LEEP和CKC两种手术方式治疗宫颈原位腺癌的效果分析

目的比较宫颈环形电切术(LEEP)与宫颈冷刀锥切术(CKC)治疗宫颈原位腺癌的临床疗效。方法选取2013年6月至2017年6月在海南西部中心医院治疗的宫颈原位腺癌患者75例,平均年龄(358±65)岁,其中45例采用LEEP治疗(LEEP组),30例采用CKC治疗(CKC组)。观察术中及术后随访情况,比较两组的术中出血量、手术费用、切缘阳性率、残留病灶率及复发率。结果LEEP组的术中出血量低于CKC组［(156±23)ml vs. (461±227)ml］,手术费用也低于CKC组［(08±05)万元 vs.(15±09)万元］,差异有统计学意义(P<0001)。LEEP组的切缘阳性率(178％ vs. 433％)、手术残留病灶率(22％ vs. 167％)和复发率(67％ vs. 233％)均低于CKC组,差异有统计学意义(P<005)。结论LEEP治疗宫颈原位腺癌具有出血量少、切缘阳性率、残留病灶率和复发率低、手术费用少等优点,值得临床推广应用。

Analysis of LEEP and CKC in the treatment of cervical adenocarcinoma in situ

Objective　To compare the efficacy of cervical loop electrosurgical excision procedure(LEEP) and cervical cold knife conization(CKC) in the treatment of cervical adenocarcinoma in situ. Methods　Retrospective analysis was made of 75 cases of cervical adenocarcinoma in situ treated with LEEP or CKC in our hospital from June 2013 to June 2017. The average age was (35.8±6.5) years. 45 cases were treated with LEEP and 30 cases were treated with CKC. The blood volume, positive rate of incision margin, residual lesion rate, recurrence rate and operation cost were compared between the two groups. Results The average intraoperative bleeding volume of LEEP and CKC were (15.6±2.3)ml and (46.1±22.7)ml respectively; the average operating expenses were (0.8±0.5) million yuan and (15±0.9) million yuan respectively(P<0.001); the positive rate of incision margin of LEEP patients was (28.9% vs. 26.7%); the residual lesion rate of LEEP patients (2.2% vs. 16.7%) and the recurrence rate (6.7% vs. 23.3%) were lower than CKC patients. The difference was statistically significant (P<0.05). Conclusion　LEEP treatment of cervical adenocarcinoma in situ has the advantages of less bleeding, positive rate of incision margin, low rate of residual lesions and recurrence, and less operation cost, which is worthy of clinical application.