吉磊++薛金玲++曹媛媛++李艳++卞干霞

DOI：10.16662/j.cnki.1674-0742.2017.23.026

[摘要] 目的 臨床分析LEEP刀治疗宫颈上皮内瘤病变的临床效果，同时分析HPV16及HPV18在患者术后的随访价值。方法 方便选取该院2015年6月—2016年6月实施治疗的80例宫颈上皮内瘤病变患者，依照患者临床手术治疗方式将其分成两组，其中对照组40例患者实施宫颈冷刀锥切术（CKC术）治疗，观察组40例患者实施宫颈环形电切刀（LEEP刀）治疗，对两组患者的临床手术治疗效果观察，术后随访两组患者6个月，定期检测及记录HPV16、HPV18变化及患者复发率。结果 手术后，CIN I患者的HPV16、HPV18阳性率显著低于CIN II及CIN III患者，对比差异有统计学意义（P<0.05），其中CIN I患者术后为0.0%、CIN II患者术后为36.0%以及CIN III患者术后为47.8%。结论 在宫颈上皮内瘤病变患者治疗中，CKC术和LEEP术临床痊愈率差异不大，但是LEEP术治疗患者的手术时间、术中出血量以及术后愈合时间显著偏短，同时HPV16、HPV18检测对于患者术后病变评估以及复发率预测，具有重要作用，具有一定随访价值。

[关键词] LEEP刀；宫颈上皮内瘤病变；HPV16；HPV18

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）08（b）-0026-03

Investigation of the Clinical Efficacy of LEEP Knife in the Treatment of Cervical Intraepithelial Neoplasia and the Follow-up Value of HPV16 / 18 after Operation

JI Lei， XUE Jin-ling， CAO Yuan-yuan， LI Yan， BIAN Gan-xia

Department of Obstetrics and Gynecology， Yancheng City No.1 Peoples Hospital， Yancheng， Jiangsu Province， 224005 China

[Abstracts] Objective This paper tries to analyze the clinical effect of LEEP knife in the treatment of cervical intraepithelial neoplasia， and the follow-up value of HPV16/18 in patients after operation. Methods Convenient selection 80 patients with cervical intraepithelial neoplasia treated in this hospital from June 2015 to June 2016 were selected and divided into two groups according to the clinical operation methods. 40 patients with cold knife conization in the control group and 40 patients adopted LEEP knife treatment in the observation group. The clinical curative effect of the two groups was observed and the follow-up for 6 months after operation of the two groups were conducted. Changes and relapse rates of the HPV16/18 of the two groups were detected and recorded regularly. Results The positive rate of HPV16 and HPV18 in patients with CIN I was significantly lower than that in CIN II and CIN III after operation. The difference was statistically significant （P<0.05）， Among them， patients with CIN I after surgery was 0.0%， CIN II patients of 36.0% and CIN III patients was 47.8%. Conclusion In the treatment of patients with cervical intraepithelial neoplasia lesions， the difference of clinical recovery rate of CKC and LEEP surgery was not big， but operation time， intraoperative blood loss and postoperative healing time of the LEEP surgery for the treatment of patients were shorter and less， besides the HPV16 and HPV18 testing is of great value of evaluation and prediction of the recurrence of patients with postoperative pathological changes， which has certain value of follow-up.endprint

[Key words] LEEP knife； Cervical intraepithelial neoplasia； HPV16； HPV18

宫颈癌是女性常见恶性肿瘤之一，发病原因目前尚不清楚，早婚、早育、多产及性生活紊乱的妇女有较高的患病率。在临床妇科恶性肿瘤中，宫颈癌属于常见肿瘤之一，同时近些年来宫颈癌患者呈现出低龄化及年轻化特点，严重影响女性身心健康[1-2]。其中CIN 是宫颈癌前病变，系宫颈感染人乳头瘤病毒（HPV 病毒）引起。在患者临床治疗中通常治疗方案为：采用LEEP术及CKC术治疗，该文则方便选取该院2015年6月—2016年6月实施治疗的80例宫颈上皮内瘤病变患者为例，对患者不同手术治疗效果分析，并分析HPV16、HPV18的随访价值，现报道如下。

1 资料与方法

1.1 一般资料

方便选取在该院实施治疗的80例宫颈上皮内瘤病变（CIN）患者，患者年龄29～55岁，平均年龄（34.2±5.6）岁，CIN I 32例、CIN II 25例以及CIN III 23例。依照患者临床手术治疗方式将其分成两组，其中对照组40例患者实施宫颈冷刀锥切术（CKC术）治疗，观察组40例患者实施宫颈环形电切刀（LEEP刀）治疗，两组患者基本资料差异无统计学意义（P>0.05），具有可比性。