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目的:探讨高频环形电切与冷刀锥切在治疗宫颈上皮内瘤变(CIN)Ⅲ中的临床疗效。方法:选取111例CINⅢ的已婚妇女作为研究对象,根据不同的手术方法随机分为高频环形电切术组(LEEP组)57例和冷刀锥切术组(CKC组)54例。分别对比分析两组手术时间、术中出血量、切口愈合时间、术后并发症情况及手术前、后病理指标,探讨两种手术方法的治疗效果。结果:LEEP组的手术时间(8.02±0.82)min、术中出血量(10.18±1.51)ml、切口愈合时间(29.21±2.19)天以及术后并发症发生率0.00%,CKC组手术时间(32.10±3.14)min、术中出血量(41.57±5.67)ml、切口愈合时间(43.74±3.96)天以及术后并发症发生率9.26%,两组差异均有统计学意义(P<0.05)。两组患者治疗后,与术前病理结果一致例数、低于术前病理级别例数、阴性例数、浸润癌例数、切缘阳性例数指标比较差异均无统计学意义(P>0.05)。两组治愈率、残留率和复发率比较差异均无统计学意义(P>0.05)。结论:与CKC相比,LEEP具有手术时间短、术中出血少等优点,值得临床推广应用。
Objective: To investigate the clinical effects of high-frequency circular incision and cold-blade incision in the treatment of cervical intraepithelial neoplasia (CIN) Ⅲ. Methods: A total of 111 married women with CIN Ⅲ were enrolled in this study. Fifty-seven patients with LEEP and 54 patients with cold-knife conization (CKC) were randomly divided into two groups according to different surgical methods. The operative time, intraoperative blood loss, incision healing time, postoperative complications and pathological parameters before and after surgery were compared between the two groups to explore the therapeutic effect of the two surgical methods. Results: The operative time (8.02 ± 0.82) min, intraoperative bleeding volume (10.18 ± 1.51) ml, incision healing time (29.21 ± 2.19) days and postoperative complication rate were 0.00% in LEEP group and 32.10 ± 3.14) min, the blood loss during operation (41.57 ± 5.67) ml, the incision healing time (43.74 ± 3.96) days and the postoperative complication rate was 9.26%. There was significant difference between the two groups (P <0.05). After treatment, there was no significant difference between the two groups in the number of patients with preoperative pathological findings, the number of pathological grade lower than the preoperative pathological grade, the number of negative cases, the number of invasive cancer and the number of positive margin cases (P> 0.05 ). The two groups of cure rate, residual rate and recurrence rate difference was not statistically significant (P> 0.05). Conclusion: Compared with CKC, LEEP has the advantages of short operation time and less intraoperative bleeding, which is worthy of clinical application.