摘要
目的评价阴道镜基础上的"即查即治"在妇女宫颈病变防治中应用价值及临床意义。方法在细胞学基础上进行阴道镜下活检,对某单位4215名女职工进行妇科宫颈病变普查,对阴道镜下诊断明确的宫颈病变患者,采取"即查即治",发现病灶立即治疗方法,并同时留取活检组织病理检查。结果宫颈涂片2854例,异常涂片243例(8.51%),327例行阴道镜检查同时行宫颈活组织检查,组织病理确诊发现:宫颈癌3例(0.07%),宫颈内瘤样病变139例(3.12%),其中CINⅠ126例(2.99%),CINⅡ12例(0.04%),CINⅢ1例(0.02%),尖锐湿疣11例(0.26%)。宫颈涂片诊断CIN符合率53.9%,阴道镜诊断CIN的符合率72.7%,两者有显著差异(P<0.05)。阴道镜诊断CIN的敏感性97.2%,特异性70.9%。104例在阴道镜较为准确诊断基础上进行"即查即治",并同时留取活检组织病理检查。结论宫颈细胞学基础的阴道镜活检是妇女宫颈癌普查中初筛与精检相结合的可靠诊疗方法,阴道镜基础上采取"即查即治",是防治宫颈病变另一途径。
Objective To evalute the accuracy and efficiency of ＂examing and treating＂ according colposcopy in prevent of cervical lesions. Methods Cytolody, colposeopy, histopathologial examination were used in screening of cervical lesions,4215women were examined, women were treated under the guidance of the colposeopy for pathological study （ exam and treat） , Cervical samples were kept for histopathologial examination. Results There were 243 cases abnormal cervical smears amoung 2854 cervical smears. 327cervical biopsies were performed under the guidance of the colposcopy for pathological study. So three cervical cancers, one hundred thirty nine cervical squamous intraepithelial lesions（ CIN Ⅰ 126 cases ,2. 99% , CIN Ⅱ 12cases ,0. 04% , CIN Ⅲ 1 case ,0. 02% ） , eleven pointed condylomata（ 0. 26% ）were detected. The sensitivity, specificity of colposcopy in evaluation of cervical squamous intraepithelial lesions were 97.2% ,70. 9%. Colposcopy and cytolody diagnostic accuracies were 72.7% ,53.9%. There was a statistically significant difference（ P 〈 0. 05 ）. One hundred and four women were treated under the guidance of the colposcopy for pathological study（ exam and treat）. Conclusion Cytolody and histopathologial examination under the guidance of colposcopy can be a very accurate diagnosic method in screening of cervical squamous cancer, exam and treat were another way of diagnosis and treatment cervical lesions.
出处
《中国实用医药》
2009年第26期21-23,共3页
China Practical Medicine
关键词
宫颈病变
阴道镜
Cervical diseases
Colposcopy
