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高频电波刀用于子宫颈病变诊断与治疗的临床观察 |
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卞美璐 刘晓华 孙蔼萍 冷冰
【摘要】 目的 总结应用高频电波刀的电圈切除术(LEEP)对宫颈病变诊治的指征、病灶切除范围和病理特点。方法 将细胞学和阴道镜检查异常［宫颈上皮内瘤样变（CIN）、不典型鳞状细胞（ASCUS）］的176例患者，分成两部分。对≥CIN2行锥切术，采用LEEP 33例、传统电刀30例；对CIN1和ASCUS行活检术，采用LEEP 60例、宫颈活检钳53例。LEEP锥切宫颈管组织深15 mm，宫颈组织深7 mm；活检术切除宫颈、宫颈管组织各深4 mm。 结果 LEEP锥切术后3个月行细胞学检查，病变持续存在率6.1%，与传统电刀的6.7%相似；手术时间(5.0±0.5) min，较传统电刀(15.0±0.4) min短；术中出血与宫颈修复时间均短于传统电刀(P<0.01)。LEEP活检术后3个月行细胞学检查，病变持续存在率1.7%，明显少于宫颈活检钳法（35.8%）。其他手术情况相似。 结论 LEEP适用于宫颈CIN2，3的锥切术和宫颈CIN1、ASCUS的活检术，省时、安全，可提供完整的病理标本，对宫颈微小浸润癌和小局灶癌的诊断率高。
【关键词】 电外科手术； 宫颈上皮内瘤样病变
Application of High Frequency Radiosurgical Knife in the Treatment of Cervical Diseases
BIAN Meilu*, LIU Xiaohua, SUN Aiping*, et al.
*Department of Obtestrics and Gynecology, China Japan Friendship Hospital, Beijing 100029, China
【Abstract】 Objective To investigate the indication,resection scope of loop electrosurgical excision procedure (LEEP) and pathological characteristics. Methods 176 cases with abnormal cytological and colposcopical findings, including cervical intraepithelial neoplasia (CIN) and atypical squamous cells of undermined significance (ASCUS), were studied. Conization of cervix was performed in 63 cases of≥CIN2, of which 33 cases with LEEP and 30 by traditional electrosurgical knife (TEK) as controls. Cervical biopsy was performed in 113 cases of CIN1 and ASCUS, of which 60 cases by LEEP and 53 by cervical biopsy forceps (CBF) as controls. Results Three months after conization of cervix the cytological persistent rate of disease was 6.1% in LEEP group and 6.7% in TEK group (P>0.05). The operation duration of LEEP is (5.0±0.5) min, and is much shorter than TEK ［(15.0±0.4) min］. The bleeding and recovery time of the cervix are also shorter (P<0.01). Three months after cervical biopsy the cytological persistent rate of diseases was only 1.7% in LEEP group, significantly less than that in CBF group (35.8%). Conclusion LEE[1] [2] 下一页
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