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目的比较聚焦超声和激光加电凝治疗伴HPV高危亚型感染的CINⅠ的临床疗效。方法对618例HPV高危亚型感染的CINⅠ患者按随机数字表法分组,分别接受CZF超声波和激光加电凝治疗,其中聚焦超声组320例,激光加电凝组298例,在治疗前和治疗后6个月进行阴道镜下活检和HPV检测,评价其有效性和安全性。结果 2组术中出血差异无统计学意义,聚焦超声组术后阴道流血、阴道流液量均显著少于激光加电凝组(P<0.05)。治疗后6个月,聚焦超声组随访300例,292例CINⅠ消退,治愈率97.3%;200例HPV高危亚型感染全部转阴,清除率66.7%,40例部分转阴,有效率80%。激光加电凝组随访290例,CINⅠ治愈280例,治愈率96.6%;185例HPV高危亚型感染全部转阴,清除率63.8%,30例部分转阴,有效率74.1%。2组组间比较,CINⅠ治愈率与HPV清除率差异无统计学意义;2组组内比较,CINⅠ的消退与HPV清除差异均有统计学意义,且均呈正相关(P<0.05,r=0.175 9、0.147 3)。结论聚焦超声和激光加电凝治疗对治疗CINⅠ及HPV高危亚型感染的清除均疗效显著且相当,但聚焦超声术后阴道流血及排液更少。
Objective To compare the clinical effects of focused ultrasound and laser plus electrocoagulation in the treatment of CIN Ⅰ infection with high-risk HPV subtypes. Methods A total of 618 cases of CIN Ⅰ patients infected with high-risk HPV subtypes were randomly divided into three groups according to random number table. CZF ultrasound and laser plus electrocoagulation were used. Among them, 320 cases were focused ultrasound and 298 cases were treated with laser and electrocoagulation. Before and after treatment, Colposcopic biopsy and HPV testing were performed 6 months later to evaluate its effectiveness and safety. Results There was no significant difference in intraoperative bleeding in the two groups. Vaginal bleeding and vaginal fluid volume in the focused ultrasound group were significantly less than those in the laser plus electrocoagulation group (P <0.05). Six months after treatment, 300 cases were followed up in 292 patients with CINⅠ. The cure rate was 97.3%. The infection rate of 200 high risk HPV subtypes was negative, the clearance rate was 66.7%, and 40 cases were partially negative. The effective rate was 80%. A total of 290 cases were followed up by laser plus electrocoagulation. CINⅠ was cured by 280 cases, the cure rate was 96.6%. 185 cases of HPV subtype infection were negative, the clearance rate was 63.8%, and 30 cases were partially negative. The effective rate was 74.1%. There was no significant difference between the two groups in the cure rate of CIN Ⅰ and the clearance rate of HPV. In the two groups, the regression of CIN Ⅰ and HPV were statistically significant (P <0.05, r = 0.175 9,0.147 3). Conclusions Focused ultrasound and laser plus electrocoagulation are effective and effective in the treatment of CIN I and HPV subtypes. However, vaginal bleeding and effusion are less after focused ultrasound.