高级别宫颈上皮内瘤变的临床诊治分析
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摘要
目的对宫颈环形电切术(LEEP)应用于高级别宫颈上皮内瘤变诊断及治疗过程中的临床意义进行研究与分析。方法回顾性分析43例高级别宫颈上皮内瘤变患者的临床资料,观察全部患者接受宫颈环形电切术前后的疾病病理分级转化情况、并发症发生情况及复发情况。结果手术前病理诊断结果为CINⅡ的12例患者中有83.33%(10/12)于手术后仍为CINⅡ,8.33%(1/12)手术后升级为CINⅢ,8.33%(1/12)手术后升级为宫颈癌;手术前病理诊断结果为CINⅢ的31例患者中有83.87%(26/31)于手术后仍为CINⅢ,9.68%(3/31)手术后降级为CINⅡ,6.45(2/31)手术后升级为宫颈癌;全部患者中仅2.33%(1/43)患者出现阴道流血增多的术后并发症;93.02%(40/43)患者疾病治愈,6.98%(3/40)患者存在手术残留,2.33%(1/43)患者于手术后1年疾病复发。结论宫颈环形电切术对高级别宫颈上皮内瘤变具有显著治疗效果,具有一定安全性,患者疾病复发率较低。
Objective To study and analyze the clinical significance of cervical ring electrotomy(LEEP) in the diagnosis and treatment of high-grade cervical intraepithelial neoplasia. Methods The clinical data of 43 patients with high-grade cervical intraepithelial neoplasia were retrospectively analyzed. All patients underwent pathological grade conversion, complications and recurrence before and after cervical ring electrosurgery. Results 83.33%(10/12) of the 12 patients with CINII before surgery were still CINII after surgery, 8.33%(1/12) were upgraded to CINIII after surgery, and 8.33%(1/12) after surgery upgrade to cervical cancer. Of the 31 patients with CINIII before surgery, 83.87%(26/31) were still CINIII after surgery, 9.68%(3/31) were postgraded to CINII after surgery, and 6.45(2/31) were upgraded to cervical cancer; only 2.33%(1/43) of all patients had postoperative complications of vaginal bleeding; 93.02%(40/43) patients were cured, and 6.98%(3/40) patients had surgical residuals, 2.33%(1/43) patients relapsed 1 year after surgery. Conclusion Cervical ring electrotomy has a significant therapeutic effect on high-grade cervical intraepithelial neoplasia, and it has certain safety. The patient's disease recurrence rate is low.
Objective To study and analyze the clinical significance of cervical ring electrotomy(LEEP) in the diagnosis and treatment of high-grade cervical intraepithelial neoplasia. Methods The clinical data of 43 patients with high-grade cervical intraepithelial neoplasia were retrospectively analyzed. All patients underwent pathological grade conversion, complications and recurrence before and after cervical ring electrosurgery. Results 83.33%(10/12) of the 12 patients with CINII before surgery were still CINII after surgery, 8.33%(1/12) were upgraded to CINIII after surgery, and 8.33%(1/12) after surgery upgrade to cervical cancer. Of the 31 patients with CINIII before surgery, 83.87%(26/31) were still CINIII after surgery, 9.68%(3/31) were postgraded to CINII after surgery, and 6.45(2/31) were upgraded to cervical cancer; only 2.33%(1/43) of all patients had postoperative complications of vaginal bleeding; 93.02%(40/43) patients were cured, and 6.98%(3/40) patients had surgical residuals, 2.33%(1/43) patients relapsed 1 year after surgery. Conclusion Cervical ring electrotomy has a significant therapeutic effect on high-grade cervical intraepithelial neoplasia, and it has certain safety. The patient's disease recurrence rate is low.
引文
[1]刘兆董,孙蓬明,高金华,等.子宫颈环形电切术诊治子宫颈上皮内瘤变132例[J].福建医药杂志,2017,20(4):430-434.
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[5]徐惠琴.248例宫颈上皮内瘤变患者宫颈环形电切术后复发的相关危险因素分析[J].中国计划生育和妇产科,2016,17(11):47-51.
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[7]葛娟,周东华,平静,等.4例宫颈腺癌伴宫颈上皮内瘤变的临床病理分析[J].医学信息,2015,20(45):35-35,36.
[8]谢安龙,何春妮.宫颈高级别上皮内瘤变LEEP术后全子宫切除的病例分析[J].中国医药指南,2015,26(5):112-113.
[9]赵敏,谢珍珠.宫颈环形电切术治疗宫颈上皮内瘤变3年随访结果分析[J].临床合理用药杂志,2014,22(17):26-26,30.
[2]刘江丽,周毅惠,周伟,等.不同手术方式治疗宫颈高级别上皮内瘤变LEEP术后切缘阳性病例分析[J].长治医学院学报,2017,14(4):287-290.
[3]柳晓肃,武燕,赵瑞霞.高级别宫颈上皮内瘤变194例临床病理分析[J].中国药物与临床,2014,20(10):1419-1421.
[4]张金荣,赵远.宫颈环形电切术与宫颈冷刀锥切术治疗高级别上皮内瘤变的临床效果及妊娠结局对比分析[J].中国计划生育学杂志,2016,31(7):472-475.
[5]徐惠琴.248例宫颈上皮内瘤变患者宫颈环形电切术后复发的相关危险因素分析[J].中国计划生育和妇产科,2016,17(11):47-51.
[6]张楠,何莲芝.宫颈环形电切术治疗高级别宫颈上皮内瘤变的远期疗效分析[J].中国临床药理学与治疗学,2014,13(12):1411-1415.
[7]葛娟,周东华,平静,等.4例宫颈腺癌伴宫颈上皮内瘤变的临床病理分析[J].医学信息,2015,20(45):35-35,36.
[8]谢安龙,何春妮.宫颈高级别上皮内瘤变LEEP术后全子宫切除的病例分析[J].中国医药指南,2015,26(5):112-113.
[9]赵敏,谢珍珠.宫颈环形电切术治疗宫颈上皮内瘤变3年随访结果分析[J].临床合理用药杂志,2014,22(17):26-26,30.