后宫颈再生。

Objective:To observe the difference in efficacy of loop electrosurgical excision procedure(LEEP)and cold knife conization(CKC)in the treatment of cervical high-grade squamous intraepithelial lesion(HSIL),and to compare the postoperative cervical regeneration status.Methods:Sixty patients with HSIL in the hospital were selected from January 2021 to June 2023 as the study subjects,and were divided into LEEP group and control group according to the envelope method,30 cases in each group.The LEEP group was treated with LEEP,while the control group was given CKC.The therapeutic effect,surgical indicators,cervical regeneration and complications were compared between groups.Results:After 6 months of treatment,the disease reversal rate in LEEP group was significantly lower than that in control group(P<0.05).The surgical time,intraoperative blood loss,and volume and length of conization tissue were significantly shorter or lower in LEEP group than those in control group(P<0.05).At 3 months and 6 months after surgery,the cervical volume and length in LEEP group were significantly more or longer than those in control group(P<0.05).There was no significant difference in the occurrence of complications between groups(P>0.05).Conclusion:CKC in the treatment of HSIL has a better effect than that of LEEP,but LEEP has simpler surgical operation,less bleeding and smaller damage to the cervix,and it is more conducive to postoperative cervical regeneration.