高频电波刀宫颈电环切除术治疗中重度宫颈柱状上皮异位临床疗效研究
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摘要
目的:探讨高频电波刀宫颈电环切除术(LEEP)治疗中重度宫颈柱状上皮异位的临床疗效。方法:选取经病理检查确诊的中重度宫颈柱状上皮异位患者140例为研究对象。根据数字表法随机将其分为对照组和观察组各70例。对照组患者采用微波治疗方法,观察组的患者采用LEEP刀治疗方法。比较两组患者的手术时间、术中出血量、术后排液时间以及手术切口愈合时间,术后疗效以及血流变指标。结果:与对照组相比,观察组的手术时间较短,术后复发率低,术后排液时间更短,手术切口愈合时间更短(P<0.05);观察组的总有效率显著高于对照组的总有效率(P<0.05);两组患者的全血高切黏度、全血低切黏度以及血浆黏度在治疗前差异均无统计学意义(P>0.05),分别在治疗后5d、治疗后10d,观察组的全血高切黏度、全血低切黏度以及血浆黏度均显著低于对照组(P<0.05)。结论:高频电波刀宫颈电环切除术治疗中重度宫颈柱状上皮异位相比较微波治疗,提高了手术治疗效率,安全且有效,损伤小等优点,还可以改善患者的宫颈微循环状态,值得在治疗宫颈柱状上皮异位中推广应用。
Objective:To investigate the clinical effect of LEEP on moderate and severe Cervical columnar epithelium ectopic.Methods:140 cases of moderate and severe Cervical columnar epithelium ectopic were selected.According to the numerical table method,it was randomly divided into 70 cases of control group and observation group.Microwave therapy was used for control group and Leep knife was used for observation group.The time in operation,the amount of bleeding,the time of drainage,the time of wound healing,the curative effect and the index of blood flow were compared between the two groups.Results:Compared with the control group,the time of operation was shorter,post operative recurrence rate,the drainage time was shorter,and the healing time in incision was shorter(P<0.05);The total efficiency of the observation group was significantly higher than that of the control group(P<0.05);There was no significant difference in total blood high viscosity,total blood low viscosity and plasma viscosity before treatment between the two groups(P>0.05),After treatment 5 dand after treatment 10 d,the total blood high viscosity,total blood low viscosity,and plasma viscosity were all significantly lower in the observation group than in the control group(P<0.05).Conclusion:The high frequency electric wave knife cervix electrocyclectomy treatment medium and severe Cervical columnar epithelium ectopic compared to microwave treatment,improved the efficiency of surgical treatment,safe and effective,small injury and other advantages,but also can improve the cervical microcirculation of patients,worthy of treatment Cervical columnar epithelium ectopic in the application.
Objective:To investigate the clinical effect of LEEP on moderate and severe Cervical columnar epithelium ectopic.Methods:140 cases of moderate and severe Cervical columnar epithelium ectopic were selected.According to the numerical table method,it was randomly divided into 70 cases of control group and observation group.Microwave therapy was used for control group and Leep knife was used for observation group.The time in operation,the amount of bleeding,the time of drainage,the time of wound healing,the curative effect and the index of blood flow were compared between the two groups.Results:Compared with the control group,the time of operation was shorter,post operative recurrence rate,the drainage time was shorter,and the healing time in incision was shorter(P<0.05);The total efficiency of the observation group was significantly higher than that of the control group(P<0.05);There was no significant difference in total blood high viscosity,total blood low viscosity and plasma viscosity before treatment between the two groups(P>0.05),After treatment 5 dand after treatment 10 d,the total blood high viscosity,total blood low viscosity,and plasma viscosity were all significantly lower in the observation group than in the control group(P<0.05).Conclusion:The high frequency electric wave knife cervix electrocyclectomy treatment medium and severe Cervical columnar epithelium ectopic compared to microwave treatment,improved the efficiency of surgical treatment,safe and effective,small injury and other advantages,but also can improve the cervical microcirculation of patients,worthy of treatment Cervical columnar epithelium ectopic in the application.
