阴道镜联合不同宫颈电热圈环切术术式治疗宫颈上皮内瘤变临床研究

摘要

目的 探讨阴道镜联合不同宫颈电热圈环切术(LEEP)术式治疗不同程度宫颈上皮内瘤变(CIN)临床疗效.方法 回顾分析阴道镜联合不同LEEP术式治疗不同程度CIN 240例患者临床资料,分析不同术式出血量及愈合时间、并发症,及LEEP术前、后病理符合情况.结果 不同LEEP术式术中出血量随着手术范围的增加呈上升趋势(P＜0.01),愈合时间随着手术范围的增加逐渐延长(P＜0.01)；LEEP术前、术后宫颈组织病理学检查结果不符合者16.66％(40/240),术后病理较术前活检病理升级14.58％(35/240),不同程度CIN术前、术后病理符合率差异有统计学意义(P＜0.01)；LEEP手术并发症包括出血、感染、宫颈管黏膜外翻、宫颈管狭窄等,不同术式的发生率不同.结论 阴道镜直视下,选择下不同LEEP术式治疗CIN可减少并发症,更加明确宫颈病变程度,同时达到治疗目的.%Objective To study the clinical effect of colposcopy combined with LEEP at different degree in the treatment of cervical intraepithelial neoplasia (CIN).Methods The clinical data of 240 CIN patients treated with colposcopy combined with different LEEP surgery at different degree were reviewed.Different operative bleeding and healing time,together with the adverse reaction were analysed.Whether the pathology was consistent with the situation before and after LEEP was evaluated.Results Bleeding in the operation with the operation scope of the increase showed ascendant trend (P ＜0.01).Healing time in the operation with the operation scope of the increase showed ascendant trend(P ＜0.01).Cervical histopathology examination result before and after operation was not consistent with the 16.66％.LEEP postoperative pathology was aggravated by 14.58％(35/240) compared to preoperative biopsy pathology.There were pathological differences of CIN in different degree pre-operation and post-operation(P ＜0.01).LEEP operation complications included hemorrhage infection,mucosal ectropion,and cervical canal stenosis of cervical canal.Conclusion Different LEEP operation under colposcopy in the treatment of cervical intraepithelial neoplasia can reduce complications,define more clearly the degree of cervical lesions,and achieve the goal of treatment.