宫腔镜下宫颈锥切术治疗宫颈上皮内瘤样变疗效观察_临床医学论文.docVIP

宫腔镜下宫颈锥切术治疗宫颈上皮内瘤样变疗效观察_临床医学论文 宫腔镜下宫颈锥切术治疗宫颈上皮内瘤样变疗效观察_临床医学论文 【摘要】 目的 探讨宫腔镜下宫颈锥切术(TCRC)治疗宫颈上皮内瘤样病变的可行性及临床疗效。 方法 在宫腔镜下对CINⅡ、Ⅲ期患者57例行TCRC(TCRC组)，36例行宫颈环形电切术LEEP(LEEP组)。观察两组手术时间、出血量及术后病理情况。 结果 TCRC组平均手术时间为(15.2±3.1)min,术中平均出血量为(6.1±1.7) ml;LEEP组平均手术时间为(14.0±2.8) min,术中平均出血量为(11.4±2.2)ml，两组出血量比较，差异有统计学意义(0. 05)。 结论 与宫颈环形电切术比较，宫腔镜下宫颈锥形切除术出血量少。 【关键词】 宫腔镜; 宫颈上皮内瘤样病变; 锥形电切术 　　【Abstract】 Objective To evaluate the effectiveness of cervical cone electrosection through hysteroscopy in treating cervical intraepithelial neoplasia. Methods Of 93 cases with CIN II and III stage, 57cases received cervical cone electrosection through hysteroscopy (TCRC group), and 37cases received loop electrosurgical excision procedure (LEEP group). Operation duration, bleeding volume and postoperative complications were compared between the two groups. Results In TCRC group, average time spent during operation was (15.2±3.1) minutes, and mean bleeding volume was (6.1±1.7) ml. In LEEP group, average operation time was (14.0±2.8) minutes, and mean bleeding volume was (11.4±2.2) ml. The TCRC group had smaller amount of blood loss during operation (0.05). There was no statistical difference in the incidence of postoperative cervical stenosis between the two groups. Conclusion TCRC neoplasia through hysteroscopy had smaller amount of blood loss during operation than LEEP. 　　【Key words】 Hysteroscopy; Cervical intraepithelial neoplasia; Cervical cone electrosection 　　宫颈癌发病率在女性恶性肿瘤中居第2位，占癌症患者总数的15 %，早期发现并积极处理宫颈癌前病变，可以阻断病程，降低宫颈浸润癌的发生和死亡率[1]。而宫颈上皮内瘤样变(cervical intraepithelial neoplasia，CIN)是公认的宫颈癌的癌前病变[2,3]，对CIN的早期发现与处理，是防治宫颈癌的关键，宫腔镜手术是一种用于治疗妇科疾病的新兴微创手术,本院采用宫腔镜下宫颈锥切术治疗(transvaginal coneresection of cervix uteri, TCRC)CIN患者,疗效满意,现报道如下。 　　对象与方法 　　一、对象 　　2005年2月至2009年3月来本院就诊经病理检查诊断为CINⅡ、Ⅲ期患者93例。93例患者依预约手术号及病者意愿分为2组。TCR C组57例,年龄25～45岁，平均年龄(38.5±5.4)岁，其中CINⅡ期39例,CINⅢ期18例。36例进行宫颈环形电切术(loop eletrosurgical excision procedure，LEEP),年龄25～44岁,平均年龄(38.9±6.2)岁，其中CINⅡ期20例,CINⅢ期16例。两组年龄和CIN分期比较，差异均无统计学意义。 　　二、方法 　　1.诊断标准