宫颈高级别鳞状上皮内病变患者宫颈冷刀锥切术术后复发的影响因素分析

Analysis of influencing factors of postoperative recurrence in patients with cervical high-grade squamous intraepithelial lesion undergoing cervix cold knife conization

目的分析宫颈高级别鳞状上皮内病变(HSIL)患者宫颈冷刀锥切术(CKC)术后复发的影响因素。方法收集76例行CKC治疗的HSIL患者的病历资料,根据术后复发情况分为复发组(n=9)和未复发组(n=67),比较两组患者的临床特征。采用Logistic回归模型分析HSIL患者CKC术后复发的影响因素。结果两组患者孕次、术前人乳头瘤病毒(HPV)高危感染情况、术后HPV持续性感染情况、切缘情况比较,差异均有统计学意义(P﹤0.05)。孕次≥3次、术前HPV高危感染、术后HPV持续性感染、切缘阳性均是HSIL患者CKC术后复发的独立危险因素(P﹤0.05)。结论孕次≥3次、术前HPV高危感染、术后HPV持续性感染、切缘阳性均是HSIL患者CKC术后复发的独立危险因素,临床需密切关注存在上述高危因素的HSIL患者。

Objective To analyze the influencing factors of postoperative recurrence in patients with cervical highgrade squamous intraepithelial lesion(HSIL)undergoing cervix cold knife conization(CKC).Method The medical records of 76 patients with HSIL who underwent CKC treatment were collected and divided into recurrence group(n=9)and non-recurrence group(n=67)according to postoperative recurrence,and the clinical characteristics were compared between the two groups.The influencing factors of postoperative recurrence in patients with HSIL underwent CKC were analyzed by Logistic regression model.Result There were statistically significant differences in gravidity times,high-risk human papilloma virus(HPV)infection before surgery,persistent HPV infection after surgery and resection margin between the two groups(P<0.05).The gravidity times≥3,high-risk HPV infection before surgery,persistent HPV infection after surgery and positive resection margin were independent risk factors for postoperative recurrence in patients with HSIL underwent CKC(P<0.05).Conclusion The gravidity times≥3,high-risk HPV infection before surgery,persistent HPV infection after surgery and positive resection margin are independent risk factors for postoperative recurrence in patients with HSIL undergoing CKC.It is necessary to pay close attention to HSIL patients with the above high-risk factors in clinical practice.