论文部分内容阅读
目的探讨宫颈环形电切术(LEEP)联合物理疗法治疗Ⅲ级宫颈上皮内瘤变(CIN)患者临床效果。方法选取2013年3月至2015年12月常熟市中医院收治的186例Ⅲ级CIN患者作为研究对象,利用随机综合平衡序贯法分为联合组和对照组,每组93例。联合组患者给予LEEP术联合物理疗法干预(即5-氨基酮戊酸光动力疗法),对照组患者仅单纯给予LEEP术治疗。比较联合组和对照组手术指标、病理情况、术后切缘阳性率、以及术后并发症情况。结果联合组手术时间、术后住院时间和切口愈合时间均明显短于对照组,且术中出血量也明显减少,两组间差异均有统计学意义(P<0.05);联合组和对照组术后病理和术前诊断符合率、降级率差异均无统计学意义(P>0.05),每组均有2例患者发现恶化,且接受进一步治疗;联合组切缘阳性率(5.38%)明显低于对照组(18.28%),而HPV转阴率(75.00%)显著高于对照组(21.43%),两组比较差异均有统计学意义(P<0.05);联合组并发症发生率仅为2.15%,显著低于对照组的12.90%(P<0.05)。结论 LEEP术联合5-氨基酮戊酸光动力疗法较治疗Ⅲ级CIN患者效果显著,值得临床推广应用。
Objective To investigate the clinical effect of cervical ring electrosurgical (LEEP) combined with physical therapy in the treatment of grade Ⅲ cervical intraepithelial neoplasia (CIN). Methods A total of 186 patients with grade Ⅲ CIN admitted to Changshu Hospital of Traditional Chinese Medicine from March 2013 to December 2015 were enrolled in this study. The patients were randomly divided into combined group and control group, with 93 patients in each group. Patients in the combined group were treated with LEEP combined with physical therapy (ie, 5-aminolevulinic acid photodynamic therapy), while those in the control group were treated with LEEP alone. The operative indexes, pathological conditions, the positive rate of postoperative margins and postoperative complications were compared between the combined group and the control group. Results The operation time, postoperative hospital stay and incision healing time in the combined group were significantly shorter than those in the control group, and the intraoperative blood loss was also significantly reduced (P <0.05). The combined group and the control group There was no significant difference between preoperative and postoperative pathological diagnosis and preoperative diagnosis (P> 0.05). Two patients in each group were found to be deteriorating and were treated for further treatment. The positive rate of margin (5.38%) was significantly higher in the combined group (18.28%) lower than control group, but the negative rate of HPV (75.00%) was significantly higher than that of control group (21.43%), the difference between the two groups was statistically significant (P <0.05); Was 2.15%, which was significantly lower than that of the control group (12.90%, P <0.05). Conclusions LEEP combined with 5-aminolevulinic acid photodynamic therapy is more effective than the treatment of grade Ⅲ CIN, which is worthy of clinical application.