宫颈冷刀锥切术和全子宫切除术治疗宫颈高级别鳞状上皮内病变的效果及安全性比较

Comparison of the efficacy and safety of cervical cold knife conization and total hysterectomy in the treatment of cervical high-grade squamous intraepithelial lesions

目的比较宫颈冷刀锥切术(CKC)和全子宫切除术(TH)治疗宫颈高级别鳞状上皮内病变的效果及安全性。方法选取2022年1月至2023年1月扬州大学附属靖江人民医院收治的124例宫颈高级别鳞状上皮内病变患者作为研究对象,根据患者的意愿,分别纳入CKC组(56例)、TH组(68例)。CKC组接受CKC治疗,TH组接受TH治疗。比较两组的手术情况、人乳头状瘤病毒(HPV)转阴率、并发症发生率。结果CKC组的术中出血量少于TH组,手术时间、首次排气时间、住院时间均短于TH组,术后3个月的HPV转阴率低于TH组,差异有统计学意义(P<0.05);两组患者术后6、12个月的HPV转阴率比较,差异无统计学意义(P>0.05)。两组患者的并发症总发生率比较,差异无统计学意义(P>0.05)。结论CKC治疗宫颈高级别鳞状上皮内病变在术中出血、康复时间方面占优,但术后短期HPV转阴率较TH略低,且并发症发生率无明显差异。在选择治疗方式时,医生需要权衡手术的各种影响因素,以制订最合适的个体化治疗方案。

Objective To compare the efficacy and safety of cervical cold knife conization(CKC)and total hysterectomy(TH)in the treatment of cervical high-grade squamous intraepithelial lesions.Methods A total of 124 patients with cervical high-grade squamous intraepithelial lesion admitted to Jingjiang People's Hospital Affiliated to Yangzhou University from January 2022 to January 2023 were selected as the research objects.According to the wishes of the patients,they were included in the CKC group(56 cases)and the TH group(68 cases).The CKC group received CKC treatment,and the TH group received TH treatment.The operation conditions,human papilloma virus(HPV)negative conversion rate and the incidence of complications were compared between the two groups.Results The amount of intraoperative blood loss in the CKC group was less than that in the TH group,the operation time,the first exhaust time,and the hospitalization time were shorter than those in the TH group,and the negative conversion rate of HPV 3 months after operation was lower than that in the TH group,and the differences were statistically significant(P<0.05).There were no significant differences in HPV negative conversion rates between the two groups at 6 and 12 months after surgery(P>0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion CKC is superior to TH in the treatment of cervical high-grade squamous intraepithelial lesion in terms of intraoperative bleeding and recovery time,but the short-term HPV negative conversion rate after operation is slightly lower than that of TH,and there is no significant difference in the incidence of complications.When choosing a treatment method,doctors need to weigh various influencing factors of surgery to formulate the most appropriate individualized treatment plan.