CAJ | 학술논문

目的：评价冷刀锥切术治疗宫颈上皮内瘤变（ CIN）Ⅲ级的有效性及其改善患者生存质量的作用。方法纳入2009年1月至2011年6月在建德市第一人民医院妇产科住院的宫颈上皮内瘤变Ⅲ级患者56例，行冷刀锥切术，观察手术时间、术中出血量、并发症及住院时间等；随访2年，进行生存质量量表SF-36评分，并加以分析。结果手术平均时间为37．10±19．63min，平均住院时间5．10±2．13天，平均出血量为34．77±15．30mL；手术治愈率为94．64％（53/56），复发率为5．36％（3/56）。术中出现1例大量出血，手术后并发出血6例。术后即刻生存质量较术前无差异（均P＞0．05）；远期（2年）生存质量较术前提高，差异有统计学意义（ t值为-3．292～-2．028，均P＜0．05）。结论对有宫颈锥切指征的患者，严格按照指征以宫颈锥切来明确诊断，可以提高宫颈癌的早期诊断率，及时发现早期病变并予以阻断，从而提高患者的生存率和远期生存质量。
목적：평개냉도추절술치료궁경상피내류변（ CIN）Ⅲ급적유효성급기개선환자생존질량적작용。방법납입2009년1월지2011년6월재건덕시제일인민의원부산과주원적궁경상피내류변Ⅲ급환자56례，행냉도추절술，관찰수술시간、술중출혈량、병발증급주원시간등；수방2년，진행생존질량량표SF-36평분，병가이분석。결과수술평균시간위37．10±19．63min，평균주원시간5．10±2．13천，평균출혈량위34．77±15．30mL；수술치유솔위94．64％（53/56），복발솔위5．36％（3/56）。술중출현1례대량출혈，수술후병발출혈6례。술후즉각생존질량교술전무차이（균P＞0．05）；원기（2년）생존질량교술전제고，차이유통계학의의（ t치위-3．292～-2．028，균P＜0．05）。결론대유궁경추절지정적환자，엄격안조지정이궁경추절래명학진단，가이제고궁경암적조기진단솔，급시발현조기병변병여이조단，종이제고환자적생존솔화원기생존질량。
Objective To evaluate the effect of cold knife conization ( CKC) in treating cervical intraepithelial neoplasia III ( CIN III) and how it improves patients ’ quality of life ( QOL) .Methods Totally 56 CINⅢcases hospitalized in department of obstetrics and gynecology of First People ’ s Hospital of Jiande City from January 2009 to June 2011 were treated with CKC .Operation time , blood loss during operation, complication and length of stay were observed .After two-year follow-up visit, QOL Scale SF-36 was used to evaluate life quality.Results The average operation time was 37.10 ±19.63 min, average hospital stay was 5.10 ±2.13 d and average blood loss was 34.77 ±15.3mL, respectively.The cure rate of CKC was 94.64% (53/56), and recurrence rate was 5.36% (3/56).There was one case with excessive bleeding during operation and 6 cases complicated with bleeding after operation .QOL immediately after operation was not different from that before operation (P>0.05), but the long-term QOL (two years after operation) was significantly higher (t value ranged -3.292--2.028, both P<0.05).Conclusion For patients with indication of CKC , we should clarity a clear diagnose in strict accordance with the indication of CKC .Thus early diagnosis rate of cervical cancer can be improved , and early pathological changes can be found timely and blocked .Therefore patients ’ survival rate and long-term life quality can be improved .