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目的:探讨改良式冷刀锥切术在治疗高级别宫颈上皮内瘤变中的价值。方法:对辽宁医学院附属第一医院2007年1月～2008年12月接受宫颈锥切术的172例高级别宫颈上皮内瘤变患者的资料进行回顾性分析。根据手术方式分为改良组及传统组。比较两组的手术时间、术中出血量、术后宫颈狭窄或粘连发生率及宫颈鳞柱交界可见率等。结果:改良组平均手术时间28 min,对照组平均手术时间35 min,改良组手术时间明显缩短(P<0.05);改良组术中出血量平均33 ml,对照组平均45 ml,改良组明显少于对照组(P<0.05);两组宫颈狭窄或粘连发生率差异无统计学意义(P>0.05),而鳞柱交界可见率差异具有统计学意义(P<0.05)。结论:改良式冷刀锥切术可以有效减少术中出血量,缩短手术时间,同时具有术后宫颈鳞柱交界可见率高,有利于术后随访等优点。
Objective: To investigate the value of modified cold-knife conization in the treatment of high-grade cervical intraepithelial neoplasia. Methods: The data of 172 patients with high grade cervical intraepithelial neoplasia who underwent cervical conization from January 2007 to December 2008 in the First Affiliated Hospital of Liaoning Medical College were analyzed retrospectively. According to the surgical method is divided into improved group and traditional group. The operation time, intraoperative blood loss, the incidence of cervical stenosis or adhesions and the visible rate of cervical squamous junction were compared between the two groups. Results: The average operation time was 28 min in the modified group and 35 min in the control group, and the operation time in the modified group was significantly shorter (P <0.05). The average intraoperative blood loss was 33 ml in the improved group and 45 ml in the control group, (P <0.05). There was no significant difference in the incidence of cervical stenosis or adhesions between the two groups (P> 0.05), but there was a statistically significant difference in the visible rate of squamous junction (P <0.05). Conclusion: Modified cold-knife conization can effectively reduce the amount of intraoperative bleeding and shorten the operation time, and has the advantages of high visualization rate of post-operative cervical scale junction and favorable postoperative follow-up.