LEEP刀系统的研制

LEEP刀为宫颈疾病手术设备，属高频电刀类，目前尚无国产化的LEEP刀。课题解决了系统的安全和电磁干扰问题，研制出手术效果能与进口产品媲关、安全稳定且成本低的LEEP刀系统。实际测试表明，该系统能够顺利切割、凝血与混切，且没有明显的碳化现象，手术效果良好，有利于LEEP术在国内的普及。     

LEEP刀联合纳米银治疗慢性宫颈炎疗效观察

目的探讨宫颈电热圈环切除术联合纳米银治疗慢性宫颈炎的临床疗效。方法将158例慢性宫颈炎患者，随机分为LEEP刀联合纳米银组（试验组）88例，单用LEEP刀组（对照组）70例。比较两组的疗效，不良反应。结果试验组的总有效率为97．7％，与对照组的总有效率81．4％，有显著性差异（P〈0．01）。结论LEEP2LI联合纳米银治疗慢性宫颈炎的效果显著，副反应小，临床效果优于单用LEEP刀。     

LEEP切除宫颈良性赘生物37例临床分析

目的:探讨高频电刀环切术(loop electrosurgical excision procedure,LEEP)在治疗宫颈良性赘生物(Benign Cervical Neoplasm)中的疗效。方法:回顾性分析2006年1月~2007年5月间,应用LEEP诊治宫颈良性赘生物37例,术后1个月、2个月、6个月复诊,观察疗效。结果:手术时间平均6·5min,术中出血5~20ml。术后病理:宫颈息肉17例(46%),宫颈湿疣8例(21·6%),宫颈腺囊肿7例(19%),宫颈肌瘤2例(5·3%),宫颈息肉伴腺囊肿3例(8·1%)。术后1个月、2个月、6个月复诊,宫颈光滑,病变部位上皮恢复其原有上皮组织,宫颈的正常形态及大小基本恢复的病例数分别为24例(64·8%),34(91·9%),35(95%)例。结论:LEEP治疗宫颈良性赘生物,操作简单、出血少、术后并发症少。     

高频电波刀治疗慢性宫颈炎的临床应用

目的探讨高频电波刀(LEEP)在治疗慢性宫颈炎的临床价值。方法采用LEEP手术治疗,切除病变组织或行宫颈锥切治疗230例,平均随诊时间6个月。结果术后2个月宫颈糜烂一次性治愈率97.12%。结论LEEP电切宫颈治疗严重宫颈炎治愈率高,安全简便,术后并发症少,患者乐于接受。     

高频电波刀在宫颈病变中的应用

目的探讨高频电波刀子宫颈环形电切除操作在治疗宫颈病变中的应用.方法对经妇科检查、宫颈脱落细胞学检查诊断为不同类型宫颈疾病的门诊患者458例,采用高频电波刀电烫、环形电切除治疗,切除病变组织标本均送病理学检查;同时观察手术时间、手术出血量及术后疗效.结果环形电切除手术治疗宫颈疾病一次成功率为98.69%(452/458),平均时间5.2分钟,出血量5.5 ml.术后阴道分泌物明显减少,无继发性出血、宫颈粘连和感染的发生;手术标本经病理学检查明确诊断.结论高频电波刀治疗各类宫颈疾病操作简单、安全,手术时间短,出血少,治疗效果佳,且可提供完整的病理标本.     

宫颈电热圈环切术在宫颈病变中的诊疗价值

目的探讨宫颈电热圈环切术(LEEP)在诊断和治疗宫颈病变中的临床价值。方法回顾性分析2005年6月—2007年6月间我院门诊接受LEEP治疗的242例宫颈病变患者的临床病理资料。结果90例慢性宫颈炎中检出5例轻度不典型增生,1例原位癌,检出率为6.6%(6/90)。152例各种CIN病例中术前术后病理诊断一致者占57.2%(87/152),术后级别升高占13.8%(21/152),其中早期浸润癌1例。11例原位癌患者行LEEP治疗后,定期复查,4例未发现病灶;2例再次LEEP,二次LEEP后活检未发现病灶;5例行子宫全切术中仅有1例全切后宫颈标本上仍有原位癌灶;1例因行LEEP术后病检为有小灶性浸润,全切术后病检为浸润癌深度<0.5mm;其余3例均未发现病灶。8例未生育的CIN患者行LEEP,其中4例分别于术后半年成功受孕,1例成功分娩。结论LEEP可弥补阴道镜活检的不足,提高宫颈病变的确诊率;治疗效果好,简单易行,但对原位癌的治疗仍需斟酌。     

IEEP治疗宫颈病变的临床评价

目的 评价LEPP(宫颈环形电切术)治疗宫颈病变的临床价值.方法 对经妇科检查、官颈TCT(薄层液基细胞学)检查、阴道镜检查及镜下活检诊断为不同类型宫颈病变的118例患者(包括宫颈糜烂、息肉、肥大等慢性炎症及尖锐湿疣、CIN:宫颈上皮内瘤变)采用LEEP切除宫颈病变组织并送病理检查,同时观察手术时间、术中出血量、患者反应及术后随访情况.结果 手术时间5～12min,出血量1～30ml,术后有3例病理诊断升级后入院手术,其余115例患者3个月复查,有2例持续CIN而行第2次LEEP,此后复查均未发现异常,LEEP治疗本组病例一次性成功率95.8%.结论 LEEP治疗宫颈病变具有简单易行、手术时间短、出血少、不良反应轻、并发症发生率低、治疗效果好,并且能提供完整的病理标本等优点,尤其适用于CIN的治疗,具有良好的社会效益,值得临床推广.     

