摘要
目的评估激光气化治疗阴道上皮内病变(Va IN)的疗效,并分析影响患者痊愈、持续、复发的高危因素。方法回顾112例经组织学首次确诊的阴道鳞状上皮病变并进行CO_2激光气化治疗的患者资料,对手术时间、手术次数、术中并发症及预后进行分析,探索影响患者疗效的高危因素。结果 112例患者中低级别病变46例,高级别病变66例。术中平均出血量(4.50±3.36)ml,平均手术时间(7.47±3.46)min,治愈75例(66.9%),持续存在23例(20.5%),复发14例(12.9%),进展为阴道癌2例。影响治疗效果的高危因素为既往是否有宫颈癌病史,影响复发的高危因素有16、18型人乳头状瘤病毒(HPV)感染、宫颈上皮内病变(CIN)病史。结论激光治疗Va IN疗效确切,可重复性及安全性均高,但激光治疗术后有持续存在、复发和进展风险。16、18型HPV感染及CIN病史在Va IN复发中起重要作用,宫颈癌病史是Va IN持续甚至发展为阴道浸润癌的高风险因素。
Objective To evaluate the efficacy of laser gasification in treatment of vaginal intraepithelial neoplasia and itsinfluencing factors. Methods One hundred and twelve patients with vaginal squamous epithelial neoplasia were treated withlaser gasification, including 46 cases with low level of lesion and 66 cases with high level lesions. The operation time, number ofoperation, intraoperative complications, prognosis of patients and the factors influencing the outcomes were analyzed. ResultsThe average intraoperative blood loss was 4.5±3.36ml, the average procedure time was 7.47±3.46 min. Seventy five cases（66.9%） were cured, 23 cases （20.5%） were persistent, 14 cases （12.9%） were recurrent and 2 cases progressed to vaginalcarcinoma. Multivariate logistic regression showed that history of cervical cancer was the influencing factor for efficacy; the historyof cervical lesions and HPV 16, 18 infection were the risk factors for the recurrence. Conclusion Laser gasification is effectiveand safe for treatment of vaginal intraepithelial lesions. HPV type 16, 18 infection and history of CIN are the risk factors ofrecurrence of vaginal intraepithelial lesion; and the history of cervical cancer is a risk factor for cervical intraepithelial lesions toprogress to vaginal invasive cancer.
作者
吴丽丽
朱斌
徐迪群
吴小珍
吴杭翡
WU Lili;ZHU Bin;XU Diqun(Yiwu Maternity and Children Hospital,Yiwu 322000,China)
出处
《浙江医学》
CAS
2018年第20期2227-2229,2236,共4页
Zhejiang Medical Journal
关键词
激光气化
阴道上皮内病变
复发
Laser gasification；Vaginal intraepithelial lesion；Recurrence
