中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2010年
8期
1019-1021
,共3页
电外科手术/方法%子宫颈/外科学%宫颈疾病/外科学
電外科手術/方法%子宮頸/外科學%宮頸疾病/外科學
전외과수술/방법%자궁경/외과학%궁경질병/외과학
Electrosurgery/MT%Cervix uteri/SU%Uterine cervical diseases/SU
目的 探讨改良式宫颈电环切除术在治疗宫颈病变的疗效.方法 将本院70例宫颈上皮内瘤变及宫颈原位癌患者按不同手术式分研究组采用改良式宫颈电环切除术治疗21例,其中CIN Ⅰ 4例、CJN Ⅱ 10例、CIN Ⅲ 4例、CIS 3例,对照组行宫颈电环切除术治疗49例,其中CIN Ⅰ7例、CIN Ⅱ 21例、CIN Ⅲ 16例、CIS 5例.观察2组患者手术时间、术中出血量、术后出血天数、锥体面积与出血量的关系.结果 研究组术中出血量[(16.57±17.47)ml],手术时间[(9.07±3.34)min],术后出血时间[(9.10±2.23)d]均低于对照组[(39.80±37.43)ml、(12.19±5.34)min、(10.49±2.76)d],其差异均有统计学意义(P<0.05);宫颈锥体体积[(14.70±13.35)mm3]与术中出血量[(32.83±14.32)ml]对数资料转为正态资料,呈正相关(r=0.430,P<0.05).两组疗效及预后比较差异均无统计学意义(P>0.05).结论 宫颈锥体体积与术中出血量有一定关系,对于锥切面积大、血运丰富,术前估计手术过程中出血多的患者,术前在宫颈3点和9点缝扎子宫动脉下行支可减少术中、后出血,从而缩短减少手术时间.
目的 探討改良式宮頸電環切除術在治療宮頸病變的療效.方法 將本院70例宮頸上皮內瘤變及宮頸原位癌患者按不同手術式分研究組採用改良式宮頸電環切除術治療21例,其中CIN Ⅰ 4例、CJN Ⅱ 10例、CIN Ⅲ 4例、CIS 3例,對照組行宮頸電環切除術治療49例,其中CIN Ⅰ7例、CIN Ⅱ 21例、CIN Ⅲ 16例、CIS 5例.觀察2組患者手術時間、術中齣血量、術後齣血天數、錐體麵積與齣血量的關繫.結果 研究組術中齣血量[(16.57±17.47)ml],手術時間[(9.07±3.34)min],術後齣血時間[(9.10±2.23)d]均低于對照組[(39.80±37.43)ml、(12.19±5.34)min、(10.49±2.76)d],其差異均有統計學意義(P<0.05);宮頸錐體體積[(14.70±13.35)mm3]與術中齣血量[(32.83±14.32)ml]對數資料轉為正態資料,呈正相關(r=0.430,P<0.05).兩組療效及預後比較差異均無統計學意義(P>0.05).結論 宮頸錐體體積與術中齣血量有一定關繫,對于錐切麵積大、血運豐富,術前估計手術過程中齣血多的患者,術前在宮頸3點和9點縫扎子宮動脈下行支可減少術中、後齣血,從而縮短減少手術時間.
목적 탐토개량식궁경전배절제술재치료궁경병변적료효.방법 장본원70례궁경상피내류변급궁경원위암환자안불동수술식분연구조채용개량식궁경전배절제술치료21례,기중CIN Ⅰ 4례、CJN Ⅱ 10례、CIN Ⅲ 4례、CIS 3례,대조조행궁경전배절제술치료49례,기중CIN Ⅰ7례、CIN Ⅱ 21례、CIN Ⅲ 16례、CIS 5례.관찰2조환자수술시간、술중출혈량、술후출혈천수、추체면적여출혈량적관계.결과 연구조술중출혈량[(16.57±17.47)ml],수술시간[(9.07±3.34)min],술후출혈시간[(9.10±2.23)d]균저우대조조[(39.80±37.43)ml、(12.19±5.34)min、(10.49±2.76)d],기차이균유통계학의의(P<0.05);궁경추체체적[(14.70±13.35)mm3]여술중출혈량[(32.83±14.32)ml]대수자료전위정태자료,정정상관(r=0.430,P<0.05).량조료효급예후비교차이균무통계학의의(P>0.05).결론 궁경추체체적여술중출혈량유일정관계,대우추절면적대、혈운봉부,술전고계수술과정중출혈다적환자,술전재궁경3점화9점봉찰자궁동맥하행지가감소술중、후출혈,종이축단감소수술시간.
Objective To study the effect of using improved loop electrosurgical excision procedure for diagnosis and treatment of cervical diseases. Methods The clinical data of 70 cases of cervical intraepithelial neoplasia or carcinoma in situ from January 2006 to Decemder 2008 in our hospital was collected.The operation time, the mean volume of blooding, days of blooding, relationship between the mean blood and areas of pyramid area of pyramid was compared between study group and control group. Improved loop electrosurgical excision procedure was executed on 21 cases of study group ( CIN Ⅰ 4 cases, CIN Ⅱ 10 cases,CIN Ⅲ4 cases, CIS3 cases ) and loop electrosurgical excision procedure was used on 49 cases in control group (CIN Ⅰ7 cases,CIN Ⅱ21 cases, CIN Ⅲ 16 cases, CIS5 cases). Results Blood loss [(16.57 ±17. 47 ) ml], operative time [( 9.07 ± 3.34 ) min] and postoperative bleeding time [(9.10 ± 2.23) d] in study group were lower than that in control group [( 39.80 ± 37.43 ) ml, ( 12. 19 ± 5.34 ) min, ( 10. 49 ±2. 76)d], and the differences were statistically significant ( P < 0. 05 ). Cervical cone volume [( 14. 70 ±13. 35 ) mm3] and blood loss [(32. 83 ± 14. 32 ) ml] were positively correlated ( r = 0. 430, P < 0. 05 ). No significant difference between prognosis of two groups was found( P >0. 05 ). Conclusion There was positive relationship between the averge blood loss in surgery and areas of pyramid excision. It'd be better to stitch the ramus descendents of uterine artery at three and nine o'clock of the cervix uteri, when the patients were expected to have large pyramid areas and abundant blood flow who may bleed more than normal. which can reduce the blood loss after surgery and reduce the time of surgery.
