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目的 :分析宫颈上皮内瘤变CINⅢ行CKC术后个体化治疗的效果。方法 :回顾性分析96例因宫颈上皮瘤CIN III级行宫颈冷刀锥切术患者临床资料,包括CKC手术、术后个体化治疗等资料,观察并比较CIN患者初次CKC术后病理情况、个体化治疗后病理情况,对所有病例随访3年。结果 :宫颈切缘阳性个体化治疗后子宫颈病灶残留率显著高于切缘阴性者;CKC术后病理结果示炎症、CIN I级、CIN II级、CIN III级、Ia期在个体化治疗后的病理下降或转阴率分别为100%、77.78%、71.43%、80.0%、57.14%;术后随访示切缘阳性的残留率与复发率则显著高于切缘阴性者。结论 :宫颈上皮内瘤变CIN III级CKC术后的个体化治疗有助于增加CKC术的病理降级与转阴率,尤其是锥切切缘阳性患者,应遵循个体化治疗原则。
Objective: To analyze the effect of individualized treatment of cervical intraepithelial neoplasia (CINⅢ) after CKC. Methods: The clinical data of 96 patients with CIN grade III cervical cold knife conization, including CKC operation and postoperative individualized treatment, were retrospectively analyzed. The pathological changes of the patients with CIN after primary CKC were observed and compared. After the treatment of pathological conditions, all cases were followed up for 3 years. Results: The residual rate of cervical lesions was significantly higher than that of negative margins after individual positive cervical margin treatment. Pathological findings of CKC showed inflammation, CIN I, CIN II, CIN III and Ia after individualized treatment The percentages of pathological changes or negative rates were 100%, 77.78%, 71.43%, 80.0% and 57.14% respectively. The follow-up showed that the positive rate of residual margin and recurrence rate were significantly higher than those with negative margin. Conclusion: Individualized treatment of cervical intraepithelial neoplasia CIN class III postoperative CKC helps to increase pathological grade and negative rate of CKC surgery, especially in patients with positive conization cut edge should follow the principle of individualized treatment.