中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
1期
44-46
,共3页
盖俊峰%陈晓军%寇明捷%杨磊
蓋俊峰%陳曉軍%寇明捷%楊磊
개준봉%진효군%구명첩%양뢰
液基薄层细胞学检查%不典型鳞状上皮细胞%宫颈疾病%阴道镜检查%乳头状瘤病毒感染
液基薄層細胞學檢查%不典型鱗狀上皮細胞%宮頸疾病%陰道鏡檢查%乳頭狀瘤病毒感染
액기박층세포학검사%불전형린상상피세포%궁경질병%음도경검사%유두상류병독감염
ThinPrep cytology%Atypical Squamous cell of undertermind significant%Cervix diseases%Colposcopy%Papillomavirus infections
目的 探讨中老年患者性质不明不典型鳞状上皮细胞(ASCUS)及ASCUS以上宫颈病变的临床处理方法.方法 根据临床对中老年患者ASCUS宫颈病变不同处理方法分组,观察1组(348例)行阴道镜检查；观察2组(316例)行高危型人乳头瘤病毒(HPV)检测,HPV阳性行阴道镜检查；观察3组(129例)定期宫颈细胞学复检,鳞状上皮内病变行阴道镜检查,比较三组临床处理情况.结果 三组574例患者同时行液基薄层细胞学检查(TCT)及阴道镜宫颈活检病理检查,结果上皮内瘤变(CIN)以上宫颈病变223例(38.9%),其中CIN Ⅰ 136例(23.7%)、CINⅡ64例(11.2%)、CINⅢ20例(3.5%)、原位癌3例(0.5%)；观察1组348例中,行阴道镜检查348例(100.0%),活检CINⅡ以上的患者36例(10.3%)；观察2组转阴道镜检查213例(67.4%),活检CINⅡ以上的患者38例(12.0%)；观察3组转阴道镜检查13例(10.1%),活检CINⅡ以上的患者3例(2.3%).活检CINⅡ以上检出率,观察1组、观察2组差异无统计学意义(P＞0.05),与观察3组比较差异均有统计学意义(x2 =7.014、9.156,均P＜0.05).结论 高危型HPV检测分流ASCUS,可减少宫颈病变处理过程中误诊、漏诊及过度治疗的问题.
目的 探討中老年患者性質不明不典型鱗狀上皮細胞(ASCUS)及ASCUS以上宮頸病變的臨床處理方法.方法 根據臨床對中老年患者ASCUS宮頸病變不同處理方法分組,觀察1組(348例)行陰道鏡檢查；觀察2組(316例)行高危型人乳頭瘤病毒(HPV)檢測,HPV暘性行陰道鏡檢查；觀察3組(129例)定期宮頸細胞學複檢,鱗狀上皮內病變行陰道鏡檢查,比較三組臨床處理情況.結果 三組574例患者同時行液基薄層細胞學檢查(TCT)及陰道鏡宮頸活檢病理檢查,結果上皮內瘤變(CIN)以上宮頸病變223例(38.9%),其中CIN Ⅰ 136例(23.7%)、CINⅡ64例(11.2%)、CINⅢ20例(3.5%)、原位癌3例(0.5%)；觀察1組348例中,行陰道鏡檢查348例(100.0%),活檢CINⅡ以上的患者36例(10.3%)；觀察2組轉陰道鏡檢查213例(67.4%),活檢CINⅡ以上的患者38例(12.0%)；觀察3組轉陰道鏡檢查13例(10.1%),活檢CINⅡ以上的患者3例(2.3%).活檢CINⅡ以上檢齣率,觀察1組、觀察2組差異無統計學意義(P＞0.05),與觀察3組比較差異均有統計學意義(x2 =7.014、9.156,均P＜0.05).結論 高危型HPV檢測分流ASCUS,可減少宮頸病變處理過程中誤診、漏診及過度治療的問題.
목적 탐토중노년환자성질불명불전형린상상피세포(ASCUS)급ASCUS이상궁경병변적림상처리방법.방법 근거림상대중노년환자ASCUS궁경병변불동처리방법분조,관찰1조(348례)행음도경검사；관찰2조(316례)행고위형인유두류병독(HPV)검측,HPV양성행음도경검사；관찰3조(129례)정기궁경세포학복검,린상상피내병변행음도경검사,비교삼조림상처리정황.결과 삼조574례환자동시행액기박층세포학검사(TCT)급음도경궁경활검병리검사,결과상피내류변(CIN)이상궁경병변223례(38.9%),기중CIN Ⅰ 136례(23.7%)、CINⅡ64례(11.2%)、CINⅢ20례(3.5%)、원위암3례(0.5%)；관찰1조348례중,행음도경검사348례(100.0%),활검CINⅡ이상적환자36례(10.3%)；관찰2조전음도경검사213례(67.4%),활검CINⅡ이상적환자38례(12.0%)；관찰3조전음도경검사13례(10.1%),활검CINⅡ이상적환자3례(2.3%).활검CINⅡ이상검출솔,관찰1조、관찰2조차이무통계학의의(P＞0.05),여관찰3조비교차이균유통계학의의(x2 =7.014、9.156,균P＜0.05).결론 고위형HPV검측분류ASCUS,가감소궁경병변처리과정중오진、루진급과도치료적문제.
Objective To study the clinical treatment methods for properties of unknown in elderly patients with atypical squamous cell of undertermind significant and above cervical lesions.Methods According to the clinical grouping of ASCUS in elderly patients with cervical lesions of different treatment methods,observation group 1 (348 cases) underwent colposcopy;observation group 2(316 cases) for high-risk human papillomavirus(HPV) detection,HPV positive colposcopy ;observation group 3 (129 cases) of cervical cytology examination regularly,squamous intraepithelial lesion colposcopy,compared three groups of clinical treatment.Results Liquid based cytology and three groups of 574 patients (TCT) and colposcopy and cervical biopsy,the results of intraepithelial neoplasia(C IN) above cervical lesions in 223 cases(38.9%),in which CIN Ⅰ 136 cases(23.7%),CIN Ⅱ in 64 cases(11.2%),CIN Ⅲ 20 cases(3.5%),3 cases of carcinoma in situ(0.5%) ;the group1 were observed in 348 cases,348 cases underwent colposcopy biopsy(100%),CIN Ⅱ above 36 cases(10.3%) were observed in the group 2;213 cases of colposcopy biopsy(67.4%),CIN Ⅱ above 38 cases (12%) were observed in the group 3 ; colposcopy examination in 13 cases (10.1%),3 cases of biopsy CIN Ⅱ of the cases(2.3%).Biopsy of CIN Ⅱ above the detection rate,the observation group 1,observation of the 2 groups had no significant differences(P ＞ 0.05),and observe the difference between the 3 groups was statistically significant(x2 =7.014,9.156,all P ＜ 0.05).Conclusion High-risk HPV detection of shunt ASCUS can reduce cervical lesions treatment process misdiagnosis,missed diagnosis and treatment of the problem of excessive.