引文
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[14]徐小卫.LEEP联合重组人干扰素α-2b栓治疗宫颈糜烂临床疗效观察[J].中国妇幼保健,2013,28(14):2311-2313.
[15]冯雪梅,贺媛,杜媛媛.宫颈糜烂不同治疗方法临床效果对比研究[J].河北医学,2013,19(12):1862-1864.
[16]杨洁,陈敦金,余琳.爱宝疗联合微波治疗宫颈糜烂的研究[J].中国妇幼保健,2006(17):2440-2442.
[17]陈艺菲,廖晓燕,蔡一铃.LEEP刀对重度宫颈糜烂患者宫颈局部微循环状态的影响研究[J].成都医学院学报,2014,9(2):159-161.
[18]李婷.利普刀对中重度宫颈糜烂患者宫颈微循环及HPV的影响[J].海南医学院学报,2016,22(6):571-573.
[2]王丽娜,邢秀月.LEEP和冷刀锥切术CKC治疗CINII-CINIII患者的疗效比较[J].陕西医学杂志,2016,45(4):454-455.
[3]Hariri S,Markowitz LE,Unger ER.Response to Pendleton et al.regarding reduction in HPV 16/18-associated high grade cervical lesions following HPV vaccine introduction in the United States[J].Vaccine,2016,34(2):201-201.
[4]张洪波.聚焦超声法联合聚维酮碘栓治疗宫颈糜烂的疗效观察[J].陕西医学杂志,2017,46(8):1070-1071.
[5]杜善平,李静,雷永红,等.重组人干扰素α-2b凝胶联合保妇康栓治疗宫颈炎的疗效观察[J].陕西医学杂志,2013,42(12):1661-1662.
[6]马会贤,张晓,常晓钦.微波与LEEP刀治疗中重度宫颈糜烂的疗效观察[J].河北医药,2013,35(12):1869-1870.
[7]李茂林,孙显峰.活血败毒汤治疗宫颈糜烂80例[J].陕西中医,2014,35(1):45.
[8]Zhu T,Chen Z,Xia Q,et al.A suppository for treating cervical erosion and its preparation method.[J].Clin Exp Obstet Gynecol,2013,40(3):361-6.
[9]张红星.宫糜粉联合微波治疗宫颈糜烂的临床疗效[J].陕西中医,2015,36(10):1290-1291.
[10]潘雪.中医药治疗宫颈HPV感染的Meta分析及活血解毒燥湿法的临床疗效研究[D].北京中医药大学,2016.
[11]Dall'Orologio GD,Lorenzi R.Restorations in abrasion/erosion cervical lesions:8-year results of a triple blind randomized controlled trial[J].American Journal of Dentistry,2014,27(5):245-50.
[12]Munoz MIC,Acevedo-Alvarez M,Monteagudo A,et al.Virtual three-dimensional ultrasound cystoscopy used for the diagnosis of cervical cerclage eroded into the bladder[J].Ultrasound in Obstetrics&Gynecology,2013,42(4):487-489.
[13]张书改,邢风琴,解燕昭,等.宫颈糜烂病因病机和治疗方法现状研究[J].河北医药,2015,37(3):421-423.
[14]徐小卫.LEEP联合重组人干扰素α-2b栓治疗宫颈糜烂临床疗效观察[J].中国妇幼保健,2013,28(14):2311-2313.
[15]冯雪梅,贺媛,杜媛媛.宫颈糜烂不同治疗方法临床效果对比研究[J].河北医学,2013,19(12):1862-1864.
[16]杨洁,陈敦金,余琳.爱宝疗联合微波治疗宫颈糜烂的研究[J].中国妇幼保健,2006(17):2440-2442.
[17]陈艺菲,廖晓燕,蔡一铃.LEEP刀对重度宫颈糜烂患者宫颈局部微循环状态的影响研究[J].成都医学院学报,2014,9(2):159-161.
[18]李婷.利普刀对中重度宫颈糜烂患者宫颈微循环及HPV的影响[J].海南医学院学报,2016,22(6):571-573.