西部偏远地区leep刀在诊疗宫颈病变中的临床应用.docVIP

西部偏远地区LEEP刀在诊疗宫颈病变中的临床应用 田艳 （贵州省六盘水市妇幼保健院妇产科，贵州 六盘水 553001） 【摘要】 目的 探讨LEEP环切刀在西部偏远地区宫颈疾病诊治中的临床价值，以及其对并发症的预防和处理。方法　回顾性分析2006年至2009年我院宫颈电环切除术诊治的517例采用LEEP手术治疗、切除病变组织或行宫颈锥切的不同类型宫颈疾病的患者,手术标本均进行病理学检查，并考察手术时间、手术出血量及术后疗效。结果 术后病理诊断与术前完全符合者388例, 占75.05% (388/ 517), 术后病理诊断级别下降占9.86%(51/ 517) , 术后病理诊断级别上升占15.09%(78/ 517)。平均手术时间6.9 min出血量7.1 mlLEEP治愈率为97.29 %(503/ 517) 。结论　LEEP治疗宫颈疾病手术时间短出血量少术后并发症少可提高宫颈上皮内瘤变和宫颈原位癌的诊断率获得满意的疗效适合在偏远地区推广使用。 【关键词】LEEP环切刀；宫颈病变；诊断和治疗 Loop electrosurgical excision procedure for diagnosis and treatment of cervical diseases in remote western aeras TIAN Yan, Women and Children Healthcare Hospital, Liu Pan Shui, 553000, Gui Zhou, China Abstract　Objective: To study the use of loop electrosurgical excision procedure (LEEP) in the diagnosis and treatment of cervical disease as well as prevention and management of LEEP related complications. Methods: From January 2006 to December 2009, clinical data on 517 cases of cervical intraepithelial neoplasia ( CIN ) or cervical in situ carcinoma treated by LEEP were analyzed retrospectively, including operation approach, pathology findings, complications and outcomes. Results: The postoperative diagnosis of 388 cases (75.05 % ) were in accordance with the preoperative ones, the postoperative diagnosis were down graded in 51 cases (9.86 %) and upgraded in 78 cases (15.09 %), The mean operation time was 6.9 min and the mean blood loss was 7.1mL. The cure rate was 97.29 %( 503/ 517) Conclusions: LEEP showed a number of benefits including short operation time, little blood loss, few complications, and improved diagnosis of CIN and cervical carcinoma in situ, satisfactory results can be achieved. It’s suitable in remote areas. Key words　loop electrosurgical excision procedure (LEEP); cervical disease; diagnosis and treatment ………………………………. 作者简介：田艳，女，37岁，贵州省六盘水市妇幼保健院副院长，硕士研究生，副主任医师。从事妇产科工作16年，专科方向主要为内镜手术和宫颈疾病。发表论文十余篇，电Email: tianyy72@163.com 　 宫颈病变主要包括宫颈糜烂、宫颈息肉、宫颈湿疣、子宫颈上皮内瘤样病变(CIN)及宫颈癌等其发病率高是女性最常见的疾病之一近年来，宫颈疾病