外用溃疡散联合LEEP刀治疗宫颈糜烂248例临床观察

目的:探讨外用溃疡散合宫颈电热圈环切除术(LEEP刀)治疗宫颈糜烂的临床疗效。方法:选择我院检查确诊为宫颈糜烂患者248例,其中128例采用外用溃疡散合LEEP刀治疗(治疗组),120例单用LEEP刀治疗(对照组),术后取相同时间观察两组术口愈合、阴道流液、流血情况,分析比较两组的治疗效果。结果:治疗组痊愈105例,显效19例,好转3例,未愈1例,总有效率99.22%。对照组治愈40例,显效52例,好转8例,未愈20例,总有效率83.33%。两组比较差异有显著性(P<0.01)。结论:宫颈电热圈环切除术治疗宫颈糜烂效果好,手术操作简单、安全有效,治愈率高,无并发症;联合外用溃疡散可促进创面愈合,减少阴道流血流液,预防感染发生。     

Loop electrosurgical excision procedure for partial upper vaginectomy

OBJECTIVES: Partial upper vaginectomy consists of removal of the vaginal apex and is indicated for the diagnosis and treatment of vaginal intraepithelial neoplasia and recurrent cancer. We present a novel surgical approach to partial upper vaginectomy by use of the loop electrosurgical excision procedure. STUDY DESIGN: A total of 15 consecutive patients with abnormal vaginal cytologic results were treated by the loop electrosurgical excision procedure for partial upper vaginectomy. After submucosal injection of local anesthetic, the loop electrode was used to resect the upper third of the vagina. An iodoform vaginal pack was placed for 24 hours. All patients with high-grade vaginal intraepithelial neoplasia received intravaginal 5-fluorouracil cream postoperatively. RESULTS: The mean blood loss was 0 mL, and the mean surgical time was 30 minutes. A complication developed in 1 patient (7%). One case of invasive carcinoma was diagnosed. No recurrences have developed in any patients with vaginal intraepithelial neoplasia after hysterectomy. CONCLUSIONS: The loop electrosurgical excision procedure for partial upper vaginectomy can be performed quickly, with minimal blood loss, minimal complications, and minimal recurrence of neoplasia, and it provides a histologic specimen for evaluation.     

Cervical adenoid basal tumors comprised of adenoid basal epithelioma associated with various types of invasive carcinoma: clinicopathologic features, human papillomavirus DNA detection, and P16 expression

Adenoid basal tumors are uncommon cervical lesions that some pathologists consider invasive carcinomas but others consider "epitheliomas" due to their low-grade histological appearance and rarely documented malignant behavior. We report the clinicopathologic features of 10 tumors comprised of both typical low-grade adenoid basal tumors (epitheliomas) intimately associated with invasive carcinomas having infiltrative growth, increased cytological atypia and mitotic activity, and various types of differentiation, including adenoid basal/squamous, pure squamous, adenoid cystic, and small cell neuroendocrine. Tumors were evaluated for the presence of human papillomavirus (HPV) DNA and immunohistochemical p16 expression. The patients in the study group ranged in age from 45 to 81 years (mean, 65 years). Most of the patients presented with abnormal cervicovaginal smears. The initial diagnosis was made on specimens obtained by cervical biopsy, laser electrocautery excision procedure (LEEP), or cone biopsy in 8 patients. Two 2 patients were incidentally diagnosed in hysterectomy specimens. All 10 patients had squamous intraepithelial lesions (9 high-grade, 1 low-grade). In all cases diagnosed in LEEP or cone biopsy specimens, the invasive carcinoma component was present in the excisional specimen and extended to the margins. Seven patients diagnosed on excisional or biopsy specimens who underwent hysterectomy had residual tumor in the cervix, ranging from microscopic foci to deeply invasive. No lymph node metastases were identified in 4 patients who were staged. Seven patients with follow-up were alive without evidence of disease after follow-up intervals of 8 to 84 months (mean, 45 months; median, 29 months). One patient with a component of small cell carcinoma died of other causes without evidence of disease at 18 months. HPV 16 DNA was detected in both the adenoid basal epithelioma and invasive carcinoma components in 9 tumors by in situ hybridization, and HPV 33 was detected by polymerase chain reaction in 1 tumor. All tumors expressed p16 diffusely. Adenoid basal tumors are high-risk HPV-related tumors that can be comprised of both a low-grade adenoid basal tumor, which can be designated as epithelioma, and invasive carcinomas of various types. The invasive component is usually evident in the excisional biopsy specimen, allowing for recognition of a tumor that needs further management.