宫颈环形电切术与冷刀锥切术对治疗宫颈上皮内瘤变Ⅲ级的疗效比较(1)
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[摘要] 目的:比较宫颈环形电切术(LEEP)和冷刀宫颈锥切术(CKC)对宫颈上皮内瘤变Ⅲ级(CIN Ⅲ)的临床疗效。方法：将172例经宫颈细胞学筛查、阴道镜检查及阴道镜下多点活检病理检查确诊为CIN Ⅲ的患者随机分为两组,观察组93例行LEEP,对照组79例行CKC,观察比较两组手术时间、术中出血量、切口愈合时间及手术前后病理。结果：两组手术治疗效果相当,LEEP组手术时间、切口愈合时间明显短于CKC组,术中出血量显著少于CKC组(P<0.05)。结论：LEEP是目前诊治CINⅢ的安全有效方法,具有手术时间短、术中出血少等优点,患者创伤小、痛苦少,优于CKC,值得进一步深入地研究并加以推广。
[关键词] 宫颈上皮内瘤变； 环形电切术； 冷刀锥切术
[中图分类号] R737.33 [文献标识码] A [文章编号] 1671-7256(2011)02-0162-04
doi：10.3969/j.issn.1671-7256.2011.02.012
Comparison of diagnositic and therapeutic values of LEEP and CKC for CIN
LIU Qing-zhi, HUANG Shan-ying, TANG Xue-lian， DU Hong-lei
(Department of Reproduction Healthcare, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen 518048, China)
[Abstract] Objective: To compare application values of loop electrosurgical excision procedure(LEEP) and cold knife conization(CKC) for the treatment of cervical intraepithelial neoplasia Ⅲ(CINⅢ). Methods: 172 patients with CINⅢ were diagnosed by TCT and multiple punch biopsy under colposcope. They were divided into two groups randomly： 93 patients in the LEEP group and 79 patients in CKC group. The operation time, amount of blood loss, time of wound healing and changes of pathological grades in the two groups were studied. Results: The two groups had the same values in therapeutic efficacy. LEEP group had shorter operative time and time of wound healing,little amount of blood loss than CKC group, there were significant differences between the two groups(P<0.05). Conclusion: LEEP is a safe and efective treating method to CINⅢ, LEEP had the merits of short operative time,blood loss, invasion and pain, and rapid recovery. LEEP is worth spreading.
[Key words] cervical intraepithelial neoplasia； loop electrosurgical excision procedure； cold knife conization
宫颈上皮内瘤变(cervical intraepithelial neoplasia, CIN)是与宫颈癌有关的癌前病变,其发病患者日趋年轻化,其中有许多患者都希望保留生育功能。在过去的40年里,宫颈癌的发生率及死亡率已明显下降,这主要归功于世界范围内对宫颈癌前病变——宫颈上皮内瘤变(CIN)的筛查及早期治疗。CIN的治疗方式多种多样,20世纪90年代出现的宫颈环形电切术(loop electrosurgical excision procedure, LEEP)由于其操作简便且并发症少,近十年来,在国内外得到了广泛应用。虽仍有病理学者认为,LEEP会增加病理标本诊断的难度,但目前积累的大量临床治疗经验提示,LEEP正在逐步取代传统的冷刀锥切(cold-knife conization, CKC)成为治疗CIN的首选诊断及治疗方法[1]。2008年1月至2009年6月,我们对172例CIN Ⅲ患者分别行LEEP和CKC术,通过比较两种手术方法的临床疗效,探讨治疗CIN Ⅲ的最佳治疗方法 ......
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