中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
43期
3031-3034
,共4页
孙璐璐%曹冬焱%卞美璐%魏丽惠%杨佳欣%杨丽%成宁海%王有芳%程雪梅%虎丽军%郎景和%沈铿
孫璐璐%曹鼕焱%卞美璐%魏麗惠%楊佳訢%楊麗%成寧海%王有芳%程雪梅%虎麗軍%郎景和%瀋鏗
손로로%조동염%변미로%위려혜%양가흔%양려%성저해%왕유방%정설매%호려군%랑경화%침갱
宫颈上皮内瘤变%Ⅱ级%电外科手术%激光%汽化
宮頸上皮內瘤變%Ⅱ級%電外科手術%激光%汽化
궁경상피내류변%Ⅱ급%전외과수술%격광%기화
Cervical intraepithelial neoplasia%Grade Ⅱ%Electrosurgery%Laser%Vaporization
目的 多中心研究评价子宫颈环形电切术(LEEP)与CO2激光汽化治疗宫颈上皮内瘤样病变Ⅱ级(CINⅡ)的疗效及并发症.方法 对因宫颈脱落细胞学异常行阴道镜检查及宫颈活检病理证实为CINⅡ患者338例,分别采用LEEP术(195例)和CO2激光汽化治疗(143例),术后进行3、6及12个月随访,比较治疗效果.结果 LEEP组195例患者,治愈174例(89.2%)、病变持续8例(4.1%)、复发7例(3.6%),激光组143例患者,治愈124例(86.7%)、病变持续7例(4.9%)、复发1例(0.70%),两组比较差异均无统计学意义(均P＞0.05).LEEP组在痊愈时间、手术次数、术中出血量与激光组比较差异有统计学意义(P＜0.05).结论 LEEP与CO2激光汽化治疗CINⅡ都是安全有效的方法,但LEEP可获得宫颈组织标本进行病理检查.治疗前疾病状态的准确评估及术后规范随访在治疗中有重要作用.
目的 多中心研究評價子宮頸環形電切術(LEEP)與CO2激光汽化治療宮頸上皮內瘤樣病變Ⅱ級(CINⅡ)的療效及併髮癥.方法 對因宮頸脫落細胞學異常行陰道鏡檢查及宮頸活檢病理證實為CINⅡ患者338例,分彆採用LEEP術(195例)和CO2激光汽化治療(143例),術後進行3、6及12箇月隨訪,比較治療效果.結果 LEEP組195例患者,治愈174例(89.2%)、病變持續8例(4.1%)、複髮7例(3.6%),激光組143例患者,治愈124例(86.7%)、病變持續7例(4.9%)、複髮1例(0.70%),兩組比較差異均無統計學意義(均P＞0.05).LEEP組在痊愈時間、手術次數、術中齣血量與激光組比較差異有統計學意義(P＜0.05).結論 LEEP與CO2激光汽化治療CINⅡ都是安全有效的方法,但LEEP可穫得宮頸組織標本進行病理檢查.治療前疾病狀態的準確評估及術後規範隨訪在治療中有重要作用.
목적 다중심연구평개자궁경배형전절술(LEEP)여CO2격광기화치료궁경상피내류양병변Ⅱ급(CINⅡ)적료효급병발증.방법 대인궁경탈락세포학이상행음도경검사급궁경활검병리증실위CINⅡ환자338례,분별채용LEEP술(195례)화CO2격광기화치료(143례),술후진행3、6급12개월수방,비교치료효과.결과 LEEP조195례환자,치유174례(89.2%)、병변지속8례(4.1%)、복발7례(3.6%),격광조143례환자,치유124례(86.7%)、병변지속7례(4.9%)、복발1례(0.70%),량조비교차이균무통계학의의(균P＞0.05).LEEP조재전유시간、수술차수、술중출혈량여격광조비교차이유통계학의의(P＜0.05).결론 LEEP여CO2격광기화치료CINⅡ도시안전유효적방법,단LEEP가획득궁경조직표본진행병리검사.치료전질병상태적준학평고급술후규범수방재치료중유중요작용.
Objective To compare the effect and complications of loop electro-surgical excision procedure (LEEP) and laser CO2 vaporization in the treatment of cervical intraepithelial neoplasia Ⅱ.Methods A total of 338 CIN Ⅱ women were recruited into this multi-center comparative study. The diagnosis was confirmed by histopathological examination for cervical epithelial cell abnormalities. And colposcopic examination was submitted to LEEP( n = 195 ) or laser CO2 vaporization( n = 143 ) respectively. A post-treatment follow-up of 3, 6 and 12 months was carried out to compare the effect of two methods. Results Among 195 women undergoing LEEP, the frequency of cure, persistent and recurrent CIN was 89. 2% (n =174), 4. 1% ( n = 8 ) and 3. 6% ( n = 7 ) respectively. And among 143 women receiving laser CO2 vaporization, the frequency of cure, persistent and recurrent CIN was 86. 7% ( n = 124), 4. 9% ( n = 7 )and 0. 70% (n = 1 ) respectively. There was no statistical difference in cure rates, persistence or recurrence of CIN (P ＞ 0. 05 ). The recovery time, the operative frequency and intra-operative blood loss were significantly different in two groups. Conclusion Both LEEP and CO2 vaporization are both effective and reliable for the treatment of cervical intraepithelial neoplasia Ⅱ. However, pathological specimens may be harvested during LEEP. It is of vital importance to conduct preoperative colposcopic assessment and standard postoperative follow-ups.
