宫颈环形电切术与冷刀锥切术治疗高级别宫颈上皮内瘤变的疗效分析-现代医学

宫颈环形电切术与冷刀锥切术治疗高级别宫颈上皮内瘤变的疗效分析

单位：南京市高淳人民医院妇科, 江苏南京 211300

分类号：R737.33

出版年·卷·期（页码）：2021·49·第三期（303-306）

摘要：

目的：研究宫颈环形电切术（LEEP）和宫颈冷刀锥切术（CKC）治疗宫颈上皮内瘤变（CIN）Ⅲ或CIN Ⅲ合并累及腺体患者的疗效。方法：回顾性分析2016年1月1日至2018年12月31日我院收治的132例CIN Ⅲ及CIN Ⅲ合并累及腺体患者的资料，根据术式分为两组，72例行宫颈LEEP为LEEP组，60例行CKC为CKC组。对比两组患者的术中出血量、手术时间、住院时间、手术切净率、术后创面出血、术后宫颈管粘连、术后宫颈阴道部缩短以及术后宫颈机能减退情况。结果：与CKC组相比，LEEP组术中出血量少，手术时间及住院时间短，术后宫颈阴道部缩短程度小（P<0.05），但手术切净率低，术后创面出血率高（P<0.05）。两组患者术后宫颈管粘连率和宫颈机能减退率比较差异无统计学意义（P>0.05）。结论：在治疗高级别CIN上，LEEP和CKC各有优缺点。CKC更适用于CIN Ⅲ及CIN Ⅲ合并累及腺体的患者。

Objective: To study the efficacy of cervial loop electrosurgical excision procedure (LEEP) and cervical cold knife conization (CKC) in the treatment of the patients with cervical intraepithelial neoplasia (CIN) Ⅲ or CIN Ⅲ with gland involvement. Methods: The data of 132 hospitalization patients with CIN Ⅲ and CIN Ⅲ with gland involvement from January 1, 2016 to December 31, 2018 were retrospectively analyzed, of whom 72 cases accepted cervical LEEP (LEEP group) and 60 cases accepted cervical CKC (CKC group). The intraoperative blood loss, operation time, hospital stay time, surgical clearance rate, postoperative wound bleeding, postoperative cervical adhesion, postoperative cervical vaginal shortening and postoperative cervical hypofunction were compared between the two groups. Results: Compared with CKC group, LEEP group had less intraoperative blood loss, shorter operation time and hospital stay, less postoperative cervical vaginal shortening (P<0.05), but lower surgical clearance rate and higher postoperative wound bleeding rate (P<0.05). There was no significant difference in the incidence of postoperative cervical adhesion and cervical hypofunction between the two groups (P>0.05).Conclusion: LEEP and CKC have their own advantages and disadvantages in the treatment of high-grade cervical intraepithelial neoplasia. CKC is more suitable for the patients with CIN Ⅲ and CIN Ⅲ with gland involvement.

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