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目的探讨阴道镜联合宫颈环形电切术(LEEP)在诊断和治疗宫颈上皮内瘤样变(CIN)Ⅲ的价值。方法回顾性分析阴道镜下活检结果为CINⅢ并接受LEEP宫颈环形电切术185例患者的临床资料。结果 LEEP术后标本送病检结果示CINⅢ142例(76.8%),CINⅡ4例(2.2%),CINⅠ8例(4.3%),宫颈浸润癌6例(3.2%),宫颈炎症25例(13.5%)。12例(6.5%)为切缘阳性,其中2例为CINⅢ,4例为CINⅡ,6例为CINⅠ;2例切缘CINⅢ手术治疗,4例CINⅡ及6例CINⅠ者给予观察,术后随访3～9个月CIN病灶自然消退。术后复发8例(4.3%)。16例(8.6%)发生脱痂期出血,术中、术后无1例发生其他并发症。手术时间15～40min,术中出血5～20ml。术后成功妊娠21例,顺产5例,剖宫产7例,早产3例,人工流产6例。结论阴道镜联合LEEP是诊断和治疗CINⅢ的有效方法,同时可保留生育功能。
Objective To investigate the value of colposcopy combined with cervical ring electrosurgical excision (LEEP) in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN) Ⅲ. Methods The clinical data of 185 patients undergoing colposcopy biopsy with CIN Ⅲ and receiving LEEP cervical ring electrosurgical excision were retrospectively analyzed. Results The results of pathological examination after LEEP showed that 142 cases (76.8%) were CINⅢ, 4 cases CINⅡ (2.2%), CINⅠ8 cases (4.3%), cervical invasive carcinoma 6 cases (3.2%) and cervix inflammation 25 cases (13.5%). 12 cases (6.5%) were positive margins, of which 2 cases were CINⅢ, 4 cases were CINⅡ, 6 cases were CINⅠ, 2 cases were treated with CINⅢ surgical margin, 4 cases were CINⅡ and 6 cases were CINⅠ, ~ 9 months CIN lesions subsided spontaneously. Postoperative recurrence in 8 cases (4.3%). In 16 cases (8.6%), hemorrhage occurred during sclerosing. No other complications occurred during operation or after operation. Surgery time 15 ~ 40min, intraoperative bleeding 5 ~ 20ml. After successful pregnancy in 21 cases, 5 cases of cesarean section, cesarean section in 7 cases, 3 cases of premature labor, 6 cases of induced abortion. Conclusion Colposcope combined with LEEP is an effective method for diagnosis and treatment of CIN Ⅲ, while preserving reproductive function.