刘凌瑜，江艳洁厦门大学附属福州市第二医院，福建福州　350007

阴道镜下活检联合LEEP术在宫颈上皮内瘤变诊治的临床价值

刘凌瑜，江艳洁
厦门大学附属福州市第二医院，福建福州350007

目的 探讨阴道镜活检联合LEEP刀诊治宫颈上皮内瘤变的临床价值。方法 方便选取并回顾性分析2012年1月—2014年12月该院收治的116例经阴道镜活检诊断为宫颈上皮内瘤变患者，采用LEEP手术，比较阴道镜下活检与LEEP术后病理检查符合情况，并观察治愈率。结果 阴道镜活检与LEEP术后病理结果的总诊断符合率为72.4%，其中CINⅠ级符合率为64.3%，CINⅡ级符合率为78.40%，CINⅢ级符合率为82.6%，LEEP术后治愈率为92.2%，复发率2.6%。结论 阴道镜在诊断宫颈病变中具有一定局限性，而LEEP术能够有效弥补其缺点，两者联合大大提高了对宫颈上皮内瘤变的诊断率，且LEEP术治疗成功率高，值得在临床上推广使用。

阴道镜；LEEP；宫颈上皮内瘤变

［Abstract］Objective To explore the clinical value of cervical intraepithelial neoplasia（CIN）treatment by punch biopsy under colposcopy and loop electrosurgical excision procedure．Methods Convenient selection and restrospective analysis for 116 patients，who diagnonsed by biopsy under colposcopy were given diagnosis and treatment by LEEP surgery from January 2012 to December 2014．To compare the pathological results of biopsy by colposcopy and LEEP surgery and observe the curative ratio．Results The total consistent rate of CIN grade diagnosed by pathological results of LEEP surgery was 78.4%，among which CINⅠgrade was 64.3%，CINⅡgrade was 78.4%and CINⅢgrade was 82.6%.The LEEP postoperative cure rate was 92.2%，the recurrence rate was 2.6%．Conclusion The biopsy under colposcop has certain limitation，which the LEEP surgery can make up for.But LEEP surgery can combined with LEEP surgery to diagnose and treat the CIN can improve the diagnostic rate；and the LEEP to diagnose and treat the CIN grade has higher cure rate，which is worth of clinical popularization and application.

［Key words］Colposcopy；LEEP；Cervical intraepithelial neoplasia

宫颈上皮内瘤变（cervicatral intraepithelial neoplasia，CIN）是一组癌前病变，它与宫颈浸润癌密切相关，当病变进一步发展到高级别CIN后，就可能发展为浸润癌［1］。宫颈上皮内瘤变如能早期及时发现，采取有效的治疗，能够明显降低宫颈癌的发病率。因此，CIN早期的诊断与治疗极为重要。临床上对于CIN疾病的确诊，阴道镜下多点活检是一种较好的方法，但由于只选取部分组织，仍可能出现漏诊，而联合使用宫颈环形电切术（loop electrical excision procedure，LEEP）可获取所有位点的组织，能大大提高组织学诊断的准确性。该次研究方便选取2012年1月—2014年12月该院收治的116例经阴道镜下活检诊断为CIN，并采用LEEP术的患者进行回顾性分析，比较阴道镜活检与LEEP术后病理结果一致性，探讨两者联合应用在诊治宫颈上皮瘤变患者的临床价值，现报道如下。……