冷刀与电刀诊治宫颈上皮内瘤变的疗效及妊娠结局的对比
发布时间：2018-09-07 16:42
【摘要】：目的探讨环形电切术(loop electrosurgical excision procedure,LEEP)与冷刀宫颈锥切术(cold-knife conization,CKC)在宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)诊治中的疗效对比及其对妊娠的影响。方法回顾性分析2010年1月~2012年1月间115例CIN患者的病历资料,其中行LEEP术的患者64例,行CKC术的患者51例,对两组方法的术中情况、手术并发症及术后病理结果进行比较,并追踪随访,比较行不同手术方法的两组患者复发情况、宫颈长度、妊娠情况和妊娠结局。结果手术时间LEEP组(12.56±3.09)min,比CKC组的(23.82±3.42)min短(P0.05);术中出血LEEP组(9.78±3.77)mL,较CKC组的(26.35±9.26)mL少(P0.05);LEEP组术后并发症发生率(7.81%)较CKC组(31.37%)低(P0.05);两组术后病检一致率(87.42%vs.85.65%)、切缘阳性率(1.56%vs.1.96%)、术后复发率(3.13%vs.1.96%)、术后宫颈长度变化(1.40±0.24 vs.1.44±0.24)差异无统计学意义(P0.05);LEEP组中妊娠率(87.50%)、流产率(3.12%)、胎膜早破发生率(7.81%)、早产率(6.25%)、新生儿低体重出生率(10.71%)与CKC组妊娠率(88.24%)、流产率(3.92%)、胎膜早破发生率(3.92%)、早产率(5.88%)、新生儿低体重出生率(11.11%)相比较,差异均无统计学意义(P0.05)。结论应用LEEP施行宫颈锥切术在手术时间、术中出血及术后并发症方面优于CKC,而对患者的术后复发情况、生育能力及妊娠结局无明显影响,诊治CIN的临床疗效与CKC相似,应得到临床的重视和应用。
[Abstract]:Objective to investigate the effect of circular electroresection (loop electrosurgical excision procedure,LEEP) and cold knife conization (cold-knife conization,CKC) in the diagnosis and treatment of cervical intraepithelial neoplasia (cervical intraepithelial neoplasia,CIN) and its effect on pregnancy. Methods the medical records of 115 patients with CIN from January 2010 to January 2012 were retrospectively analyzed, including 64 cases of LEEP and 51 cases of CKC. The operative conditions, surgical complications and postoperative pathological results were compared between the two groups. The recurrence, length of cervix, pregnancy and pregnancy outcome were compared between the two groups. Results the time of operation in LEEP group (12.56 卤3.09) min, was shorter than that in CKC group (23.82 卤3.42) min (P0.05), in intraoperative hemorrhage LEEP group (9.78 卤3.77) mL, was lower than that in CKC group (26.35 卤9.26) mL (P0.05), the incidence of postoperative complications in LEEP group (7.81%) was lower than that in CKC group (31.37%) (P0.05), the consistent rate of postoperative diagnosis (87.42 vs.85.65%), the positive rate of incision margin (1.56vs.1.96%), the postoperative recurrence rate (3.13vs.1.96%) and the postoperative recurrence rate (3.13vs.1.96%) in LEEP group were lower than those in CKC group (P0.05). There was no significant difference in cervical length (1.40 卤0.24 vs.1.44 卤0.24) (P0.05). The pregnancy rate (87.50%), abortion rate (3.12%), premature rupture of membranes (7.81%), premature delivery rate (6.25%), low birth rate (10.71%) and pregnancy rate (88.24%), abortion rate (3.92%), premature rupture of membranes (3.92%), pregnancy rate (88.24%), abortion rate (3.92%), premature rupture of membranes (3.92%), premature birth rate (6.25%), low birth rate (10.71%), abortion rate (88.24%), premature rupture of membranes (3.92%), premature delivery rate (3.92%) The rate (5.88%), compared with the low birth rate of newborns (11.11%), The difference was not statistically significant (P0.05). Conclusion LEEP is superior to CKC, in terms of operation time, intraoperative bleeding and postoperative complications, but has no significant effect on recurrence, fertility and pregnancy outcome. The clinical efficacy of CIN is similar to that of CKC. Should get clinical attention and application.
【作者单位】： 西安交通大学医学部第二附属医院妇产科;
【分类号】：R737.33
[Abstract]:Objective to investigate the effect of circular electroresection (loop electrosurgical excision procedure,LEEP) and cold knife conization (cold-knife conization,CKC) in the diagnosis and treatment of cervical intraepithelial neoplasia (cervical intraepithelial neoplasia,CIN) and its effect on pregnancy. Methods the medical records of 115 patients with CIN from January 2010 to January 2012 were retrospectively analyzed, including 64 cases of LEEP and 51 cases of CKC. The operative conditions, surgical complications and postoperative pathological results were compared between the two groups. The recurrence, length of cervix, pregnancy and pregnancy outcome were compared between the two groups. Results the time of operation in LEEP group (12.56 卤3.09) min, was shorter than that in CKC group (23.82 卤3.42) min (P0.05), in intraoperative hemorrhage LEEP group (9.78 卤3.77) mL, was lower than that in CKC group (26.35 卤9.26) mL (P0.05), the incidence of postoperative complications in LEEP group (7.81%) was lower than that in CKC group (31.37%) (P0.05), the consistent rate of postoperative diagnosis (87.42 vs.85.65%), the positive rate of incision margin (1.56vs.1.96%), the postoperative recurrence rate (3.13vs.1.96%) and the postoperative recurrence rate (3.13vs.1.96%) in LEEP group were lower than those in CKC group (P0.05). There was no significant difference in cervical length (1.40 卤0.24 vs.1.44 卤0.24) (P0.05). The pregnancy rate (87.50%), abortion rate (3.12%), premature rupture of membranes (7.81%), premature delivery rate (6.25%), low birth rate (10.71%) and pregnancy rate (88.24%), abortion rate (3.92%), premature rupture of membranes (3.92%), pregnancy rate (88.24%), abortion rate (3.92%), premature rupture of membranes (3.92%), premature birth rate (6.25%), low birth rate (10.71%), abortion rate (88.24%), premature rupture of membranes (3.92%), premature delivery rate (3.92%) The rate (5.88%), compared with the low birth rate of newborns (11.11%), The difference was not statistically significant (P0.05). Conclusion LEEP is superior to CKC, in terms of operation time, intraoperative bleeding and postoperative complications, but has no significant effect on recurrence, fertility and pregnancy outcome. The clinical efficacy of CIN is similar to that of CKC. Should get clinical attention and application.
【作者单位】： 西安交通大学医学部第二附属医院妇产科;
【分类号】：R737.33
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