發(fā)布時(shí)間：2018-09-07 16:42

【摘要】：目的探討環(huán)形電切術(shù)(loop electrosurgical excision procedure,LEEP)與冷刀宮頸錐切術(shù)(cold-knife conization,CKC)在宮頸上皮內(nèi)瘤變(cervical intraepithelial neoplasia,CIN)診治中的療效對(duì)比及其對(duì)妊娠的影響。方法回顧性分析2010年1月~2012年1月間115例CIN患者的病歷資料,其中行LEEP術(shù)的患者64例,行CKC術(shù)的患者51例,對(duì)兩組方法的術(shù)中情況、手術(shù)并發(fā)癥及術(shù)后病理結(jié)果進(jìn)行比較,并追蹤隨訪,比較行不同手術(shù)方法的兩組患者復(fù)發(fā)情況、宮頸長度、妊娠情況和妊娠結(jié)局。結(jié)果手術(shù)時(shí)間LEEP組(12.56±3.09)min,比CKC組的(23.82±3.42)min短(P0.05);術(shù)中出血LEEP組(9.78±3.77)mL,較CKC組的(26.35±9.26)mL少(P0.05);LEEP組術(shù)后并發(fā)癥發(fā)生率(7.81%)較CKC組(31.37%)低(P0.05);兩組術(shù)后病檢一致率(87.42%vs.85.65%)、切緣陽性率(1.56%vs.1.96%)、術(shù)后復(fù)發(fā)率(3.13%vs.1.96%)、術(shù)后宮頸長度變化(1.40±0.24 vs.1.44±0.24)差異無統(tǒng)計(jì)學(xué)意義(P0.05);LEEP組中妊娠率(87.50%)、流產(chǎn)率(3.12%)、胎膜早破發(fā)生率(7.81%)、早產(chǎn)率(6.25%)、新生兒低體重出生率(10.71%)與CKC組妊娠率(88.24%)、流產(chǎn)率(3.92%)、胎膜早破發(fā)生率(3.92%)、早產(chǎn)率(5.88%)、新生兒低體重出生率(11.11%)相比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論應(yīng)用LEEP施行宮頸錐切術(shù)在手術(shù)時(shí)間、術(shù)中出血及術(shù)后并發(fā)癥方面優(yōu)于CKC,而對(duì)患者的術(shù)后復(fù)發(fā)情況、生育能力及妊娠結(jié)局無明顯影響,診治CIN的臨床療效與CKC相似,應(yīng)得到臨床的重視和應(yīng)用。
[Abstract]:Objective to investigate the effect of circular electroresection (loop electrosurgical excision procedure,LEEP) and cold knife conization (cold-knife conization,CKC) in the diagnosis and treatment of cervical intraepithelial neoplasia (cervical intraepithelial neoplasia,CIN) and its effect on pregnancy. Methods the medical records of 115 patients with CIN from January 2010 to January 2012 were retrospectively analyzed, including 64 cases of LEEP and 51 cases of CKC. The operative conditions, surgical complications and postoperative pathological results were compared between the two groups. The recurrence, length of cervix, pregnancy and pregnancy outcome were compared between the two groups. Results the time of operation in LEEP group (12.56 鹵3.09) min, was shorter than that in CKC group (23.82 鹵3.42) min (P0.05), in intraoperative hemorrhage LEEP group (9.78 鹵3.77) mL, was lower than that in CKC group (26.35 鹵9.26) mL (P0.05), the incidence of postoperative complications in LEEP group (7.81%) was lower than that in CKC group (31.37%) (P0.05), the consistent rate of postoperative diagnosis (87.42 vs.85.65%), the positive rate of incision margin (1.56vs.1.96%), the postoperative recurrence rate (3.13vs.1.96%) and the postoperative recurrence rate (3.13vs.1.96%) in LEEP group were lower than those in CKC group (P0.05). There was no significant difference in cervical length (1.40 鹵0.24 vs.1.44 鹵0.24) (P0.05). The pregnancy rate (87.50%), abortion rate (3.12%), premature rupture of membranes (7.81%), premature delivery rate (6.25%), low birth rate (10.71%) and pregnancy rate (88.24%), abortion rate (3.92%), premature rupture of membranes (3.92%), pregnancy rate (88.24%), abortion rate (3.92%), premature rupture of membranes (3.92%), premature birth rate (6.25%), low birth rate (10.71%), abortion rate (88.24%), premature rupture of membranes (3.92%), premature delivery rate (3.92%) The rate (5.88%), compared with the low birth rate of newborns (11.11%), The difference was not statistically significant (P0.05). Conclusion LEEP is superior to CKC, in terms of operation time, intraoperative bleeding and postoperative complications, but has no significant effect on recurrence, fertility and pregnancy outcome. The clinical efficacy of CIN is similar to that of CKC. Should get clinical attention and application.
【作者單位】： 西安交通大學(xué)醫(yī)學(xué)部第二附屬醫(yī)院婦產(chǎn)科;
【分類號(hào)】：R737.33

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本文編號(hào)：2228825