宫颈锥切术治疗宫颈鳞状上皮内瘤变的临床分析

摘要：目的 通过对宫颈鳞状上皮内瘤变Ⅲ级（CINⅢ）临床病例分析，探讨合理的治疗方法。方法 回顾性分析2005年1月至2006年12月天津市中心妇产科医院收治的110例CINⅢ。结果110例中行宫颈锥切术87例； 全子宫切除术8例； 筋膜外全子宫切除术15例； 宫颈锥切术后二次开腹手术18例（筋膜外全子宫切除术4例；改良根治性全子宫切除术+盆腔淋巴结切除10例；根治性全子宫切除术+盆腔淋巴结切除4例）；辅助治疗1例术前诊断宫颈原位癌同时合并子宫肌瘤行筋膜外全子宫切除术，术后病理分期Ⅰa2补充放疗。结论 三阶梯检查是标准的诊断流程；宫颈锥切术是CINⅢ首选的手术方式；出血和宫颈管狭窄是术后常见并发症；Ia1锥切术后切缘阴性和 ECC阴性可严密随诊。

Clinical analyse of 110 cases of cervical intraepithelial neoplasia

Abstract:Objectives To approach reasonable treatment mehods by analyzing clinical cases of cervical intraepithelial neoplasia Ⅲ(CINⅢ).Methods 110 cases of CINⅢ enrolled in Tianjin Central Hospital of Obstetrics and Gynecology from Jan 2005 to Dec 2006 were analyzed .Results Of the 110 patients,87 cases underwent conization,8 hysterectomy;15 extralfascial hysterectomy.18 patients accepted secondary abdominal surgey(4 extrafascial hysterectomy;10 secondary extensive hysterectomy and lymphadenectomy; 4extensive hysterectomy and lymphadenectomy).Ex -trafascial hysterectomy was adminietrated on one patients with carcinoma in situ of cervix(CIS) and uterine myoma.The patho-staging was Ⅰa2,and radiotherapy was added.Conclusions Three-step examination is the standard procedure.Conization is the first sletion of CINⅢ.Bleeding and cervical canal stenosis are the common complications.Patients of stage Ia1 with negative edge after conization and endocervical curettage should be fllowed closely.