慢性宫颈炎宫颈电圈切除术治疗模式的临床研究

目的:探讨电圈切除术(loop electrosurgical excision procedure,LEEP)治疗慢性宫颈炎的疗效及病理意义。方法:选择单纯型宫颈炎、颗粒型宫颈炎、乳突型宫颈炎各100例患者分别行浅环切除术、深环切除术或锥切术,并送病理检查。另外50例单纯型宫颈炎术前再联合检测高危型人乳头瘤病毒,HPV检测阴性则行消融术,术前阴道镜下再行4点活检送病理检查。结果:慢性宫颈炎的病例中有近20%为宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN),且有12.0%为重度CIN。结论:不同形态宫颈炎行不同模式LEEP治疗,一方面达到了良好的治疗效果,另一方面可保留标本送病理检查,避免了重度C IN的漏诊。单纯型宫颈炎行消融术达到很好疗效,但因无病理标本,术前宜联合宫颈液基细胞学检测及高危型人乳头瘤病毒检测。

Clinical research of loop electrosurgical excision procedure in treatment of chronic cervicits

Objective:To explore the clinical efficacy and pathological significance of loop electrosurgical excision procedure in treatment of chronic cervicits.Methods:100 cases with simple cervicitis,100 cases with particle type cervicitis and 100 cases with papillary cervicitis received superficial,deep and subuliform LEEP,respectively,then pathological examination was performed;for 50 cases with simple cervicitis,high risk human papillomavirus(HPV) examination before operation was conducted,and for the cases with negative HPV,catheter ablation was carried out;preoperative four points biopsy under colposcope were obtained for pathological examination.Results:20% of the cases with chronic cervicitis were cervical intraepithelial neoplasia(CIN),and 12% of them were severe CIN.Conclusion:The cases with cervicitis of different forms need LEEP treatment of different modes,which can achieve a good therapeutic effect on the one hand,keep specimens for pathological examination to avoid missed diagnosis of severe CIN on the other hand;the clinical efficacy of catheter ablation is good in treatment of simple cervicitis,preoperative thinprep cytological test(TCT) and high risk HPV examination should be conducted because there was no pathological specimens.