超高频电波刀宫颈环切术与宫颈冷刀锥切术治疗宫颈上皮内瘤变的临床效果比较

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摘要目的比较超高频电波刀宫颈环切术（LEEP）及宫颈冷刀锥切术（CKC）治疗宫颈上皮内瘤变的临床效果。方法选取徐州医科大学附属第三医院2016年5月～2018年5月收治的200例宫颈上皮内瘤变患者作为研究对象，按照抽签的方法分为观察组（100例）和对照组（100例）。观察组采取LEEP 术式进行治疗，对照组则采取CKC治疗。记录两组患者的手术时间、术中出血量、术后出血量、子宫颈修复时间、阴道分泌物排出时间、术后高危型HPV 感染率及住院时间，比较两组的术后妊娠情况、早产、胎膜早破、剖宫产、新生儿窒息、低出生体重儿、产后出血、宫颈损伤、生殖道感染发生情况及并发症发生情况；观察两组患者手术前后的心率、焦虑自评量表（SAS）评分、静脉血中白细胞计数（WBC）及C反应蛋白（CRP）水平。结果观察组的手术时间、子宫颈修复时间及住院时间短于对照组，术中出血量、术后出血量少于对照组，术后高危型HPV 感染率低于对照组，差异有统计学意义（P＜0.05）。两组的阴道分泌物排出时间比较，差异无统计学意义（P＞0.05）。两组术后的CRP、WBC、心率均高于术前，且观察组术后的CRP、WBC、心率低于对照组，差异有统计学意义（P＜0.05）；两组术后的SAS评分低于术前，且观察组术后的SAS评分低于对照组，差异有统计学意义（P＜0.05）。观察组的术后妊娠率高于对照组，低出生体重儿、胎膜早破及生殖道感染发生率低于对照组，差异有统计学意义（P＜0.05）。观察组与对照组的术后并发症总发生率比较，差异无统计学意义（P＞0.05）。结论 LEEP治疗宫颈上皮内瘤变临床效果较CKC 更好，且能有效降低不良妊娠发生率，安全性高，值得临床推广。

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关键词 ：超高频电波刀宫颈环切术, 宫颈上皮内瘤变, 围生结局

Abstract：Objective To compare the clinical effect of loop electrosurgical excision procedure (LEEP) and cold knife conization (CKC) in the treatment of cervical intraepithelial neoplasia.Methods From May 2016 to May 2018 in the Third Affiliated Hospital of Xuzhou Medical University，a total of 200 patients with cervical intraepithelial neoplasia were selected as the research subjects，they were divided into the observation group (100 cases) and the control group (100 cases) according to the method of drawing lots.The observation group was treated with LEEP，while the control group was treated with CKC.The operation time，intraoperative bleeding volume，postoperative bleeding volume，cervical repair time，vaginal discharge time，postoperative high-risk HPV infection rate and hospitalization time of the two groups were recorded.The postoperative pregnancy，premature delivery，premature rupture of membranes，cesarean section，asphyxia neonatorum，low birth weight infants，postpartum hemorrhage，cervical injury，reproductive tract infection and the incidence of complications of the two groups were compared The heart rate，the self-rating anxiety scale (SAS)score，white blood cell count (WBC) and C-reactive protein (CRP) levels of the two groups were observed before and after operation.Results The operation time，cervical repair time and hospitalization time of the observation group were shorter than those of the control group，the intraoperative and postoperative bleeding volume of the observation group were less than those of the control group，and the postoperative high-risk HPV infection rate of the observation group was lower than that of the control group，the differences were statistically significant (P＜0.05).There was no significant difference in vaginal discharge time between the two groups (P＞0.05).The levels of CRP，WBC and heart rate of the two groups after operation were higher than those before operation，and the levels of CRP，WBC and heart rate of the observation group after operation were lower than those of the control group，the differences were statistically significant (P＜0.05).The SAS score of the two groups after operation was lower than that before operation，and the SAS score of the observation group after operation was lower than that of the control group，the differences were statistically significant (P＜0.05).The postoperative pregnancy rate of the observation group was higher than that of the control group，and the incidence of low birth weight infants，premature rupture of membranes and reproductive tract infection rate of the observation group were lower than those of the control group，the differences were statistically significant (P＜0.05).There was no significant difference in the total incidence of postoperative complications between the observation group and the control group (P＞0.05).Conclusion LEEP is better than CKC in the treatment of cervical epithelioid lesions，and it can effectively reduce the incidence of adverse pregnancy and has high safety.It is worthy of clinical promotion.

Key words： Loop electrosurgical excision procedure Cervical intraepithelial neoplasia Perinatal outcome

基金资助:江苏省徐州市科技项目（XZZD1150）

通讯作者: 赵春艳（1987-），女，硕士，讲师，研究方向：新发病原诊断

作者简介: 王玉莹（1980-），女，本科，副主任医师，研究方向：妇产科学

引用本文:

王玉莹；袁晔；赵春艳. 超高频电波刀宫颈环切术与宫颈冷刀锥切术治疗宫颈上皮内瘤变的临床效果比较[J]. 中国当代医药, 2020, 27(33): 4-8.
WANG Yu-ying；YUAN Ye；ZHAO Chun-yan. Comparison of the clinical effect of loop electrosurgical excision procedure and cold knife conization in the treatment of cervical epithelial neoplasia. 中国当代医药, 2020, 27(33): 4-8.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2020/V27/I33/4

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