上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (12): 1628-.doi: 10.3969/j.issn.1674-8115.2012.12.022

• 论著（临床研究） • 上一篇    下一篇

不同LEEP术式治疗宫颈上皮内瘤样病变和宫颈糜烂的疗效观察

张肖青, 徐惠群   

  1. 上海市徐汇区大华医院妇科, 上海 200237
  • 出版日期:2012-12-28 发布日期:2012-12-31
  • 通讯作者: 徐惠群, 电子信箱: drxuhuiqun@gmail.com。
  • 作者简介:张肖青（1968—）, 女, 主治医师, 硕士生；电子信箱: xiaoxiaoqing10302003@yahoo.com.cn。

Curative effects of different LEEP in treatment of cervical intraepithelial neoplasia and cervical erosion

ZHANG Xiao-qing, XU Hui-qun   

  1. Department of Gynaecology, Shanghai Xuhui District Dahua Hospital, Shanghai 200237, China
  • Online:2012-12-28 Published:2012-12-31

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摘要：

目的 观察高频电波刀电圈切除(LEEP)治疗宫颈上皮内瘤样病变(CIN)和宫颈糜烂的疗效。方法 回顾性分析192例接受LEEP术治疗的CIN和宫颈糜烂患者的临床资料。根据患者病变情况实施不同术式，包括浅宫颈环切术（SRE）、深宫颈环切术（DRE)和宫颈锥切术（LEEPC）。评价LEEP术治疗CIN及宫颈糜烂的疗效，评价LEEP术后宫颈塑形效果，观察并发症发生情况。结果 192例患者中，接受SRE、DRE、LEEPC术式的患者分别为84、68和40例。术后6个月，CIN治愈率为95.59% （65/68）；2例CINⅡ级病例和1例CINⅢ级病例术后有病变残留；CINⅡ级及CINⅢ级病例中，各有1例复发。术后3个月，宫颈糜烂的治愈率为94.35% （117/124）；其中SRE、DRE、LEEPC术式的治愈率分别为96.43% （54/56）、91.11% （41/45）和95.65% （22/23）。术后3个月，行LEEP术治疗的患者对宫颈塑形的满意度为93.75％ (180／192)。行SRE、DRE、LEEPC术治疗的患者对宫颈塑形的满意度分别为92.86％ (78/84)、95.66％ (65/68)和92.5％ (37/40)。术后3个月，宫颈黏膜外翻的发生率为4.17% （8/192），其中行SRE术治疗的患者占7.14% （8/84），行DRE术治疗的患者占2.94% （2/68）；行LEEPC术治疗的患者中，3例发生颈管狭窄，占7.5% （3/40）。结论 针对不同性质及程度的宫颈疾病采用相应LEEP术式，治愈率高，术后塑形效果好；对于CIN和宫颈糜烂的治疗方案应个体化。

关键词: 高频电波刀电圈切除, 宫颈上皮内瘤样病变, 宫颈糜烂, 宫颈塑形

Abstract:

Objective To investigate the curative effects of high-frequency loop electrosurgical excision procedure (LEEP) in treatment of cervical intraepithelial neoplasia (CIN) and cervical erosion. Methods The clinical data of 192 patients with CIN and cervical erosion undergoing LEEP were retrospectively analysed. According to different conditions in patients, shallow cervical ring excision (SRE),deep ring excision (DRE) or LEEP conization (LEEPC) were performed. The curative effects of LEEP in treatment of CIN and cervical erosion were evaluated, the effect of cervical regeneration was assessed, and the prevalence of complications was observed. Results There were 84, 68 and 40 patients undergoing SRE, DRE and LEEPC respectively. Six months after operation, the cure rate of CIN was 95.59% （65/68）, there was lesion residue after operation in 2 patients with CINⅡ and 1 patient with CINⅢ, and there was relapse in 1 patient with CINⅡ and 1 patient with CINⅢ. Three months after operation, the cure rate of cervical erosion was 94.35%（117/124）, and the cure rates of SRE, DRE and LEEPC were 96.43% （54/56）, 91.11% （41/45) and 95.65% （22/23) respectively. Three months after operation,the satisfaction rate of cervical regeneration from patients undergoing LEEP was 93.75% (180/192), and the satisfaction rates of cervical regeneration from patients undergoing SRE, DRE and LEEPC were 92.86％ (78/84), 95.66％ (65/68) and 92.5％ (37/40) respectively. Three months after operation, the prevalence of cervical mucous eversion was 4.17% （8/192）, among which SRE accounted for 7.14% (8/84), and DRE accounted for 2.94% (2/68).Carotid stenosis occurred in 7.5%(3/40) of patients undergoing LEEPC. Conclusion Corresponding LEEP should be adopted according to different cervical diseases, which may yield higher cure rate and better cervical regeneration. Individualized procedure should be carried out for the treatment of CIN and cervical erosion.

Key words: loop electrosurgical excision procedure, cervical intraepithelial neoplasia, cervical erosion, cervical regeneration