人乳头状瘤病毒持续感染的临床诊断与环形电切除术治疗

发布时间：2018-08-05 13:25

【摘要】：目的探索宫颈上皮内瘤样病变(CIN)后人乳头状瘤病毒(HPV)16、18持续感染的环形电切除术(LEEP)治疗方法,以提高临床治疗效果。方法对195例因宫颈上皮内瘤样病变进行初次LEEP术的患者进行术后随访,检测其HPV16、18的感染结果,对持续感染HPV的患者进行密切监控,对其进行宫颈细胞检测及阴道镜活检,病灶残留及复发者进行二次手术治疗。结果 LEEP术前HPV16、18的感染率为86.15%,术后6个月持续感染率为23.21%;HPV持续感染对病灶残存及复发的预测灵敏度可达92.86%;二次手术采用子宫全切术1例,部分宫颈切除术2例,二次LEEP术12例。结论 LEEP术对清除宫颈HPV16、18具有一定的作用,术后HPV持续感染是CIN残留及复发的危险信号,可作为监控病灶发展的指标;对于术后HPV持续感染的患者应采取密切随访,对于病灶残存患者应进行积极治疗,治疗方法应根据具体情况处理。
[Abstract]:Objective to explore the method of (LEEP) in the treatment of persistent infection of human papillomavirus (HPV) 16) 18 after cervical intraepithelial neoplasia (CIN) in order to improve the clinical effect. Methods one hundred and fifty-five patients with intraepithelial neoplasia of cervix were followed up for the first time after LEEP operation. The results of HPV16 ~ (18) infection were detected. The patients with persistent infection of HPV were closely monitored, and their cervical cells were detected and colposcopy biopsy was performed. Patients with residual or recurrent lesions were treated with secondary surgery. Results the infection rate of HPV16 ~ (18) was 86.15 before LEEP, and the predictive sensitivity of persistent infection of HPV16 ~ (18) in 6 months after operation was 92.866.The second operation was performed with hysterectomy in 1 case, partial cervicectomy in 2 cases, and secondary LEEP operation in 12 cases. Conclusion LEEP has a certain effect on the removal of cervical HPV16M18. Postoperative persistent infection of HPV is a risk signal for the residual and recurrence of CIN and can be used as an indicator to monitor the development of the lesion, and a close follow-up should be taken for the patients with persistent HPV infection after operation. Patients with residual lesions should be treated actively and treated according to specific conditions.
【作者单位】：余杭区妇幼保健院妇科;
【基金】：浙江省卫生厅重点扶持基金资助项目(ZW2010B026)
【分类号】：R737.33

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