阴道镜检查联合宫颈环形电切除术对宫颈上皮肉瘤变诊断与疗效分析
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摘要
目的观察阴道镜检查联合宫颈环形电切除术诊断与治疗宫颈上皮肉瘤变的临床效果。方法选取2016年12月～2017年12月我中心CIN患者116例以治疗方法差异分为观察组与对照组,各58例。对照组以宫颈环形电切除术治疗,观察组以阴道镜检查联合宫颈环形电切除术治疗。比较两组手术时间、术中出血量及两组临床疗效。结果观察组手术时间、术中出血量优于对照组,差异有统计学意义(P <0.05)。观察组总有效率为98.28%,优于对照组的79.31%,差异有统计学意义(P <0.05)。结论阴道镜检查联合宫颈环形电切除术诊断与治疗宫颈上皮肉瘤变临床疗效较好,可有效提高诊断率及切缘阴性率,同时缩短手术时间、减少术中出血量,值得临床推广。
Objective To observe the clinical effect of colposcopy combined with loop electrosurgical excision procedure in the diagnosis and treatment of cervical epithelial sarcoma(CIN). Methods From December 2016 to December 2017,116 patients with CIN in the Maternal and Child Health Family Planning Service Center of Shaoguan City were divided into observation group and control group,58 cases each.The control group was treated with loop electrosurgical excision procedure,and the observation group was treated with colposcopy combined with loop electrosurgical excision procedure.The operation time,intraoperative blood loss and clinical efficacy of the two groups were compared. Results The operation time and intraoperative blood loss of the observation group were better than the control group,the difference was statistically significant(P < 0.05).The total effective rate of the observation group was 98.28%,which was better than that of the control group 79.31%,the difference was statistically significant(P < 0.05). Conclusion Colposcopy combined with loop electrosurgical excision procedure for the diagnosis and treatment of cervical epithelial sarcoma has a good clinical effect,can effectively improve the diagnosis rate and negative margin,while shortening the operation time,reducing the amount of intraoperative blood loss,it is worth promoting.
Objective To observe the clinical effect of colposcopy combined with loop electrosurgical excision procedure in the diagnosis and treatment of cervical epithelial sarcoma(CIN). Methods From December 2016 to December 2017,116 patients with CIN in the Maternal and Child Health Family Planning Service Center of Shaoguan City were divided into observation group and control group,58 cases each.The control group was treated with loop electrosurgical excision procedure,and the observation group was treated with colposcopy combined with loop electrosurgical excision procedure.The operation time,intraoperative blood loss and clinical efficacy of the two groups were compared. Results The operation time and intraoperative blood loss of the observation group were better than the control group,the difference was statistically significant(P < 0.05).The total effective rate of the observation group was 98.28%,which was better than that of the control group 79.31%,the difference was statistically significant(P < 0.05). Conclusion Colposcopy combined with loop electrosurgical excision procedure for the diagnosis and treatment of cervical epithelial sarcoma has a good clinical effect,can effectively improve the diagnosis rate and negative margin,while shortening the operation time,reducing the amount of intraoperative blood loss,it is worth promoting.
引文
[1]Merlos-Gutiérrez AL,Vargas-Espinosa JM,GonzálezGonzález G,et al.Recurrence of cervical intraepithelial neoplasia pre-conization with diathermic handle[J].Ginecol Obstet Mex,2016,84(2):95-104.
[2]Herfs M,Somja J,Howitt BE,et al.Unique recurrence patterns of cervical intraepithelial neoplasia after excision of the squamocolumnar junction[J].Int J Cancer,2015,136(5):1043-1052.
[3]Santesso N,Mustafa RA,Schünemann HJ,et al.World Health Organization Guidelines for treatment of cervical intraepithelial neoplasia 2-3 and screen-and-treat strategies to prevent cervical cancer[J].Int J Gynaecol Obstet,2016,132(3):252-258.
[4]Koeneman MM,Kruse AJ,Kooreman LFS,et al.TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia(TOPIC trial):study protocol for a randomized controlled trial[J].BMC Cancer,2016,16(1):132.
[5]孙丽州.妊娠期行宫颈环形电切除术的安全性及对妊娠结局的影响[J].中国实用妇科与产科杂志,2013,26(4):252-254.
[6]Frederiksen ME,Njor S,Lynge E,et al.Psychological effects of diagnosis and treatment of cervical intraepithelial neoplasia:a systematic review[J].Sex Transm Infect,2015,91(4):248-256.
[7]Dolman L,Sauvaget C,Muwonge R,et al.Meta-analysis of the efficacy of cold coagulation as a treatment method for cervical intraepithelial neoplasia:a systematic review[J].BJOG,2014,121(8):929-942.
