宫颈环形电切除术联合干扰素治疗宫颈上皮内瘤变的临床研究

摘要

目的：探讨LEEP刀联合干扰素治疗宫颈上皮内瘤变(CIN)的临床疗效。方法整群选取2011年2月—2015年10月该院收治的118例宫颈CINⅡ、Ⅲ级患者为研究对象，根据随机原则分为观察组和对照组。其中对照组(56例)采用单纯宫颈环形电切除术(LEEP刀)治疗，观察组(62例)在LEEP刀治疗前联合重组干扰素栓α-2b治疗治疗半年后比较两组患者的临床疗效以及免疫球蛋白和T细胞亚群水平。结果治疗结束后对照组总有效率低于观察组(P<0.05)。随访1年后对照组有4例复发，而观察组无复发病例。对照组术中出血量和平均愈合时间明显长与观察组(P<0.05)。此外，观察组患者血清中IgA、IgG和IgM含量以及CD4+T细胞比例均高于对照组，而CD8+T细胞比例低于对照组。结论宫颈环形电切除术结合干扰素治疗能有效改善CIN的临床疗效和免疫功能，是一种理想的治疗方法。%Objective To observe the clinical curative effect of Leep knife and interferon in treatment of cervical intraep-ithelial neoplasias. Methods 118 cases of patients with cervical CIN of grade Ⅱ and Ⅲ admitted and treated in our hospi-tal from February 2011 to October 2015 were selected as the research objects and randomly divided into two groups, the control group (56 cases) were treated with simple loop electrosurgical excision procedure (Leep knife), the observation group (62 cases) were treated with recombinant interferon α-2b before the LEEP knife treatment, and the clinical curative effect, immune globulin and T cell subset levels were compared between the two groups after 6-month treatment. Results The dif-ference in the total effective rate between the control group and the observation group had statistical significance by com-parison at the end of the treatment, [71.4% (40/56) vs 93.5% (58/62)], (χ2=10.2275, P<0.01), after 1-year follow-up, recur-rence occurred to 4 cases in the control group and recurrence occurred to 0 case in the observation group, and the differ-ences in the intraoperative blood loss and average healing time between the control group and the observation group had statistical significance by comparison, [(10.5±3.5) ml, (5.5±1.5) weeks vs (5.0±1.5) ml, (4.0±0.5) weeks], P<0.05, in addition, the IgA, ,IgG and IgM contents in serum and CD4+ T cell ratio in the observation group were higher than those in the con-trol group, but the CD8+ T cell ratio in the observation group was lower than that in the control group. Conclusion Loop electrosurgical excision procedure and interferon treatment can effectively improve the clinical curative effect of CIN and immunologic function, which is an ideal treatment method.