宫颈锥切术诊治宫颈上皮内瘤变(CIN)159例临床分析

目的:评价宫颈锥切术在CIN诊断与治疗中的应用价值。方法:分析159例宫颈锥切术患者资料及随访结果。结果:LEEP锥切术138例,冷刀锥切术21例,两者在手术时间、术中出血上差异有统计学意义(P<0.01);脱痂期出血多5例,LEEP术后4例,冷刀锥切术后1例,占3.14%;术后病理降级69例(43.40%),等级者76例(47.80%),升级者14例(8.80%,包括2例宫颈浸润癌);术后3个月冷刀锥切组与LEEP锥切组宫颈光滑分别为17例(80.95%)和135例(97.82%),两者之间差异有统计学意义(P<0.05);术后3个月及半年各细胞学随访1次,复发3例,治愈率98.11%,无感染、宫颈粘连及狭窄发生。结论:正确掌握宫颈锥切术的指征与方法可以避免CIN的漏诊,提高治疗的成功率。

Clinical analysis of 159 patients with cervical intraepithelial neoplasia diagnosed and treated by cervical conization

Objective:To evaluate the application value of cervical conization in diagnosis and treatment of cervical intraepithelial neoplasia(CIN).Methods:Clinical data and follow-up results of 159 cases were analysed retrospectively.Results:138 cases and 21 cases were treated by LEEP conization and cold-knife conization,respectively,there was significant difference in surgery time and intraoperative blood loss(P<0.01);5 cases(3.14%) had large blood loss in stadium decrustation,including 4 cases after LEEP conization and 1 case after cold-knife conization;after conization,the amount of pathologic degradation,unchanged and upgradation were 69 cases(43.40%),76 cases(47.80%) and 14 cases(8.80%,including 2 cases of invasive cervical carcinoma);there was significant difference in the proportion of smooth cervix between LEEP conization group(135 cases,97.82%) and cold-knife conization group(17 cases,80.95%) after 3 months(P<0.05);cytologic follow-up was carried out on the third and sixth month after conization,3 cases relapsed,the cure rate was 98.11%,no infection,cervical adhesion and stenosis occurred.Conclusion:Masting the indications and techniques of cervical conization correctly may avoid missed diagnosis and increase success rate of CIN.