全子宫切除术后高级别残端阴道上皮内瘤变的治疗进展

Advances in the Treatment of High-Grade Stump Vaginal Intraepithelial Neoplasia after Total Hysterectomy

目前治疗全子宫切除术后高级别残端阴道上皮内瘤变的治疗方法包括手术切除如冷刀切除、宫颈环形电切术、激光刀切除术,物理消融如二氧化碳激光消融、超声手术抽吸术、光动力疗法,局部上药如咪喹莫特、三氯乙酸和5-氟尿嘧啶、放射治疗。全子宫切除术后高级别残端阴道上皮内瘤变病变位置多位于阴道断端缝合的褶皱凹陷中,治疗方式的选择需要根据每一位患者的临床表现、疾病进展过程及既往治疗手段拟定具有针对性的个体化治疗方案。

The current treatment methods for high-grade stump vaginal intraepithelial neoplasia after total hysterectomy include surgical excision such as cold knife resection, cervical loop resection, laser knife resection, physical ablation such as carbon dioxide laser ablation, ultrasound surgical aspiration, photodynamic therapy, topical drugs such as imiquimod, trichloroacetic acid and 5-fluorouracil, and radiation therapy. After total hysterectomy, the location of high-grade stump vaginal intraepithelial neoplasia is mostly located in the fold depression of the vaginal stump suture, and the choice of treatment method needs to be tailored according to the clinical manifestations of each patient, the course of disease progression and previous treatments.