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目的分析宫颈上皮内瘤样病变(CIN)采用高频电波刀电圈切除术(LEEP)治疗的疗效。方法阴道镜下定点活检病理组织学诊断为CIN者86例、炎症及赘生物64例、宫颈HPV感染38例,共188例,其中有86例行LEEP手术。CIN I和HPV感染用环形电极颈管加用方形电极切除,CINⅡ~Ⅲ采用三角形电极作锥切术,如病变范围大,加用环形电极补充切除,在病变外侧0.1~0.5 cm处进出电极。LEEP标本全部送病理检查。结果LEEP手术时间每例2~15 min;出血多数少于5 ml;无需麻醉;手术效果好,术后4~8周宫颈完全上皮化,仅少数宫颈、阴道有炎症者影响愈合。术后2~3个月95.45%病人阴道镜复查未发现异常,90.91%宫颈涂片未找到瘤细胞,9.09%病人涂片仍有核肥大或轻度核异质。结论CIN为癌前病变,早期诊断和治疗十分重要。阴道镜诊断CIN技术先进,定点活检准确率高。LEEP手术时间短、出血少、无痛苦,且操作简单,术后并发症少,去除病灶效果理想,是处理CIN最好的方法。
Objective To analyze the curative effect of cervical intraepithelial neoplasia (CIN) treated with high frequency electrosurgical excision (LEEP). Methods Totally 86 cases were diagnosed as CIN by histopathology by colposcopy biopsy under colposcopy, 64 cases were inflammation and neoplasm, and 38 cases were cervical HPV infection. A total of 188 cases were treated with LEEP. CIN I and HPV infection with ring electrode neck plus square electrode resection, CIN Ⅱ ~ Ⅲ triangle electrode for conization, such as the lesion range, plus ring electrode replacement resection, 0.1 ~ 0.5 cm at the outside of the lesion out of the electrode. LEEP specimens sent to all pathological examination. Results LEEP operation time of 2 to 15 minutes per case; most of the bleeding less than 5 ml; without anesthesia; surgery is good, 4 to 8 weeks after complete cervical epithelialization, only a few cervical and vaginal inflammation affect healing. After 2 to 3 months, 95.45% of the patients had no colposcopy retrospective examination. 90.91% of cervical smears did not find tumor cells, while 9.09% of smears still showed nuclear hypertrophy or mild nuclear heterogeneity. Conclusion CIN is a precancerous lesion, which is very important for early diagnosis and treatment. Colposcopy diagnosis of CIN advanced technology, fixed-point biopsy accuracy. LEEP operation time is short, less bleeding, no pain, and simple operation, less postoperative complications, removal of lesions ideal, is the best way to deal with CIN.