摘要
为了探讨冷刀宫颈锥切术对宫颈上皮内瘤变的诊断治疗作用,并评价临床疗效,回顾性分析因宫颈病变行宫颈细胞学检查、阴道镜下多点活检和宫颈锥切术的患者186例,对比宫颈锥切术和阴道镜下多点活检的病理检查结果,分析冷刀宫颈锥切术的临床疗效和并发症。两者病理完全符合138例,占74.2%,不符合48例,占25.8%。8例(4.3%)患者锥切边缘受累,治愈率为98.9%,复发率为1.1%。发现早期浸润癌5例,其中2例仅行宫颈锥切随访无复发。11例患者后行子宫切除术或扩大子宫切除术。冷刀宫颈锥切术的主要并发症为出血和宫颈管狭窄,发生率分别为4.3%(8/186)和1.6%(3/186)。初步研究结果提示,宫颈锥切术比阴道镜下多点活检对宫颈上皮内瘤变的诊断更准确,并具有重要治疗作用。
The objective of this study was to evaluate the diagnostic and therapeutic efficacy using cold knife eonization for cervical intraepithelial neoplasia （CIN）, their postoperative histoligical findings and clinical outcomes. A total of 186 patients with cervical intraepithelial neoplasia （CIN） were analyzed, and the histological findings be- tween cervical conization and colposcopie multiple punch biopsies were compared. Of the 186 cases, there was a corre- lation in histological findings between cervical eonization and colposcopic multiple punch biopsies in 138 cases （74.2%）, the other 48 cases （25.8%） did not correspond. Incomplete excision occurred in 8 （4.3%）cases of 186 pa- tients with CIN lesion in the cone specimens, but the failure rate （persistence or recurrence） was only 1.1 %, and the cure rate was 98.90%. Five cases of early invasive cancer were detected, and 2 cases were treated with conization with- out reocurrence. Eleven cases had additional hysterectomy or semi-radical hysterectomy. The main complications as- sociated with conization were haemorrhage and cervical stenosis. Bleeding occurred in 4.3% （8/186） of the patients, and cervical stenosis occurred in 1.6 % （3/186） of the patients. In conclusion, cervical intraepithelial neoplasia is diag- nosed more correctly by conization than colposeopie multiple punch biopsies. Otherwise conization can play an important therapeutic role for cervical intraepithelial neoplasia and early invasive cancer.
出处
《中华肿瘤防治杂志》
CAS
2009年第11期872-874,共3页
Chinese Journal of Cancer Prevention and Treatment
