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目的比较宫颈环形电切术(LEEP)与宫颈冷刀锥切术(CKC)治疗宫颈上皮内瘤变(CIN)患者的近期疗效,分析术后复发相关因素。方法选取2013年10月-2015年10月甘肃省小陇山林业实验局职工医院142例CIN患者,应用随机数字表分为观察组与对照组,每组71例。对照组患者采用CKC术式,观察组患者采用LEEP术式。比较两组患者的手术情况、锥切组织大小、并发症发生率、临床疗效,分析观察组疾病复发相关因素。结果观察组患者的手术时间、术中失血量、手术费用及住院时间均少于对照组,差异均有统计学意义(均P<0.05)。观察组患者的锥切面积及锥高均小于对照组,差异均有统计学意义(均P<0.05)。观察组患者并发症发生率(8.46%)低于对照组(21.13%),差异有统计学意义(P<0.05)。观察组与对照组患者痊愈率分别为88.73%(63例)和90.14%(64例),两组比较差异无统计学意义(P>0.05)。年龄>40岁、颈管累及、术后液基薄层细胞学检测(TCT)阳性均与术后疾病复发有一定相关性(P<0.05),CIN分级及腺体累及与术后疾病复发无明显相关性(P>0.05)。结论 LEEP治疗CIN的效果显著,可减少手术时间、术中失血量、手术费用及住院时间,并发症发生率与疾病复发率较低;年龄>40岁、颈管累及、术后TCT阳性均与术后疾病复发有一定相关性。
Objective To compare the short-term curative effect of cervical ring excision (LEEP) and cervical cold knife conization (CKC) in patients with cervical intraepithelial neoplasia (CIN) and analyze the related factors of postoperative recurrence. Methods From October 2013 to October 2015, 142 patients with CIN in Xiaolongshan Forestry Experimental Station Gansu Province were randomly divided into observation group and control group with 71 cases in each group. Patients in the control group were treated with CKC, and patients in the observation group were treated with LEEP. The operation conditions, the size of conization tissue, the complication rate and the clinical curative effect were compared between the two groups. The related factors of relapse in the observation group were analyzed. Results The operation time, intraoperative blood loss, operation cost and hospital stay in the observation group were all less than those in the control group, with significant differences (all P <0.05). The conical section area and conical height of the observation group were less than those of the control group, the differences were statistically significant (P <0.05). The incidence of complications in the observation group (8.46%) was lower than that in the control group (21.13%), with statistical significance (P <0.05). The cure rate of observation group and control group was 88.73% (63 cases) and 90.14% (64 cases), respectively. There was no significant difference between the two groups (P> 0.05). The age of> 40 years old, the involvement of the neck, postoperative liquid-based thin-layer cytology (TCT) positive and postoperative recurrence of a certain correlation (P <0.05), CIN grade and gland involvement and postoperative recurrence of disease Significant correlation (P> 0.05). Conclusions The therapeutic effect of LEEP on CIN is significant, which can reduce the operation time, intraoperative blood loss, operation costs and hospitalization time. The incidence of complications and the relapse rate of the disease are lower. The age of> 40 years old, Postoperative recurrence of disease has some relevance.