[8]Jiang YM,Chen CX,Li L.Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia[J].Onco Targets Ther,2016,9(Issue 1):3907-3915.
[9]Spinillo A,Gardella B,Iacobone AD,et al.Outcome of Persistent Low-Grade Cervical Intraepithelial Neoplasia Treated With Loop Electrosurgical Excision Procedure[J].J Low Genit Tract Dis,2016,20(4):307-311.
[10]樊庆泊.子宫颈环行电切除操作在宫颈上皮内瘤变诊治方面的应用[J].现代妇产科进展,2014,43(11):472.
[11]黄俊.宫颈环形电切除术治疗宫颈癌前病变的疗效分析[J].当代医学,2015,21(16):72-73.
[12]Rozemeijer K,van Kemenade FJ,Penning C,et al.Exploring the trend of increased cervical intraepithelial neoplasia detection rates in the Netherlands[J].J Med Screen,2015,22(3):144-150.
[13]Greene SA,McGrath CJ,Lehman DA,et al.Treatment of human immunodeficiency virus(HIV)-infected women to prevent cervical cancer may stimulate HIV RNA cervical shedding and risk HIV transmission[J].Clin Infect Dis,2018,66(11):1778-1784.
[14]曹庆华.宫颈环形电切术对宫颈上皮瘤变和早期宫颈癌的诊断价值[J].安徽医药,2016,20(3):537-528.
[15]陈小琴,刘汉萍,郑芙,等.阴道镜检查结合LEEP刀治疗宫颈病变疗效研究[J].中国妇幼保健,2013,22(26):5221-5222.
[2]Herfs M,Somja J,Howitt BE,et al.Unique recurrence patterns of cervical intraepithelial neoplasia after excision of the squamocolumnar junction[J].Int J Cancer,2015,136(5):1043-1052.
[3]Santesso N,Mustafa RA,Schünemann HJ,et al.World Health Organization Guidelines for treatment of cervical intraepithelial neoplasia 2-3 and screen-and-treat strategies to prevent cervical cancer[J].Int J Gynaecol Obstet,2016,132(3):252-258.
[4]Koeneman MM,Kruse AJ,Kooreman LFS,et al.TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia(TOPIC trial):study protocol for a randomized controlled trial[J].BMC Cancer,2016,16(1):132.
[5]孙丽州.妊娠期行宫颈环形电切除术的安全性及对妊娠结局的影响[J].中国实用妇科与产科杂志,2013,26(4):252-254.
[6]Frederiksen ME,Njor S,Lynge E,et al.Psychological effects of diagnosis and treatment of cervical intraepithelial neoplasia:a systematic review[J].Sex Transm Infect,2015,91(4):248-256.
[7]Dolman L,Sauvaget C,Muwonge R,et al.Meta-analysis of the efficacy of cold coagulation as a treatment method for cervical intraepithelial neoplasia:a systematic review[J].BJOG,2014,121(8):929-942.
[8]Jiang YM,Chen CX,Li L.Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia[J].Onco Targets Ther,2016,9(Issue 1):3907-3915.
[9]Spinillo A,Gardella B,Iacobone AD,et al.Outcome of Persistent Low-Grade Cervical Intraepithelial Neoplasia Treated With Loop Electrosurgical Excision Procedure[J].J Low Genit Tract Dis,2016,20(4):307-311.
[10]樊庆泊.子宫颈环行电切除操作在宫颈上皮内瘤变诊治方面的应用[J].现代妇产科进展,2014,43(11):472.
[11]黄俊.宫颈环形电切除术治疗宫颈癌前病变的疗效分析[J].当代医学,2015,21(16):72-73.
[12]Rozemeijer K,van Kemenade FJ,Penning C,et al.Exploring the trend of increased cervical intraepithelial neoplasia detection rates in the Netherlands[J].J Med Screen,2015,22(3):144-150.
[13]Greene SA,McGrath CJ,Lehman DA,et al.Treatment of human immunodeficiency virus(HIV)-infected women to prevent cervical cancer may stimulate HIV RNA cervical shedding and risk HIV transmission[J].Clin Infect Dis,2018,66(11):1778-1784.
[14]曹庆华.宫颈环形电切术对宫颈上皮瘤变和早期宫颈癌的诊断价值[J].安徽医药,2016,20(3):537-528.
[15]陈小琴,刘汉萍,郑芙,等.阴道镜检查结合LEEP刀治疗宫颈病变疗效研究[J].中国妇幼保健,2013,22(26):5221-5222.