冷刀宫颈锥切术诊治宫颈上皮内瘤变的临床分析.doc

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1、冷刀宫颈锥切术诊治宫颈上皮内瘤变的临床分析［摘要］目的：评价冷刀宫颈锥切术对宫颈上皮内瘤变（CIN）的诊治效果。方法：回顾性分析在本院接受诊治的93例宫颈上皮内瘤变癌患者的资料，对比宫颈锥切术和阴道镜下多点宫颈活检组织学诊断结果，评价它们术后的组织学发现和临床结果。结果:93例中有69例（74.2%）宫颈锥切和阴道镜多点活检的病理发现相符合，其余24例（25.8%）不符合。4例（4.3%）未完全切除，但复发率仅为2.2%,治愈率为97.8%。发现3例早期浸润癌。6例随后行了宫切除术。宫颈锥切术相关的主要并发症是出血和宫颈狭窄，5例（5.4%）发生

2、出血，2例（2.2%）发生宫颈狭窄。结论：宫颈锥切诊断宫颈上皮内瘤变比阴道镜下多点活检更准确。宫颈锥切在治疗宫颈上皮内瘤变方面的作用也很重要，如果操作适当其并发症的风险低。它能在疾病诊治过程中提供一个正确的组织学依据，在许多病例屮有临床价值。［关键词］宫颈上皮内瘤变；冷刀宫颈锥切术；活检；病理［中图分类号］R737.33［文献标识码］B［文章编号］1674-4721（2011）06（b）-143-03Diagnosticandtherapeuticcoldknifeconizationforcervicalintraepithelialneopl

3、asiaFENGTianen,ZIIAIYarningDepartmentof1STSurgery,KaifengTumourHospital,HenanProvince,Kaifeng475003,China[Abstract]Objective:Toevaluatethediagnosticandtherapeuticefficacyofusingcoldknifeconizationforcervicalintraepithelialneoplasia(CIN).Methods:Thedataof93caseswithCINdiagnose

4、dandtreatedinourhospitalwereretrospectivelyanalyzed.Thehistologicdiagnosesfromcervicalconizationandfromcolposcopicmultiplepunchbiopsieswerecompared,andthentheirpostoperativehistologicfindingsandclinicaloutcomeswereevaluated.Results:Ofthe93patients,therewasacorrelationinhistol

5、ogicfindingsbetweencervicalconizationandcolposcopicmultiplepunchbiopsiesin69cases(74.2%),andtherewasnocorrelationintheother24cases(25.8%).Tncompleteexcisionwasperformedin4cases(4.3%),butthefailureratewasonly2.2%;thecureratewas97.8%.Threecaseswithearlyinvasivecancerwerefound・S

6、ixpatientsunderwentsubsequenthysterectomy.Themaincomplicationsassociatedwithconizationwerehemorrhageandcervicalstenosis.Bleedingoccurredin5(5.4%)ofthepatients，andcervicalstenosisoccurredin2(2.2%).Conclusion:Cervicalintraepithelialneoplasiaisdiagnosedmoreaccuratelyusingconizat

7、ionthanbycolposcopicmultiplepunchbiopsies.ConizationcanalsoplayanimporlantroleinthetreatmentforCIN・Ifproperlyperformed,theprocedurewillhavealowriskofcomplications・Itcanprovideanaccuratehistologicrepresentationofthediseaseprocess,anditisalsocurativeinmostcases・[Keywords]Cervic

8、alintraepithelialneoplasia;Coldknifeconization;Biopsy;Pathology宫颈癌是世