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目的探讨宫颈上皮内瘤变不同手术的治疗效果及TCT、HPV术后检查价值。方法选取周口市中医院2012年2月至2015年5月收治的106例拟行宫颈上皮内瘤变(CIN)手术治疗的患者为研究对象,采用随机数表法将患者分为观察组与对照组,每组53例。观察组采用宫颈环形电切术(LEEP),对照组采用宫颈冷刀锥切术(CKC),在术后6个月,对所有患者行薄层液基细胞学技术(TCT)及人乳头瘤病毒(HPV)检查。对两组手术一般指标、术后并发症发生情况及手术效果进行比较,并分析术后TCT、HPV检查价值。结果 1观察组手术时间、术中出血量及住院时间分别为(16.78±2.34)min、(15.06±4.04)ml、(4.68±1.25)d,与对照组比较显著较低,差异有统计学意义(P<0.05);2术后两组伤口感染及出血发生率比较无统计学意义(P>0.05),观察组宫颈管粘连发生率为3.77%,与对照组的15.09%比较显著较低,差异有统计学意义(P<0.05);3两组手术治愈率、残留率及复发率均无统计学意义(P>0.05);4术后6个月,TCT检查准确性、特异性、阳性预测值及阴性预测值分别为60.24%、75.44%、70.36%、71.07%,HPV检查准确性、特异性、阳性预测值及阴性预测值分别为72.56%、72.31%、65.23%、64.33%。结论 LEEP治疗宫颈上皮内瘤变疗效显著,并且可缩短手术时间,减少术中出血量,患者住院时间也较短,术后并发症发生率更低。同时在术后对患者行TCT及HPV检查,有助于判断患者术后病变残存和复发情况,具有较高的临床价值。
Objective To investigate the therapeutic effect of different operations on cervical intraepithelial neoplasia and the value of postoperative examination of TCT and HPV. Methods 106 cases of cervical intraepithelial neoplasia (CIN) surgically treated in Zhoukou Hospital of Traditional Chinese Medicine from February 2012 to May 2015 were selected as the research subjects. The patients were divided into observation group and control group by random number table method Group, 53 cases in each group. The patients in the observation group were treated with cervical ring electrosurgical excision (LEEP) and the control group with cervical cold knife conization (CKC). Six months after operation, all patients were treated with thin layer liquid-based cytology (TCT) and human papilloma Virus (HPV) examination. The two groups of general indicators of surgery, postoperative complications and surgical results were compared, and analysis of postoperative TCT, HPV test value. Results The operation time, intraoperative blood loss and hospital stay in the observation group were (16.78 ± 2.34) min, (15.06 ± 4.04) ml and (4.68 ± 1.25) d, respectively, which were significantly lower than those in the control group (P0.05) .There was no significant difference in the incidence of wound infection and bleeding among the two groups after operation (P> 0.05). The incidence of cervical adhesions in the observation group was 3.77%, which was significantly lower than that in the control group (15.09% The difference was statistically significant (P <0.05); 3 The cure rate, residual rate and recurrence rate of the two groups were not statistically significant (P> 0.05); 4 after 6 months, TCT examination accuracy, specificity, positive The predictive value and negative predictive value were 60.24%, 75.44%, 70.36%, 71.07% respectively. The accuracy, specificity, positive predictive value and negative predictive value of HPV testing were 72.56%, 72.31%, 65.23% and 64.33%, respectively. Conclusions The treatment of cervical intraepithelial neoplasia with LEEP has significant curative effect, and can shorten the operation time, reduce the intraoperative blood loss, hospitalization time is shorter, and the incidence of postoperative complications is lower. At the same time in patients with postoperative TCT and HPV testing, help determine the patient residual disease and recurrence, with high clinical value.