宫颈上皮内瘤变锥切术切缘阳性患者临床特征分析

目的:探讨高频电波刀治疗宫颈上皮内瘤变(CIN)术后切缘阳性的患者转归。方法:回顾分析2004年1月～2006年1月经阴道镜辅助高频电波刀(LEEP)治疗CIN,术后切缘有累及的34例患者的临床资料,其中CINⅠ5例,CIN～Ⅱ22例,CINⅡ～Ⅲ7例,治疗方法分别采用LEEP锥切术(29例)、活检术(5例),对术后病变的持续存在、治疗和复发等情况进行分析。结果:34例中宫颈中度糜烂13例(38.23%),重度糜烂19例(55.88%)。术后复切13例(CINⅠ～Ⅱ16例,CINⅡ～Ⅲ7例),21例复切后病理为炎性组织,1例为CINⅠ,1例为原位癌。术后随访无一例病变复发。结论:高频电波刀治疗CIN安全、有效,切缘阳性可能与宫颈的病变范围有关,术后的定期随访十分重要。

Clinical Analysis of the Positive Margin of Conization with Cervical Intraepithelial Neoplasia

Objective:To evaluate the prognosis and follow-up of the positive margin after the treatment of cervical intraepithe- lial neoplasia(CIN)by high frequency rediosurgical knife(HFRK).Methods:A retrospective analysis of .34 cases with CIN un- dergoing conization by HFRK between Jan 1 2004 and Jan 1 2006.All cases were treated by HFRK under colposcopic guidance for loop electrosurgical excision procedure(I.EEP)conizalion(29 cases).I.EEP hiopsy(5 cases).The residual of cervical lesion and management and recurrence after operation were evaluated.Results:Moderate cervical erosion was 1.3 cases(38.23%)of all cases.and severe cervical erosion was 19 cases(55.88%).2.3 cases was retreatmented by LEEP The pathological diagnosis of 21 cases is inflammatory tissue and and I cases was CIN I and 1 cases was cervical carcinoma was situ.The recurrence CIN oc- curred in none patients followed after operation.Conclusion:I.EEP is a kind of safe and effeclive method for the treatment of CIN.The positive margin of conization may be related with the observed lesion of the cervix.It is very important in the period of fol- low-up.