221例宫颈上皮内瘤变患者的治疗与随访

A Follow-up Study of 221 Women With Cervical Intraepithelial Neoplasia

目的 分析宫颈上皮内瘤变 (CIN)不同治疗方案的随访结果 ,评价其临床疗效。方法 对 1995～ 1999年我院宫颈活检诊断为CIN的 2 35例患者 ,根据病变程度及本人意愿施以不同的治疗和处理 ,并对随访结果进行回顾性分析。结果 低度上皮内病变 (LGSIL)即CINI中期待治疗组 12个月及 2 4个月后自然转常率分别为 78 33%和 81 67% ;期待治疗组与激光治疗组转常率间差别无显著性 (P >0 0 5 )。高度上皮内病变 (HGSIL)组中 ,激光治疗组与LLETZ组及与全子宫切除治疗组间差别均有显著性 (P<0 0 5 ) ;而LLETZ组与全子宫切除组间 ,差别无显著性 (P <0 0 5 )。结论 在保证良好依从性的前提下 ,期待治疗对CINI患者是一种安全的疗法。LLETZ是治疗HGSIL安全而有效的方法 。

Objective To evaluate the different therapeutic schedule and its clinical effect on cervical intraepithelial neoplasia (CIN).Methods 235 patients diagnosed as CIN were treated with different treatment(14 were lost to followed-up). The follow-up results were analyzed retrospectively.Results In low grade squamous intraepithelial lesion (LGSIL),the rates of spontaneous resolution in expectant group in 12 months and 24 months were 78 33% and 81 67% respectively. The resolution rates in expectant group and laser therapy group were no significantly different (P>0 05). In high grade squamous intraepithelial lesion (HGSIL), the differences between the laser treated group and either LLETZ or total hysterectomy groups turned into normal rate was significantly (P<0 05). There was no significant difference between LLETZ and total hysterectomy groups (P>0 05).Conclusions Expectant treatment for CIN I is safe in a reliable patient population. LLETZ is a safe and effective treatment for HGSIL. The long-term efficacy of LLETZ should be investigated and assessed by extending the period of follow-up.