袁云显萋塞墓丕丝盥缝鲞垄室蕉土超痘瘗童趁瑟塑渔症生丝缝攫墓!垒翅
富颈环形电切术在宫颈上皮内瘤变诊断和治疗中的作用
南云泽金延泽郑
喜延边大学医院妇产科(吉林延吉)
133000
・1881・
・妇女保健・
中国豳书分类号RTI&4
文献标识码A
文章编謦1001-4411{2007}14-1881-03
【摘要】
目的:探讨寓颈环形电切术(LEEP)在官颈上皮内瘤变诊断和治疗中的作用。方法:2003年2月一2004年12
冀采属LEEP对拍搠经过缨憨学、羽道镜下害颈多点添捡病理诊瞬CIN.病人进行遂一步诊凝翻治疗,对其疗效、术后劳发疲俸
回顾性分析。结果;46例年龄为2l一52多,平均3s。o辛岁,30一39岁26例,占56.52%;朝鲜族24侧,汉族22例,两组糖
比,无照著性差异(P>O.01)。细胞学检焱正常2例(4.34%),不典型鳞状上皮(ASCAS)9例(19.57%),低度鳞状上戍内
痍变(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CIN
l 26
例、CIN嚣15铡、CINIII 5攒。零后病理诊断与术前完全符合者筠德,占稻.48%,零后瘸理缓裂下降15镶,蠢32.6%,零后
病理级别上升ll例,占23.9l%。2例术前诊断为CIN m,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例因宫颈漫润癌行宫颈癌根治术)细胞学均正常,2例术膀标本宫颈管处切缘CINm病变阳性,1个月聪行宫颈冷刀锥
锈术。LEEP治愈率为91。3%(42/46)。维论:LEEP怒诊治CIN鳇安全有效方法,哥浚弥褥酲遘镜下活检的嚣限往,哭要攀握
手术指征,规范手术步骤,切照宫颈管组织,术后密切观察,可获得满意的疗效。
【关键词】
嚣颈环形电切术宫颈上皮内瘤变病理诊断
The effect of loop electrosurgical exicision procedure
on
diagnosis and
treatment
for
cervical intraepithelial neoplasia
NAN
Yun—ze。】l鹣Yan—Ze,ZHENG羝,Department of
Obstetrics and
Gynecology,Affiliated
Hospital
of
Yanbian Uni—
versity,YanJi
1
33000,五lin,China
(Abstract】
Objective:To
study the effect of loop
electrosurgical
excision
procedure(LEEP)锄diagnosis
and treatment for cervi-
cal intraepithelial
neoplagia(CIN).Methods:46
cases
wi掇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
Cl/18eS
were
21
to
52 years old
(the
average
age
wag
38.04),in
which 26
cas档were
30 to 39.There
Wag
no
significant difference of
nationalities
between
Korean(24
ca-
s黯)and
Chinese(22cages).Normal
cytology襁2
CaStrO(4.强%),ASCA。S
Wag
9
es.ses(19.露%≥,LSIL
W8824㈣≤52.17%),
HSIL
WaS
11
c螂(23,91‘%).26
ca8es
of CIN l,15
case!s
of CIN II,5
caBe8
of CIN III,all
of
which diagnosed
by pathological
biopsy
under
eolpescopy.The
postoperative diagnosis ot"20
eases(43.48%)were
in
accordance
with the
preoperative ones.The
postoperative diag-
nosis were
downgraded in 15
cases(32。6%)and
upgraded
in 11
cas髂(23.91%>,2
Cases being diagnosed躐CIN珏before
operation,
whose
postoperative
pathological
diagnosis were squamous cell carcinoma of cervix
I
accepted radical
hysterectomy.Postoperative bleeding
in
15cages,lower
abdominal
pain
in
5cases,vaginal
discharge in 36 ca8e‰44
c船es(excluding
2
cases
of
wglamoas
cell carcinoma who
ac;,
cepted radical
hysterectomy)were
showed
110
abnormalities
in Pap smear during follow—up,while
2 cages
among them
demonstrated
H施-
hie resection
margin
and
give.the
Cold Knife
Conization(CKC)after
one
month‘.The CUre
rate was
91.3%(42/46).33
Cage8
were
fol-
lowed
for
one
year
and 1l
c88e8
for
half
a
year
to
one
year after
operation.Conclusion:LEEP
is
a
safe
and effective
procedure in treating
CIN.Satisfactory results
Call
be achieved
by mastering
surgical
indication and
standard
procedure,excising
cervical
canal
sufficiently and
paying
attention
to
postoperative
pathology.
[Key words]Loop
electrosurgical
excision
procedure(LEEP);Cervical
intraepithelial
neoplasia(CIN);Pathology
diagnosis
宫颈上皮态瘸变(cervical
intraepithelial
neoplasia,oN)
是宫颈没润癌演变发展过程中的癌前期瘸燮阶段,从CIN发
展为宫颈癌约需lO年,近年来年轻宫颈癌的发生率裔明显上
舞趋势,浚每年2强一3%的速度增长¨’,所浚对富颈瘸的醣
治重点在于对CIN的诊断与治疗上。近年来宫颈环行电切术
(100p
electrosurgieal excision
procedure,LEEP)广泛应用于
CIN的诊断和治疗。龌EP在去除病交酶弱瓣,又挺供了缝缓
病理学诊断。本文对2003年2月一2004年12月我院行LEEP
手术酶稻铡CIN病入瓣裰关资辩送行运籁牲努耩。
1资料与方法
1.1
一觳资瓣辐鲷年龄秀2l一52罗,警均3s.酣岁,
30—39岁者26例,占56.52%,>40岁者17例,占
36。96%;<30岁者3例,占6.5%;朝鲜族斛例,汉族22
铡,两缝耀爨:无显著豫差异(P>0。01>。全部穗有性搏侮,
有妊娠分娩史者43例。
万方数据