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目的介绍宫颈锥形切除术的方法,明确宫颈锥切术能否被阴道镜下多点活组织检查(活检)代替,以及探讨宫颈锥切术在宫颈上皮内瘤变(CIN)诊治中的价值。方法整理5年来宫颈锥切76例患者临床资料,对比其阴道镜下活检及锥切病理报告。结果宫颈锥切术与阴道镜下多点活检的病理检查结果完全符合者48例(63.16%);宫颈锥切术后,因发现宫颈浸润癌,行广泛子宫切除术者4例;因原位癌行全子宫切除术者6例,8例CINⅢ级患者宫颈锥切术后密切随诊,保留了生育功能。结论宫颈锥切术是子宫颈上皮肉瘤变病变程度的高级确诊手段,它不能被阴道镜下多点活检所取代。对其他诊断方法有疑问的病例尤其实用,并且,随着CIN及年轻宫颈癌的增多,宫颈锥切术成为有生育要求的年轻患者较恰当的治疗选择。值得临床推广。
Objective To introduce the method of cervical conization, to determine whether cervical conization can be replaced by colposcopy biopsy (biopsy), and to explore the value of cervical conization in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN). . Methods The clinical data of 76 patients with conization of the cervix in 5 years were collected and compared with the colposcopy biopsy and conization. Results 48 cases (63.16%) were confirmed by pathological examination of cervical conization and multi-point biopsy under colposcopy; 4 cases of extensive hysterectomy because of cervical invasive carcinoma after cervical conization; Carcinoma line hysterectomy in 6 cases, 8 cases of CIN Ⅲ patients with cervical conization after close follow-up, to retain the reproductive function. Conclusions Cervical conization is a high-level diagnostic method for the degree of cervical epithelial sarcoma. It can not be replaced by colposcopy multi-point biopsy. Cases that have been questioned for other diagnostic methods are particularly useful, and as CIN and younger cervical cancer increase, cervical conization becomes the more appropriate treatment option for younger patients with fertility requirements. Worth clinical promotion.