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目的评价CO_2激光宫颈锥切术治疗宫颈上皮内瘤变(CIN)的疗效。方法CIN患者60例,其中CINⅠ33例,CINⅡ25例,CINⅢ2例。合并HPV阳性病例16例。以功率15 W,光斑直径0.3～0.5 cm的CO_2激光对病变圆锥形烧灼、深度10～20 mm,超过病灶5 mm。结果6个月内一次治愈率为93.3%(56/60);二次治愈率5.0%(3/60);总的治愈率为98。3%。病变持续存在率1.7% (1/60)。16例HPV阳性病例,术后3个月细胞学检查转为阴性者75.0%(12/16例);6个月转为阴性者25.0%(4/16例)。术后无一例发生宫颈管狭窄及粘连。未生育7例中有3例术后妊娠并足月经阴道正常分娩。结论CO_2激光锥切术治疗CIN手术操作简便,术中不出血或少量出血,治愈率高,术后并发症少,HPV感染可以同时得到治疗,不影响妊娠及阴道分娩,为治疗CIN的有效疗法。
Objective To evaluate the efficacy of CO_2 laser cervical conization in the treatment of cervical intraepithelial neoplasia (CIN). Methods There were 60 patients with CIN, including 33 cases of CINI, 25 cases of CINII, and 2 cases of CINIII. Merged HPV positive cases in 16 cases. A CO 2 laser with a power of 15 W and a spot diameter of 0.3-0.5 cm was used to burn conical lesions with a depth of 10-20 mm, exceeding the lesion by 5 mm. Results The primary cure rate was 93.3% (56/60) within 6 months; the secondary cure rate was 5.0% (3/60); the overall cure rate was 98.3%. The persistence of lesions was 1.7% (1/60). Among the 16 HPV-positive cases, 75.0% (12/16) had negative cytology tests at 3 months after surgery and 25.0% (4/16) of those who turned negative at 6 months. No postoperative cervical stenosis and adhesions occurred. Three of the 7 cases without fertility had normal postpartum pregnancy and full term vaginal delivery. Conclusions CO_2 laser conization has advantages of simple operation, no intraoperative hemorrhage or slight bleeding, high cure rate and few postoperative complications. HPV infection can be treated at the same time without affecting pregnancy and vaginal delivery. It is an effective therapy for the treatment of CIN. .