宫腔镜下宫颈锥切术治疗宫颈上皮内瘤变Ⅲ级术后及远期疗效观察

目的探讨宫腔镜下宫颈锥切术(TCRC)治疗宫颈上皮内瘤变Ⅲ级的可行性及临床疗效。方法在宫腔镜下对CIN(Ⅲ级)患者74例行宫颈锥切术(TCRC组),65例行冷刀宫颈锥切术(CKC组)。比较两组手术时间、出血量、病理一致率、复发率、宫颈粘连率、以及妊娠率等。结果 TCRC组平均手术时间为(15.1±3.2)min,术中平均出血量为(12.5±1.8)ml,治愈率为94.6%,复发率为5.4%;CKC组平均手术时间为(25.8±3.8)min,术中平均出血量为(21.6±2.4)ml,治愈率为81.5%,复发率为18.5%。两组手术时间、出血量、治愈率、复发率,差异有统计学意义(P<0.05)。结论与冷刀宫颈锥切术比较,宫腔镜下宫颈锥形切除术出血量少,耗时短,定位准确,并发症少,治愈率高、复发率低,对妊娠无不良影响。

Effect of cervical conization through hysteroscopy for cervical intraepithelial neoplasia III

Objective To evaluate the therapeutic effect of cervical conization through hysteroscopy in the treatment of cervical intraepithelial neoplasia(CIN) Ⅲ.Methods Seventy-four patients with CIN Ⅲ underwent cervical conization through hysteroscopy(TCRC group),and 65 received cold knife conization(CKC group).The operating time,volume of blood loss,concordance rate with pathology,recurernce rate,rate of cervix adhesion and pregnancy rate were compared between the two groups.Results The operating time,mean blood loss,cure rate,and recurrence rate were 15.1±3.2 min,12.5±1.8 ml,94.6%,and 5.4% in TCRC group,respectively,as compared with those of 25.8±3.8 min,21.6±2.4 ml,81.5%,and 18.5% in CKC group,all showing significant differences between the two groups(P<0.05).Conclusion Compared with CKC,TCRC has such advantages as less blood loss,shorter operating time,more accurate lesion localization,fewer complications,higher cure rate,and lower recurrence rate without significant adverse effect on pregnancy.