CAJ | 학술논문

目的：探讨宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN）行宫颈环状电切术（loop electrosur-gical excision procedure,LEEP）治愈率、持续存在率及复发率是否与民族差异有关.方法：对通辽市及周边乡镇不同民族（蒙古族及汉族）妇女进行宫颈脱落细胞的液基细胞学检查（thin-prep cytologic test,TCT）,结果回报非良性反应性改变者行阴道镜下定位活检,病理回报为CIN而行LEEP术的347例患者（蒙古族164例,汉族183例）进行随访,分析术后的病变治愈、持续存在及复发情况.结果：（1）LEEP术后总治愈率汉族高于蒙古族（.2）术后总持续存在率蒙古族及汉族均有下降趋势,残留的病灶为CINⅡ或以下更低级别的病变（.3）术后总的复发率蒙古族及汉族均呈上升趋势,且术后1年二者总复发率比较,无统计学差异（P〉0.05）.术后3、5年二者总复发率比较,蒙古族高于汉族,具有统计学差异（P〈0.05）（.4）病变持续存在或复发的患者多数合并人乳头瘤病毒（（human papilloma virus,HPV）感染.结论：（1）民族的差异可能导致CIN患者LEEP术后复发率的不同（.2）LEEP是治疗CIN的安全、有效方法,且术后保持随访能及时发现并治疗残留或复发的CIN（.3）LEEP治疗后患者是否感染HPV可能是病变持续存在和复发高危因素.
목적：탐토궁경상피내류변（cervical intraepithelial neoplasia,CIN）행궁경배상전절술（loop electrosur-gical excision procedure,LEEP）치유솔、지속존재솔급복발솔시부여민족차이유관.방법：대통료시급주변향진불동민족（몽고족급한족）부녀진행궁경탈락세포적액기세포학검사（thin-prep cytologic test,TCT）,결과회보비량성반응성개변자행음도경하정위활검,병리회보위CIN이행LEEP술적347례환자（몽고족164례,한족183례）진행수방,분석술후적병변치유、지속존재급복발정황.결과：（1）LEEP술후총치유솔한족고우몽고족（.2）술후총지속존재솔몽고족급한족균유하강추세,잔류적병조위CINⅡ혹이하경저급별적병변（.3）술후총적복발솔몽고족급한족균정상승추세,차술후1년이자총복발솔비교,무통계학차이（P〉0.05）.술후3、5년이자총복발솔비교,몽고족고우한족,구유통계학차이（P〈0.05）（.4）병변지속존재혹복발적환자다수합병인유두류병독（（human papilloma virus,HPV）감염.결론：（1）민족적차이가능도치CIN환자LEEP술후복발솔적불동（.2）LEEP시치료CIN적안전、유효방법,차술후보지수방능급시발현병치료잔류혹복발적CIN（.3）LEEP치료후환자시부감염HPV가능시병변지속존재화복발고위인소.
Objective: To investigate wheter the cure rate,persistence rate and recurrence rate of cervical intraepithelia neoplasia(CIN)relate to the national differences after loop electrosurgical excision procedure(LEEP).Methods: 347 patients(164 Mongolian cases,183 Han cases)with CIN diagnosed by vaginoscope biopsy underwent LEEP operation and were followed up,the cure,persistence and recurrence situation after LEEP were analyzed.Results:(1)The total postoperative cure rate of Han patients was higher than that of Mongolian patients.(2)The total postoperative persistence rate of both nationalities was on the decline,the residual pathological changes were CIN II or even lower.(3)The total postoperative recurrence rate of both nationalities was on the rise,no statistical difference(P0.05)comparing the recurrence rate 1 year later after LEEP.The total postoperative recurrence rate of Mongolian patients is higher than that of Han patients after 3 years and 5 years,with statistical difference(P0.05).(4)Most of the cases of persistence and recurrence are infected with human papilloma virus(HPV).Conclusion:(1)The national difference may cause the differences of the recurrence rate of CIN after LEEP.(2)LEEP treatment is a safe and effective method to cure CIN,and the follow up survey can screen and treat the residual pathological changes and recurrence of CIN.(3)Whether the patients infect with HPV may be a high risk factor for the persistence and recurrence of CIN after LEEP.