128例湿热型宫颈上皮内瘤变手术患者临床相关问题探讨

发布时间：2018-02-02 11:52

本文关键词： 宫颈上皮内瘤变人乳头瘤病毒冷刀锥切术湿热证　出处：《南京中医药大学学报》2017年03期 　论文类型：期刊论文

【摘要】：目的通过对128例湿热型宫颈上皮内瘤变(CIN)手术患者临床资料的回顾性分析,探讨该病湿热型患者的发病因素、诊治策略以及预防措施。方法收集2007年1月至2016年7月128例湿热型CIN住院手术患者的临床资料,采用统一表格记录,对患者症状、体征、检测指标、手术方式、病理结果及发病相关因素等进行统计分析。结果本病证患者好发年龄在30~50岁之间,临床以带下异常、性交出血、月经失调症状为主,占75.0%;中医辨证以湿热证型为主,多兼夹肾虚、脾虚、肝郁及瘀血证;宫颈检查以肥大合并糜烂者多见,占77.3%,外观无异常者占10.2%;人乳头瘤病毒(HPV)阳性者中以16/18型多见,定量值的大小与病变轻重程度无明显相关性;手术前后病理结果一致者占50.8%,病变程度上升者占29.7%,下降者占19.5%,术后原位癌或早浸癌的发现率较术前上升了5.4%。结论湿热型CIN有一定的临床特殊性,其发病与患者过早性生活、多个性伴侣、宫颈阴道慢性炎症等因素致免疫功能下降后HPV感染相关;宫颈冷刀锥切术在避免本病误诊、漏诊、术后大出血及避免其他手术热电效应干扰病理诊断等方面具有优势。正确认识本病的特殊性、选择恰当的手术方式局部和整体治疗、预防复发至关重要。
[Abstract]:Objective: through the 128 cases of damp heat type of cervical intraepithelial neoplasia (CIN) were retrospectively analyzed the clinical data of surgical patients and explore the pathogenesis of the disease in patients with type of damp heat, treatment strategies and preventive measures. Methods clinical data of 128 cases of damp heat type CIN in hospitalized patients from January 2007 to July 2016, the records of patients. The symptoms, signs, indexes, surgical methods, pathological findings and related factors were analyzed. Results the patients of primary aged between 30~50 years old, with clinical sexual intercourse bleeding, abnormal vaginal discharge, irregular menstruation symptoms, accounted for 75%; TCM syndrome of damp heat type, and clip kidney deficiency, spleen deficiency liver, and blood stasis; check to cervical hypertrophy with erosion were found, accounting for 77.3%, no abnormal appearance accounted for 10.2%; human papilloma virus (HPV) infected with 16/18 type, size and lesion quantitative value of light There was no significant correlation between the severity of preoperative and postoperative pathological results; accounted for 50.8%, increased the extent of lesion accounted for 29.7%, accounted for 19.5% decline, after resection of carcinoma in situ or early invasive carcinoma detection rate higher than before surgery 5.4%. conclusion of damp heat type CIN has clinical specificity, the incidence of patients with premature sexual life, many sexual partners, decreased immune function caused by chronic inflammation of cervical HPV infection; cervical cold knife conization in avoiding misdiagnosis, missed diagnosis, postoperative bleeding and avoid the advantages of other surgical pathological diagnosis. The thermoelectric effect of interference to correctly understand the special nature of this disease, selection of local and overall treatment the appropriate surgical approach, relapse prevention is very important.

【作者单位】：南京中医药大学附属医院;
【基金】：江苏省中医药领军人才研修项目(LJ200910) 吴阶平医学基金宫颈癌研究项目(320.6750.15015)
【分类号】：R737.33
【正文快照】： 宫颈癌是目前妇科临床三大恶性肿瘤之一,严重危害妇女的身心健康,宫颈上皮内瘤变(CIN)是宫颈癌前病变。据报道,宫颈CINⅡ~Ⅲ级未经治疗,2/3患者则可能发展为宫颈原位癌,甚或浸润癌[1]。为了寻找宫颈CIN的发病因素,研究早期正确诊治的策略,选择恰当的手术方案和预防术后复发的

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