摘要
目的：探讨宫颈环形电切术（LEEP）在宫颈上皮内瘤变诊断和治疗中的作用。方法：2003年2月～2004年12月采用LEEP对46例经过细胞学、阴道镜下宫颈多点活检病理诊断CIN病人进行进一步诊断和治疗，对其疗效、术后并发症作回顾性分析。结果：46例年龄为21～52岁，平均38．04岁，30～39岁26例，占56．52％；朝鲜族24例，汉族22例，两组相比，无显著性差异（P〉0．01）。细胞学检查正常2例（4．34％），不典型鳞状上皮（ASCAS）9例（19．57％），低度鳞状上皮内病变（LSIL）24例（52．17％），高度鳞状上皮内病变（HSIL）11例（23．91％）。阴道镜下宫颈多点活检病理诊断为CINⅠ26例、CINⅡ15例、CINⅢ5例。术后病理诊断与术前完全符合者20例，占43．48％，术后病理级别下降15例，占32．6％，术后病理级别上升11例，占23．91％。2例术前诊断为CINⅢ，术后病理为宫颈鳞状上皮浸润癌而行宫颈癌根治术。随访中44例（除外2例因宫颈浸润癌行宫颈癌根治术）细胞学均正常，2例术后标本宫颈管处切缘CINⅢ病变阳性，1个月后行宫颈冷刀锥切术。LEEP治愈率为91．3％（42／46）。结论：LEEP是诊治CIN的安全有效方法，可以弥补阴道镜下活检的局限性，只要掌握手术指征，规范手术步骤，切足宫颈管组织，术后密切观察，可获得满意的疗效。
Objective： To study the effect of loop electrosurgical excision procedure （LEEP） on diagnosis and treatment for cervical intraepithelial neoplasia （CIN） . Methods： 46 cases with CIN identified by cytology and pathological biopsy under colposcopy treated by LEEP from February 2003 to December 2004, were analyzed retrospectively. Results： The ages of the 46 cases were 21 to 52 years old （the average age was 38. 04）, in which 26 cases were 30 to 39. There was no significant difference of nationalities between Korean （24 cases） and Chinese （22cases） . Normal cytology was 2 cases （4. 34% ）, ASCAS was 9 cases （ 19.57% ）, LSIL was24 cases （52. 17% ）, HSIL was 11 cases （23.91%） . 26 cases of CIN Ⅰ, 15 cases of CIN Ⅱ, 5 cases of CIN Ⅲ, all of which diagnosed by pathological biopsy under colposcopy. The postoperative diagnosis of 20 cases （43.48%） were in accordance with the preoperative ones. The postoperative diagnosis were downgraded in 15 cases （32. 6% ） and upgraded in 11 cases （23.91%） . 2 cases being diagnosed as CIN Ⅱ before operation, whose postoperative pathological diagnosis were squamous cell carcinoma of cervix, accepted radical hysterectomy. Postoperative bleeding in 15cases, lower abdominal pain in 5cases, vaginal discharge in 36 cases. 44 cases （excluding 2 cases of squamous cell carcinoma who accepted radical hysterectomy） were showed no abnormalities in Pap smear during follow-up, while 2 cases among them demonstrated readable resection margin and given the Cold Knife Conization （CKC） after one month. The cure rate was 91.3% （42/46） . 33 cases were followed for one year and 11 cases for half a year to one year after operation. Conclusion： LEEP is a safe and effective procedure in treating CIN. Satisfactory results can be achieved by mastering surgical indication and standard procedure , excising cervical canal sufficiently and paying attention to postoperative pathology.
出处
《中国妇幼保健》
CAS
北大核心
2007年第14期1881-1883,共3页
Maternal and Child Health Care of China
关键词
宫颈环形电切术
宫颈上皮内瘤变
病理诊断
Loop electrosurgical excision procedure （LEEP）
Cervical intraepithelial neoplasia （CIN）
Pathology diagnosis
