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目的探讨宫颈锥切术与子宫全切术治疗宫颈上皮内瘤样病变Ⅲ(cervical intraepithelial neoplasiasⅢ)的临床价值。方法于2010年12月—2013年12月选取82例CINⅢ患者,随机分为对照组与观察组,每组各41例,其中对照组予以子宫全切术,观察组予以宫颈锥切术。比较两组术中出血量、手术时间、住院时间、医疗费用及术后镇痛药使用率与并发症发生率等临床情况,再随访1年观察两组复发率,计量资料以±s表示,采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组术中出血量、手术时间、住院时间及医疗费用[(41.82±12.52)ml、(40.23±10.34)h、(4.23±0.33)d、(1 572.53±184.24)元],均明显优于对照组[(82.56±16.36)ml、(72.72±11.57)h、(6.78±0.46)d、(3 467.34±268.72)元],比较差异均有统计学意义(均P<0.05)。术后观察组镇痛药使用率及并发症发生率(4.88%、4.88%),也明显低于对照组(19.51%、21.95%),比较差异均有统计学意义(均P<0.05)。两组1年内复发率差异比较无统计学意义(P>0.05)。结论宫颈锥切术治疗CINⅢ安全有效,具有出血少、微创伤、手术时间与住院时间短以及预后恢复快等特点,并且还能为患者保留生育功能,极具临床意义,更具推广价值。
Objective To investigate the clinical value of cervical conization and total hysterectomy in the treatment of cervical intraepithelial neoplasias Ⅲ. Methods From December 2010 to December 2013, 82 patients with CINⅢ were selected and randomly divided into control group and observation group, 41 cases in each group. The control group received total hysterectomy and the observation group received cervical conization. The clinical data of blood loss, operation time, hospitalization time, medical expenses, postoperative analgesic usage and complication rate were compared between the two groups. The recurrence rate was observed after one year follow-up. The measurement data were expressed as ± s , Using t test, counting data using χ2 test, P <0.05 for the difference was statistically significant. Results The intraoperative blood loss, operation time, hospital stay and medical expenses in the observation group were significantly (41.82 ± 12.52) ml, (40.23 ± 10.34) h and (4.23 ± 0.33) days, respectively (1572.53 ± 184.24) (82.56 ± 16.36) ml, (72.72 ± 11.57) h, (6.78 ± 0.46) d, (3 467.34 ± 268.72) yuan in the control group, respectively. All the differences were statistically significant (all P <0.05). Analgesic use rate and complication rate in postoperative observation group (4.88%, 4.88%) were also significantly lower than those in control group (19.51%, 21.95%). There were significant differences between the two groups (all P <0.05). There was no significant difference in relapse rate between two groups within one year (P> 0.05). Conclusions Cervical conization is a safe and effective method for the treatment of CIN Ⅲ. It has the characteristics of less bleeding, less trauma, shorter operation time and shorter hospital stay and faster recovery of prognosis. It also retains the reproductive function for patients with clinical significance and promotion value.