何金慧,汪英
HE Jinhui,WANG Ying

• 1:资阳市第二中医院妇产科
• 2:四川省人民医院肿瘤科

摘要(Abstract)：

目的:探讨宫颈环形电切术(LEEP)应用于宫颈癌前病变(CIN)的临床效果。方法:CIN患者221例,采用LEEP手术进行治疗,比较术前CIN级别与术后病理诊断符合率,评价术前、术后1年和3年高危型人类乳头瘤病毒(HR-HPV)感染率,术后并发症。结果:221例CIN患者术前检查和术后病例确诊CINⅠ级的符合率达83.4%,CINⅡ级和CINⅢ级的符合率达90.4%;病理结果示一次性切除病变组织189例(85.5%),补切周边手术32例(14.5%);1年和3年随访时HR-HPV感染率较手术前明显降低;3年HR-HPV感染者最低,差异有统计学意义(P<0.05);7例出现并发症,发生率为3%;术后1年随访时未复发110例(49.8%),随访3年未复发51例(23.1%)。结论:LEEP手术是治疗CIN安全有效的方法。
Objective: To investigate the clinical effect of loop electrosurgical excision procedure( LEEP) on cervical intraepithelial neoplasia( CIN). Methods: A total of 221 patients of CIN were treated by LEEP,the coincidence rate of CIN grades before treatment with pathological diagnosis after treatment was analyzed,and evaluating postoperative complications and infection rate of HR-HPV of patients pre-treatment,1 year after treatment and 3 years after treatment. Results: Coincidence rate of CIN I of pre-treatment test and after-treatment confirmed diagnosis were 83. 4%; coincidence rate of CIN II and CIN III were 90. 4%; pathological results showed that 189 patients with one-time removal of pathological tissue( 85. 5%),32 with peripheral operation( 14. 5%). After treatment visit in 1 year and 3 years showed that HR-HPV infection rate were obvious lower than pre-treatment stage; patients after 3 years of treatment showed the lowest HR-HPV infection rate,differences were statistical significant( P < 0. 05); 7 patients showed complications( 3%); 110 patients showed no complications after1 year of treatment( 49. 8%); 51 patients showed no complications after 3 year of treatment( 23. 1%). Conclusion: LEEP is an effective and safe therapy for CIN treatment.

关键词(KeyWords)： 宫颈环形电切术;宫颈肿瘤;癌前病变;乳头状瘤病毒,人;手术后并发症
loop electrosurgical excision procedure;cervical neoplasms;cervical intraepithelial neoplasia;papillomavirus,human;postoperative complications

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 何金慧,汪英
HE Jinhui,WANG Ying

DOI: 10.19367/j.cnki.1000-2707.2015.04.026

参考文献(References)：

• [1]丛琪,陆明霞.LEEP治疗宫颈癌前病变的疗效观察[J].临床医学,2013(8):1688-1689.
• [2]齐岩.LEEP刀治疗宫颈癌前病变120例临床疗效分析[J].当代医学,2012(19):76.
• [3]徐水芳,王桂芳,顾明华.LEEP术后病理检查与阴道镜宫颈活检对宫颈癌前病变的诊断准确性[J].实用癌症杂志,2013(3):269-271.
• [4]祝淑平.干扰素联合LEEP刀治疗宫颈糜烂的临床效果分析[J].中国当代医药,2014(11):29-30.
• [5]金云霞.子宫颈电环切除术在宫颈上皮内瘤变的应用分析[J].中外医学研究,2012(8):3-4.
• [6]刘鹤鸣,李昱珑.子宫颈电环切除术治疗宫颈上皮内瘤90例疗效分析[J].当代医学,2010(32):64-65.
• [7]李芹,马汝婵.LEEP在宫颈癌前病变诊治中的应用[J].河北医学,2010(1):58-60.
• [8]赵俊杰,韩淑霞.LEEP治疗宫颈癌前病变的疗效观察[J].宁夏医学杂志,2011(7):650-651.

文章评论(Comment)：