[1]赵应梅,段迎春,徐申超,等.两种宫颈锥切方法治疗高级别宫颈上皮内瘤变 临床疗效比较[J].中国计划生育和妇产科,2018,(9):65-69,72.
　ZHAO Ying-mei,DUAN Ying-chun,XU Shen-chao,et al.Comparison of clinical effects of two cervical conization methods in the treatment of high-grade cervical intraepithelial neoplasia[J].Chinese Journal of Family Planning & Gynecotokology,2018,(9):65-69,72.
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两种宫颈锥切方法治疗高级别宫颈上皮内瘤变 临床疗效比较
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年9期
页码:
65-69,72
栏目:
论著与临床
出版日期:
2018-09-25

文章信息/Info

Title:
Comparison of clinical effects of two cervical conization methods in the treatment of high-grade cervical intraepithelial neoplasia
作者:
赵应梅; 段迎春; 徐申超; 戴海燕; 胡花*
复旦大学附属上海市浦东医院妇产科
Author(s):
ZHAO Ying-mei;  DUAN Ying-chun; XU Shen-chao;  DAI Hai-yan;  HU Hua*
Department of Obstetrics and Gynecology,Shanghai Pudong Hospital affiliated to Fudan University,Shanghai 201399,P.R.China
关键词:
宫颈上皮内瘤变; 宫颈普通电刀锥切术; 宫颈环形电切除术; 改良法
Keywords:
high-grade cervical intraepithelial lesions; general electrosurgical knife conization; loop electrosurgical excision procedure; modified
分类号:
R 713.4
摘要:
目的评价通过技术改进后的普通电刀锥切术(general electrosurgical knife conization，EKC)和环行电切术(loop electrosurgical excision procedure,LEEP)治疗高级别宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的临床疗效。方法回顾性分析上海市浦东医院妇科2013年1月至2015年9月收治的243例高级别CIN患者的临床资料，行改良法EKC治疗的106例患者为EKC组，同期接受LEEP治疗的137例患者为LEEP组。比较EKC和LEEP两种手术方法治疗高级别CIN的临床疗效。结果① 两组手术时间和术中出血量比较，差异均无统计学意义（P>005）；② 两组病理标本均可识别，EKC组锥切标本高度大于LEEP组（P＜005），LEEP组宫颈内口切缘阳性率高于EKC组（P<005），两组术后病变累腺率及术前、术后病变符合率差异无统计学意义 (P＞005)；③ EKC组术后病灶残留率低于LEEP组（P<005）；EKC组术后6个月病变复发率低于LEEP组（P<005）；④ 术后6、12、18、24个月两组高危人乳头瘤病毒持续感染率差异均无统计学意义（P>005）；⑤ 两组术后宫颈出血、盆腔炎发生率差异无统计学意义（P＞005），EKC组术后宫颈狭窄粘连发生率低于LEEP组(P<005)。结论EKC和LEEP治疗高级别CIN均具有出血少、手术时间短的优点，但EKC具有切除深度足够，残留率、复发率低及术后并发症少等优点，能获得较好的治疗效果。
Abstract:
ObjectiveTo evaluate the clinical effects of modified general electrosurgical knife conization(EKC) and loop electrosurgical excision procedure(LEEP) in the treatment of high-grade cervical intraepithelial lesions(CINⅡ,Ⅲ).MethodsThe retrospective analysis of the clinical data was carried out in 243 cases of high-grade cervical intraepithelial lesions from January 2013 to September 2015 in Department of Gynaecology in Shanghai Pudong Hospital. 106 cases undergoing modified EKC were taken as the EKC group and contemporaneous 137 cases receiving LEEP as the LEEP group. The clinical effects of EKC and LEEP in the treatment of high-grade cervical intraepithelial lesions were compared. Results① There was no statistically significant difference in the intraoperative blood loss volume and the operative time between the two groups(P>005); ② The pathological specimens of both groups were identified. The height of the cone-cut specimens in the EKC group was higher than that in the LEEP group(P<005). The positive rate of the cervical margin in the LEEP group was higher than that in the EKC group(P<005). There was no significant difference in the rate of glandular involvement between the two groups and the preoperative and postoperative lesions(P>005); ③ The residual rate of postoperative lesions in EKC group was lower than that in LEEP group (P<005). The recurrence rate of lesions in EKC group was lower than that in LEEP group (P<005);④ There was no statistically significant difference in the persistent infectionrate of high risk-human papilloma virus(HPV-DNA) in 6,12,18 and 24 months(P>005); ⑤ The incidence of postoperative cervical hemorrhage and pelvic inflammatory disease was similar in the two groups(P＞005). The incidence of cervical stenosis adhesion in the EKC group was lower than that in the LEEP group(P<005).ConclusionThe modified general electrosurgical knife conization and LEEP methods all have the advantages of short operative time and less bleeding for treating CINⅡ,CINⅢ, but the modified general electrosurgical knife conization treatment is superior to LEEP in the aspects of the specimens size, the lesion residual rate, the postoperative recurrent rate and with less complications. The procedure also can obtain good therapeutic effects.

参考文献/References:

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备注/Memo

备注/Memo:
上海市浦东新区卫生系统重点学科建设资助(项目编号：Pwzx2014一05)
更新日期/Last Update: 2018-09-25