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目的探讨宫颈局部微波治疗、高频电波刀电圈切除术和冷刀锥切术对宫颈上皮内瘤样病变(cervical intraepithelial lesion,CIN)Ⅱ、Ⅲ级转归的影响。方法对289例2000年3月~2006年2月在我院门诊经阴道镜下宫颈活检病理诊断为CINⅡ、Ⅲ级者,按照我国中华医学会和美国阴道镜和宫颈病理学会制定的CIN的处理指南分别进行治疗和随访。结果233例完成随访(80.6%,233/289),随访时间3~56个月,平均11.8月。77.7%(181/233)的CINⅡ、Ⅲ级进行了治疗,其余22.3%(52/233)未治疗。治疗后CINⅡ、Ⅲ级病变消失率为88.4%(160/181),未治疗者病变消失率63.5%(33/52),差异有显著性(χ2=17.664,P=0.000)。CINⅡ级的微波治疗、高频电波刀电圈切除术和冷刀锥切术与病变转归无关(χ2=0.008,P=0.996),CINⅢ级采用冷刀锥切术与高频电波刀电圈切除术与病变消失无关(χ2=0.017,P=0.897)。结论CIN病变的治疗能提高CINⅡ、Ⅲ级的病变消失率,但3种治疗方法对CIN病变的转归差异无显著性。
Objective To investigate the effects of local microwave treatment, electrosurgical excision and cold-knife conization on the grade Ⅱ and Ⅲ of cervical intraepithelial lesion (CIN). Methods A total of 289 cases of CINⅡ and Ⅲ grade underwent colposcopic biopsy in our clinic from March 2000 to February 2006 were treated with CIN according to the Chinese Medical Association and the American Society of Colposcopy and Cervical Pathology The guidelines were separately treated and followed up. Results 233 cases were followed up (80.6%, 233/289), followed up for 3 to 56 months (mean, 11.8 months). 77.7% (181/233) of CIN II and III were treated, and the remaining 22.3% (52/233) were untreated. After treatment, the disappearance rate of CINⅡ and Ⅲ grade lesions was 88.4% (160/181), and the disappearance rate of lesions in non-treated patients was 63.5% (33/52). The difference was significant (χ2 = 17.664, P = 0.000). CIN II microwave treatment, high frequency electrosurgical knife electrocoagulation and cold knife conization were not associated with the outcome of the disease (χ2 = 0.008, P = 0.996). CIN Ⅲ was treated with cold knife conization and high frequency electric knife Resection and lesions disappeared (χ2 = 0.017, P = 0.897). Conclusion The treatment of CIN lesions can improve the rate of CINⅡ and Ⅲ grade lesions disappearance, but there is no significant difference between the three treatment methods in the prognosis of CIN lesions.