LEEP治疗宫颈上皮内瘤变256例疗效及其术后复发的影响因素分析

目的探讨LEEP治疗宫颈上皮内瘤变（CIN）的临床效果及其治疗转归的影响因素。方法回顾性分析256例经LEEP治疗的CIN患者的临床资料,分析影响其临床疗效及术后复发的相关因素。结果本组患者的治愈率为90.6%（232/256）,复发率为9.4%（24/256）;治愈组与复发组在年龄、术前HPV感染、术前CIN病理分级、手术切缘情况、病变范围、病变是否累及腺体等方面比较差异均有统计学意义（P〈0.01或P〈0.05）。结论 LEEP在CIN患者中具有确切的疗效,但对于年龄较大、术前HPV阳性、术前CIN分级较高、手术切缘阳性、病变范围较广、累及腺体的患者,术前应进行全面评估,制定切实可行的手术方案,以期彻底治愈。

Clinical effects of LEEP in the treatment of patients with CIN and the influence factors of relapse.

Objective To discuss the clinical effects of LEEP in the treatment of patients with CIN, and to analyze the influence factors of relapse. Methods Two hundred and fifty-six patients with CIN were treated with LEEP. The clinical effects were analyzed. Then the patients were divided into the cured group and recurrent group ac- cording to the treatment outcome, and the influence factors of relapse were analyzed. Results Among the 256 patients, 232 were successfully cured, with the cure rate of 90.6% （232/256） and the recurrence rate of 9.4% （24/256）. There was statistically significant difference in age, preoperative HPV infection, preoperative CIN pathological results, surgical margin status, lesion involving glands or not, and extent of disease （P〈0.01 or P〈0.05）. Conclusion LEEP has signifi- cant effects in patients with CIN. We should perform comprehensive assessment for the patients with older age, HPV-positive preoperative, preoperative high grade CIN, positive surgical margins, wide diseases range, lesions in- volving glands, to develop a viable surgical solution for complete cure.