阴道镜下子宫颈电环切除术治疗宫颈上皮内瘤变80例护理体会

目的:探讨阴道镜下子宫颈电环切除术(LEEP)治疗宫颈上皮内瘤变(CIN)的疗效及护理。方法:对80例CIN患者采用LEEP治疗,术前充分准备,术中积极配合并严密监护患者意识、生命体征及血氧饱和度,术后观察患者阴道继发出血、阴道流液、宫颈狭窄、宫腔积血、感染及宫颈内口松弛等并发症,防治感染。结果:本组手术过程均顺利,术后随访6个月,治愈76例,术后足月阴道分娩10例。术中阴道出血10ml5例,术后第2~10天阴道出现少量血性分泌物60例,4例术后病理证实有浸润癌改做宫颈根治术。本组均无盆腔感染、继发出血、宫腔内口松弛、宫颈狭窄及宫腔积血等并发症发生。结论:阴道镜下子宫电环切除术治疗宫颈上皮内瘤变具有微创、出血少、恢复快、安全、并发症少等优点,尤其对于患有CINⅡ~Ⅲ级又要保留生育功能的年轻患者,LEEP是较安全、有效的治疗方法。

Experience of nursing care of 80 patients with CIN treated with loop electrosurgical excision procedure by colposcope.

Objective: To study the effectiveness and nursing care in the treatment of cervical intraepithelial neoplasia (CIN) with loop electrosurgical excision procedure by colposcope. Methods: 80 patients were treated with LEEP, when full preoperative preparation, good cooperation in operation and postoperative attentive observation were adopted including observation of patient's consciousness, vital signs, secondary vaginal bleeding and fluid, stenosis of neck of uterus and hematocele in uterine cavity, etc. Results: 76 patients were cured, 10 patients had vaginal delivery by 6 months follow-up. Vaginal bleeding of 10ml occurred in 5 patients; a little vaginal bloody secretion was found in 60 patients from poatoperative 2nd to 10th day; 4 patients were operated on cervicectomy due to infiltrating cancer, but no complication of infection of pelvic cavity, secondary bleeding, etc. Conclusion: LEEP has more advantages, such as miniincision, less bleeding, quick recovery and less complication, which is safe and effective in the treatment of CIN in grade II-III.