子宫颈电圈切除术诊断和治疗子宫颈上皮内瘤变的临床价值

目的探讨高频电波刀行子宫颈电圈切除术（LEEP）诊治子宫颈上皮内瘤变（CIN）的临床应用价值。方法对经子宫颈脱落细胞学检查、阴道镜下子宫颈多点活检病理初步诊断为CIN的患者52例，采用LEEP治疗，对LEEP术后患者随访同时观察手术时间、出血量及术后疗效。结果LEEP对患者治愈率达98．07％（51／52），对于CINⅠ、Ⅱ级患者治愈率达100％，术后定期随诊，术后1年无CIN复发。平均手术时间7．8min，出血量10ml，无继发性出血和感染的发生，手术标本经病理学检查明确诊断。结论LEEP治疗CIN手术操作简单、时间短、出血少、术后阴道排液少，安全有效，成功率高，且可提供完整的病理标本，是CIN非常理想的诊断与治疗方法，可有效阻断癌前病变发展为浸润癌。

Clinical value of LEEP for the diagnosis and treatment of cervical intraepithelial neoplasia

Objective To investigate the clinical values of loop electrosurgical excision procedure (LEEP) in diagnosis and treatment of cervical intraepithelial neoplasia(CIN). Methods Fifty-two patients with cervical intraepithelial neoplasia underwent LEEP following cytology, colposcopy and multiple biopsies, were treated by LEEP. The cure rate, the operative time, bleeding volume and patients reaction of LEEP to the cervical intraepithelial neoplasia were investigated during the follow-up. Results The effective rate was 98.07 % in the patients treated by LEEP. The effective rate was 100 % in the patients in grade CIN Ⅰ or CIN Ⅱ by LEEP. No patients in grade CIN Ⅰ and Ⅱ had recurrence during the follow-up 1 year. The mean operative time was 7.8 minutes. The mean bleeding volume was 10 ml. No secondary bleeding and post-operative infection occurred. All these surgical specimens were checked successfully for pathology diagnosis. Conclusion The advantages to use the LEEP to manage cervical intraepithelial neoplasia include its simpleness to handle, short operative time,less bleeding, less vaginal discharge, safety, and high cure rate. LEEP can offer intact sample for pathological diagnosis. LEEP electrotome is a very ideal therapy for the cervical intraepithelial neoplasia, and can block the development of precancerosis to infiltrating carcinoma effectively.