宫腔电切镜行宫颈锥形电切术在子宫颈上皮内瘤变治疗中的作用

Role of Cervical Cone Electroscection with Hysteroscopic Resectoscope in the Treatment of Cervical Intraepithelial Neoplasia (CIN)

目的:探讨宫腔电切镜在宫颈锥形电切术治疗宫颈上皮内瘤变(CIN)的效果及可行性。方法:采用阴道镜辅助下应用宫腔电切镜行宫颈锥形电切术治疗48例CIN患者。患者平均年龄为35.7±6.10岁(25～46岁),术前阴道镜下活检诊断为CIN Ⅰ 6例(12.5％),CIN Ⅱ 18例(37.5％),CIN Ⅲ24例(50％)。结果:宫腔电切镜行宫颈锥形电切术手术时间短,出血少,术中无并发症发生。术后病理检查发现,阴性病人4例(8％),CIN Ⅰ 6例(12.5％),CIN Ⅱ 16例(33％),CIN Ⅲ 20例(41.7％),原位癌1例,行全子宫切除治疗,微小浸润癌1例,行全子宫单附件加盆腔淋巴清扫。2例术后病理报告切除的宫颈、子宫均未找到癌细胞,也无不典型增生存在。其余46例经平均随诊13.5月,未发现CIN残留及复发,治愈率达100％。至今未发现宫颈狭窄及闭锁者。结论:初步结果表明宫腔电切镜行宫颈锥形电切术治疗CIN疗效好,并发症少。

Objective: To determine the effectiveness and safety of cervical cone electrosection with hysteroscopic resectoscope in the treatment of CIN. Methods: Forty-eight patients with the mean age of 35. 7±6. 10 years (ranged from 25 to 46 years), including 6 patients of CIN I, 18 patients of CIN II and 24 patients of CIN III, were given cervical cone electrosection by using hysteroscopic resectoscope with colposcopic guidance. Results: The operation time was short and the blood lost was little. There were no complications occurred in the procedure. According to the pathologic diagnosis after operation, 4 patients were absence in CIN,6 patients were CIN I,16 patients were CIN II, 20 patients were CIN III,1 patient was intraepitheli-alcarcinoma and 1 patient was early invasive carcinoma. The latter two patients underwent hysterectomy. After mean 13. 5 months' follow-up, recurrence CIN and residual CIN did not occurred in the 46 patients. The cure rate was 100%. No complications such as straitness and atresia of cervix occurred. Conclusion: Cervical cone electrosection with hysteroscopic resectoscope in the treatment of cervical intraepithelial neo-plasia(CIN) is effective and safe.