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目的探讨宫颈环形电切除术(LEEP)治疗宫颈上皮内瘤变(CIN)的临床价值。方法经阴道镜及宫颈活检初步诊断为CIN的门诊患者239例,行LEEP治疗,切除标本均送病理学检查,并观察手术时间、出血量及术后疗效,同时治疗前和治疗后6个月及12个月采用HPV基因芯片检测高危型HPV-DNA。结果LEEP手术时间短、出血少、术后并发症少,一次性治愈率达97.90%、复发率为2.09%。术前与术后病理结果一致者162例(67.78%),级别下降54例(22.59%),级别上升23例(9.62%)。宫颈高危型HPV感染率术前为72.38%,术后6个月下降为14.22%,术后12个月下降为3.76%,差异均有统计学意义(P<0.05)。结论LEEP治疗CIN具有操作简单、安全有效、可重复性、提供完整病理标本、有效消除部分病例的HPV感染、降低宫颈癌发生率的优点,但术后仍有病变持续存在及复发可能,需随访。
Objective To investigate the clinical value of cervical ring excision (LEEP) in the treatment of cervical intraepithelial neoplasia (CIN). Methods 239 cases of outpatients initially diagnosed as CIN by colposcopy and cervical biopsy underwent LEEP treatment. All the specimens were sent for pathological examination and the operation time, bleeding volume and postoperative efficacy were observed. At the same time, 6 months And 12 months using HPV gene chip detection of high-risk HPV-DNA. Results LEEP operation time is short, less bleeding, less postoperative complications, one-time cure rate was 97.90%, the recurrence rate was 2.09%. There were 162 cases (67.78%) with preoperative and postoperative pathological findings, 54 cases (22.59%) decreased in grade and 23 cases (9.62%) were elevated in grade. The prevalence of high-risk cervical HPV was 72.38% preoperatively, decreased to 14.22% at 6 months and 3.76% at 12 months postoperatively, with significant differences (P <0.05). Conclusions The treatment of CIN with LEEP is simple, safe, effective, reproducible and provides a complete pathological specimen. It is effective in eliminating HPV infection and reducing the incidence of cervical cancer in some cases. However, there are still persistent lesions and recurrence after operation. .