姜小予

[摘要]目的 对子宫颈环形电切术（LEEP）和子宫颈电刀锥切术治疗子宫颈上皮内瘤变（CIN）的临床疗效进行观察和对比，以探讨子宫颈上皮内瘤变的适宜治疗方法。 方法 将我院近年来收治的100例CIN患者随机分成治疗组和对照组，治疗组用 LEEP刀治疗，对照组用电刀锥切术治疗，每组各50例患者。比较两组患者的临床疗效和不良反应发生率。 结果 治疗组手术时间、愈合时间和住院时间明显短于对照组，且术中出血量少、术后并发症发生率低，两组比较差异有统计学意义（P＜0.05）；手术前后病理检查结果相符率比较，两组差异不大，但切缘阳性率治疗组高于对照组；远期疗效方面，对于CIN 1、2期的患者两组疗效相近，但对于CIN 3期患者的复发率对照组低于治疗组（P＜0.05），两组患者术后高危 HPV持续感染率无明显差异（P＞0.05）。 结论 LEEP刀治疗宫颈上皮内瘤变方法简单，手术时间短，费用低，且出血量少，术后宫颈恢复快，并发症少，安全有效，易被患者接受，值得推广。但对于 CIN 3期的患者，为了减少复发，仍可选择传统的电刀锥切治疗。

[关键词] LEEP刀；子宫颈电刀锥切术；宫颈上皮内瘤变；疗效比较

[中图分类号] R737.33   [文献标识码] B   [文章编号] 2095-0616（2014）08-208-03

The comparison of LEEP cutter and the electric knife conization efficacy in the treatment of cervical intraepithelial neoplasia

JIANG Xiaoyu

Department of Gynaecology and Obstetrics, Fourth People's Hospital of Haimen City in Jiangsu Province, Haimen 226141, China

[Abstract] Objective To observe and contrast the cervical LEEP (LEEP) and cervical conization for cervical intraepithelial neoplasia (CIN) clinical efficacy, and investigate the suitable method of treatment of cervical intraepithelial neoplasia. Methods 100 patients with CIN in our hospital in recent years were randomly divided into the treatment group and the control group by double blind method, the treatment group was treated with LEEP knife, the control group was treated with conization treatment, there was 50 patients in each group. The occurrence rates of the clinical efficacy and adverse reactions of two groups were compared. Results The operation time, healing time and hospitalization time in treatment group were shorter than that in the control group, had low rate of postoperative complications and intraoperative hemorrhage, the two groups had significant difference (P＜0.05); Before and after operation pathologic examination results rate comparison, two groups had little difference, but a positive margin rate higher than the treatment group; long-term effect, for CIN 1, 2 of the two groups of patients had similar effect, but for patients with CIN stage 3 recurrence rate was lower than that of the control group (P＜0.05 group), two groups of patients with after persistent high-risk HPV infection rate was no significant difference (P＞0.05). Conclusion LEEP knife treatment of cervical intraepithelial neoplasia method has the advantages of simple operation, short time, low cost, and less bleeding, postoperative cervical rapid recovery, fewer complications, safe and effective, easy to be accepted by patients, and is worthy of promotion. But for CIN 3 of the patients, in order to reduce relapse, still can choose electric knife cone traditional resection.

[Key words] LEEP knife; Cervical conization; Cervical intraepithelial neoplasia; Curative effect

子宫颈上皮内瘤变（cervical intraepithelianeoplasia，CIN）反映子宫颈癌发生、发展的连续过程，包括轻、中、重度不典型增生及原位癌，常发生于25～35 岁妇女，是与子宫颈浸润癌有密切相关的一组癌前病变，90%以上CIN有HPV感染[1]。从CIN发展成宫颈癌需要一个较长的演变过程，一般需10～15年，故随细胞学新技术（如子宫颈液基细胞学检查）和阴道镜在妇科的广泛应用，CIN检出率明显增加，如何及时治疗并减少对患者的损伤又要有效避免复发是每个临床医生都值得深思的问题。……