宫颈锥切术治疗宫颈上皮内瘤变的临床研究

目的探讨宫颈锥切在诊治不同级别宫颈上皮内瘤变(CIN)的效果。方法回顾性分析142例行宫颈锥切手术的宫颈上皮内瘤变患者,观察手术时间、出血量、手术前后组织病理诊断结果变化及高危型人乳头瘤病毒变化,评价宫颈锥切诊断情况及治疗效果。结果 LEEP手术时间及出血量均少于冷刀锥切术,差异有统计学意义(P0.05)。术前电子阴道镜下活检结果与宫颈锥切术后病理结果诊断一致率为71.12%(101/142)。宫颈锥切术后病理结果级别升高15例(10.56%),手术前后HPV-DNA负荷量下降明显,差异有统计学意义(P0.01)。结论宫颈锥切手术较电子阴道镜下宫颈多点活检的宫颈浸润癌检出率更高,宫颈锥切在切除病变的同时可以有效消除高危型HPV感染,是一种诊断、治疗CIN的非常理想的手段。

Cervical Conization for Cervical Intraepithelial Neoplasia

Objective To evaluate the efficacy of cervical conization in the treatment of different grade of cervical intraepithetial neoplasia（CIN）. Methods All 142 eases CIN treated by cervical conization were retrospectively analyzed. Operation time, blood loss during the operation,changes of histopathologic results and high-risk HPV before and after the operation were studied. The diagnosis and treatment results by cervical conization were evaluated. Results The average operation time and blood loss by using loop electrosurgieal excision procedure（LEEP） were less than those by cold knife conization significantly（P〈0.05）. The concordance rate of histopathologic results under colposcope before operation and after cervical conization was 71.12% （101/142）. Fifteen cases had increased CIN grade after cervical conization（10.56%）. The HPV-DNA loading dose after operation was significantly declined（P〈 0.01 ）. Conclusion The detection rate of invasive cervical cancer by cervical conization is higher than multiple punch biopsy under electronic colposeope.Cervical conization is an effective method for the diagnosis and treatment of CIN,and it can eliminate high-risk HPV and,at the same time,remove the cervical lesion.