宫颈冷刀锥切术治疗宫颈上皮内瘤变临床分析.docVIP

宫颈冷刀锥切术治疗宫颈上皮内瘤变临床分析 　　doi：10.3969/j.issn.1007-614x.2014.17.24 　　摘要目的：评价宫颈上皮内瘤变（CIN）冷刀锥切（CKC）治疗的效果及术后高危型HPV的消退情况。方法：回顾性分析2001-2012年行冷刀锥切术治疗249例宫颈上皮内瘤变患者的临床资料。结果：宫颈冷刀锥切术前后结果一致171例（69%）；两者结果有差异78例（31%）。宫颈病变程度按照病理检查结果分级：CINⅠ42例（17%），CINⅡ96例（39%），CINⅢ111例（44%），其中HPV感染216例（87%）。术前高危型HPV感染的宫颈上皮内瘤变患者术后6个、12个、24个月清除率分别为82.1%、90.1%、94.4%。结论：宫颈冷刀锥在宫颈CIN的诊断及治疗上具有优势，术后高危型HPV大部分消退。 　　关键词宫颈上皮内瘤变宫颈冷刀锥切人乳头瘤病毒病理切片 　　Clinical analysis of cervical cold knife conization in the treatment of cervical intraepithelial neoplasia 　　Yang Xiaohong，Zhang Pan 　　Department of Gynaecology and Obstetrics，the Fourth People’s Hospital of Chenzhou City，Hunan 423000 　　AbstractObjective：To evaluate the effect of cold knife conization（CKC） in the treatment of cervical intraepithelial neoplasia（CIN） and the regression of the high risk HPV after the operation.Methods：We retrospectively analyzed the clinical datas of 249 cases with cervical intraepithelial neoplasia and they all had the cold knife conization treatment from 2001 to 2012.Results： The results of before and after the cervical cold knife conization were consistent in 171 cases（69%）.The results were different in 78 cases（31%）.The degree of cervical lesions by pathological examination results：42 cases were CIN gradeⅠ（17%），96 cases were CINⅡ（39%），111 cases were CINⅢ（44%），including 216 cases were HPV infection（87%）.The clearance rates of the high risk HPV infection before operation of cervical intraepithelial neoplasia after 6 months，12 months，24 months were 82.1%，90.1%， 94.4%.Conclusion：The cervical cold knife conization has advantages in the diagnosis and treatment of cervical CIN.The high-risk HPV largely faded away after the operation. 　　Key wordsCervical intraepithelial neoplasia；Cervical cold knife conization；Human papilloma virus；Pathological sections 　　子宫颈癌为妇科常见肿瘤之一，在女性生殖器官癌瘤中占据首位，且为女性各种恶性肿瘤最多见的癌瘤。其地区分布有差异，平均发病年龄也存在差异。一般以40～50岁多见，60～70岁达到另一高峰，20岁以前尽管少发但是本病有年轻化的趋势[1]。近年来，随着宫颈细胞学检查、HPV检测等检测技术在各级医院的普及，宫颈上皮内瘤变早期发现率明显提高。宫颈锥切是诊治宫颈上皮内瘤的重要