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目的:评价宫颈锥切术在CIN诊断与治疗中的应用价值。方法:分析159例宫颈锥切术患者资料及随访结果。结果:LEEP锥切术138例,冷刀锥切术21例,两者在手术时间、术中出血上差异有统计学意义(P<0.01);脱痂期出血多5例,LEEP术后4例,冷刀锥切术后1例,占3.14%;术后病理降级69例(43.40%),等级者76例(47.80%),升级者14例(8.80%,包括2例宫颈浸润癌);术后3个月冷刀锥切组与LEEP锥切组宫颈光滑分别为17例(80.95%)和135例(97.82%),两者之间差异有统计学意义(P<0.05);术后3个月及半年各细胞学随访1次,复发3例,治愈率98.11%,无感染、宫颈粘连及狭窄发生。结论:正确掌握宫颈锥切术的指征与方法可以避免CIN的漏诊,提高治疗的成功率。
Objective: To evaluate the value of cervical conization in the diagnosis and treatment of CIN. Methods: 159 cases of cervical conization patients and follow-up results. Results: There were 138 cases of LEEP conization and 21 cases of cold knife conization, both of them had significant difference in operation time and intraoperative bleeding (P <0.01), 5 cases of extracapsular bleeding, 4 cases of LEEP One case after cold knife conization, accounting for 3.14%; 69 cases (43.40%) were pathologically degraded, 76 cases (47.80%) were grade, 14 cases were upgraded (8.80%, including 2 cases of invasive cervical cancer) (P <0.05). There were 17 cases (80.95%) and 135 cases (97.82%) of smooth cervical conization group and LEEP conization group at 3 months after operation, respectively After three months and six months of each cytology follow-up 1, 3 cases of recurrence, the cure rate was 98.11%, no infection, cervical adhesions and stenosis occurred. Conclusion: Correct understanding of the indications and methods of cervical conization can avoid the missed diagnosis of CIN and improve the success rate of treatment.