宫颈锥切治疗宫颈上皮内瘤变的两种术式分析

目的分析高频电波刀手术（LEEP）和宫腔镜下宫颈锥切术（TCRC）的特点,探讨两种术式治疗宫颈上皮内瘤样病变（CIN）的临床效果。方法回顾分析2007年10月至2009年12月在荔湾区人民医院因诊断为CINⅡ～Ⅲ行宫颈锥切的患者122例,其中LEEP55例,TCRC67例,对两组的锥切情况、术后情况等进行比较分析。结果手术时间LEEP组（5.27±1.27）min,短于TCRC组（16.46±4.30）min（P〈0.05）;术后大出血LEEP组多于TCRC组（P〈0.05）;术中出血量、切缘阳性率、切口愈合时间两组差异无统计学意义。此外,TCRC组术中发现子宫内膜息肉5例。结论 LEEP和TCRC均能有效治疗CINⅡ～Ⅲ;而TCRC效果更佳并能了解子宫内膜的情况。

Two surgical procedures of cervical conization for cervical intraepithelial neoplasia

Objective To analyze the characteristics of hysteroscopic surgery and conization with LEEP knife and to explore the clinical efficacy of surgical treatment of cervical intraepithelial lesions（CIN）with two kinds of surgical procedures.Methods The clinical data of 122 cases of CIN II ～ III treated with cervical conization in this hospital during October 2007 to December 2009 were retrospectively reviewed and analyzed.Among them,operation with high-frequency radio waves（LEEP）knife was performed in 55 cases,and hysteroscopic conization（TCRC）in 67 cases,and cone biopsy and post operation situation were compared between these two groups.Results The operating time in LEEP group was（5.27±1.27）min,and it was shorter than that of TCRC group（16.46±4.30 min）（P〈0.05）.Severe bleeding in LEEP group was frequently occurred in comparison with that of TCRC group（P〈0.05）.The difference in amount of blood loss,cut positive margin rate and wound healing time was not significant between these two groups.In addition,there were endometrial polyps seen in patients of TCRC group.Conclusion CIN Ⅱ - Ⅲ can be effectively treated by operation with LEEP knife or TCRC,and TCRC is much better in result and it also can understand the situation of endometrium.