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目的观察射频热凝固疗法(RFT)在宫颈环形电切术(LEEP)中止血及减少术后愈合期出血的优势,探讨LEEP和射频热凝固疗法止血的机制。方法回顾性分析2014年5月-2015年5月于济南军区总医院行LEEP术的宫颈上皮内瘤变患者122例,其中研究组(69例)术中采用射频止血,对照组(53例)采用常规LEEP球形电极止血,观察两组施术时间、术中出血量及术后4周愈合期间异常出血等并发症的发生率。结果研究组与对照组平均手术时间分别为(3.5±0.5)min与(5.5±1.1)min,研究组明显短于对照组(P<0.05),平均出血量分别为(12.2±3.9)ml与(14.6±6.0)ml,研究组明显少于对照组(P<0.05)。术后4周愈合期间异常出血发生率,研究组为8.7%(6/69),对照组为32.1%(17/53),其中对照组中6例多次出现并发出血最终需行射频止血。结论 RFT应用于LEEP术后止血效果显著,明显减少手术时间及术后异常出血发生率。
Objective To observe the advantages of radiofrequency thermocoagulation (RFT) in hemostasis during cervical ring electrosurgical excision (LEEP) and to reduce hemorrhage after healed, so as to explore the mechanism of hemostasis by LEEP and radiofrequency thermocoagulation. Methods A retrospective analysis of 122 patients with cervical intraepithelial neoplasia who underwent LEEP operation from May 2014 to May 2015 in Ji’nan Military General Hospital was performed. Among them, 69 cases were treated with radiofrequency ablation and 53 cases were as control group. Conventional LEEP spherical electrodes were used to stop the bleeding. The operation time, intraoperative blood loss and the incidence of complications such as abnormal bleeding during the healing period of 4 weeks after operation were observed. Results The mean operative time of the study group and the control group were (3.5 ± 0.5) min and (5.5 ± 1.1) min, respectively, which was significantly shorter in the study group than in the control group (P <0.05). The average bleeding volume was (12.2 ± 3.9) (14.6 ± 6.0) ml, the study group was significantly less than the control group (P <0.05). The incidence of abnormal bleeding during 4 weeks postoperative healing was 8.7% (6/69) in the study group and 32.1% (17/53) in the control group, of which 6 cases in the control group had multiple concurrent hemorrhage requiring final radio frequency hemostasis. Conclusion The application of RFT to LEEP has a significant effect on hemostasis and significantly reduces the operation time and the incidence of postoperative abnormal bleeding.