目的:探讨因宫颈病变行初次宫颈锥切术后需要补充手术的必要性及如何选择再次手术方式，为初次锥切术后进一步分层处理提供临床资料。方法:选择浙江省温州市人民医院2016年3月至2018年3月因宫颈病变行初次宫颈锥切术，术后6个月内入院再次行二次手术，剔除确诊Ⅰa1期伴脉管浸润以上级别进一步行根治术患者17例，对其中资料完整的116例患者进行研究；根据2次手术术后病理结果分为有残留和无残留，对各临床和病理因素（包括切缘、是否累及腺体、宫颈管搔刮情况）的残留率进行单因素分析，将P ≤ 0.10的各因素进一步行向前逐步Logistic回归分析；对其中41例行重复锥切术患者临床、病理资料和术后随访资料进行分析总结。结果:单因素分析显示：切缘阳性患者病变残留率55.36%（31/56），其中宫颈管切缘阳性和阴道切缘阳性患者病变残留率分别为63.64%（14/22）和50.00%（17/34），均高于切缘阴性患者的30.00%（18/60），差异有统计学意义（n P<0.05）；孕次≥ 3次、产次≥ 2次、有症状的残留率均低于孕次<3次、产次0.05）；多因素分析显示：宫颈管切缘阳性和阴道切缘阳性均为病变残留的独立高危因素，OR值分别为4.083（95% CI 1.459 ~ 11.430，n P=0.007）和2.333（95% CI 0.978 ~ 5.569，n P=0.056）；41例重复锥切术患者术后标本存在宫颈病变19例（46.34%），存在高级别宫颈病变11例（26.83%）；41例中二次手术切缘阳性2例（4.88%），均补充行全子宫切除术；术中多量出血发生率4.88%（2/41），术后大出血发生率2.43%（1/41）。n 结论:切缘阳性尤其是宫颈管切缘阳性提示存在病变残留可能，应考虑补充2次手术；重复宫颈锥切术可以切除残留的宫颈病变组织，创伤小，可以作为首选的治疗方法。“,”Objective:To explore the necessity of supplementary operation after primary cervical conization for cervical lesions and the choosing method of reoperation, so as to provide clinical data for further stratification treatment after primary conization.Methods:A prospective study was performed in 116 patients with complete data due to cervical biopsy diagnosis of cervical lesions who first received cervical conization, and received supplementary surgeries within 6 months at Wenzhou People Hospital from March 2016 to March 2018, and 17 cases who received radical resection diagnosed grade Ⅰa1 with vascular infiltration or above were excluded. The patients were divided into residual and non-residual according to residual disease of supplementary surgical specimens. The residual rates of clinical and pathological factors (including incision margin, gland involvement, curettage of cervical canal) were analyzed by univariate analysis. The factors of n P ≤ 0.10 were further analyzed by progressive Logistic regression. The clinical and pathological data of 41 patients undergoing repeated conization were analyzed. The follow-up data were analyzed and summarized.n Results:Univariate analysis showed that the residual rate of disease in the patients with positive margin, endocervical cone margin involvement and other positive margin was 55.36% (31/56), 63.64% (14/22) and 50.00% (17/34), respectively, higher than that of the patients with negative margin 30.00% (18/60) with statistical significance (n P<0.05). There was no significant difference in pregnancy (≥ 3), parity (≥ 2), symptomatic cases between the two groups, but alln P < 0.10. Multivariate analysis showed that both endocervical cone margin involvement and vaginal incision margin were independent risk factors for residual disease, and n OR was 4.083 (95% n CI 1.459 to 11.430, n P = 0.007) and 2.333 (95% n CI 0.978 to 5.569, n P = 0.056); 19 cases (46.34%) of cervical lesions and 11 cases (26.83%) of high-grade cervical lesions were found in 41 cases after repeated conization. 2 cases (4.88%) of positive margin of incision were supplemented with total hysterectomy; the incidence of intraoperative massive bleeding was 4.88% (2/41). The incidence of massive hemorrhage after operation was 2.43% (1/41).n Conclusions:Margin involvement and vaginal incision margin might predict the occurrence of residual disease. Additional surgery should be considered in these cases. Repeat conization can remove residual cervical lesions with minimal trauma and can be used as the preferred treatment.