宫颈环形电切术治疗宫颈上皮内瘤样病变238例

目的 观察宫颈环形电切术治疗Ⅱ～Ⅲ级、Ⅲ级宫颈上皮内瘤样病变(CIN)的临床疗效及其安全性.方法 回顾性分析经阴道镜下活检诊断为Ⅱ～Ⅲ级、Ⅲ级CIN的238例患者的临床资料.均采用宫颈环形电切术(LEEP)行宫颈锥形切除,观察手术后感染和出血、病灶残留情况,随访手术治疗效果和复发情况,随访观察高危型人类乳头瘤病毒(HPV)感染持续及其转阴时间.结果 术后发生宫颈感染21例(8.82%),术后平均出血时间为9 d;术后发生病灶残留25例(10.50%);术后平均随访时间20个月,复发9例(3.78%);术后高危型HPV感染持续平均时间为7个月.结论 宫颈环形电切术在切除高级别CIN病变的同时,还能有效清除高危型HPV感染,用于治疗宫颈上皮内瘤变是安全有效的.

Loop Electrosurgical Excision Procedure in the Treatment of Cervical Intraepithelial Neoplasia in 238 Cases

Objective To investigte the clinical curative effect and clinical saf ety of loop electrosurgical excision procedure（LEEP） in the treatment of cervica l intraepithelial neoplasia Ⅱ-Ⅲ,Ⅲ（CINⅡ-Ⅲ,CINⅢ）.Methods Two hundred and t hirty-eight cases of CINⅡ-Ⅲ,CINⅢdiagnosed by multiple punch biopsies under electronic colposcope and treated by cervical conization with LEEP were retrospe ctively analyzed.The infection,bleeding and postoperative residual focus were ob served after LEEP.The therapeutic effectiveness and recurrence,persistent period and negative conversion time of high risk human papillomavirus（HPV） infection were followed up.Results The cervical infection after LEEP was in 21 cases（8.82 %）.The average bleeding time was 9 d.Postoperative residual focus was in 25 cas es（10.50%）.The postoperative follow-up period was 20 months and recurrence wa s in 9 cases（3.78%）.The average persistent period of high risk HPV infection af ter LEEP was 7 months.Conclusion LEEP removes the high level CIN lesions,at the same time effectively eliminate high-risk HPV infection,which is effective and safe in the treatment of CINⅡ-Ⅲ,CINⅢ.