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目的探讨高频电刀宫颈电圈环切术(LEEP术)在宫颈病变中诊断及其联合不同药物治疗的应用。方法回顾性分析LEEP术治疗1 576例宫颈病变患者资料,观察患者LEEP术前后的组织病理变化及术后随访结果,并对其疗效进行分析。结果本研究中LEEP术符合适应证的1 248例(79.19%),不符合适应证的328例(20.81%)。术后病理相符90.98%(1 434/1 576),不符9.01%(142/1 576),其中0.57%(9/1 576)病理降级,8.44%(133/1 576)升级,切缘阴性率为98.92%(1 559/1 576)。术后3个月复查LEEP术一次性治愈率为98.48%(1 552/1 576)。联合壳聚糖宫颈贴膜止血抗感染患者(952例)的术后创面脱痂出血时间,创面愈合时间与未使用的患者(624例)比较差异有统计学意义(P<0.05);联合重组人干扰素α-2b阴道泡腾胶囊抗人类乳头瘤病毒(HPV)术后6个月复查转阴率为92.04%(532/578),未使用的转阴率只有77.83%(179/230),比较差异有统计学意义(P<0.05)。结论 LEEP术在临床上治疗宫颈病变简单,安全、有效,有着重要的诊断和治疗价值。LEEP术后配合使用壳聚糖宫颈贴膜脱痂出血量少、并发症少,宫颈创面愈合时间缩短;术后联合使用重组人干扰素α-2b阴道泡腾胶囊,HPV转阴率显著提高。
Objective To investigate the application of high frequency electrosurgical excision of cervix electrocautery (LEEP) in the diagnosis of cervical lesions and its combination with different medical treatments. Methods The data of 1 576 cases of cervical lesions treated with LEEP were retrospectively analyzed. The histopathological changes and postoperative follow-up results of LEEP before and after operation were observed and analyzed. Results In the study, 1,248 (79.19%) of the LEEP patients met the indications and 328 (20.81%) did not meet the indications. Pathology was 90.98% (1443/1 576), accounting for 9.01% (142/1 576), of which 0.57% (9/1 576) pathological grade, 8.44% (133/1 576) 98.92% (1 559/1 576). LEEP one-time cure rate was 98.48% (1 552/1 576) at 3 months after operation. (952 cases) treated with chitosan cervical membrane hemostatic anti-infection patients had a statistically significant difference (P <0.05) in wound bleeding time and healing time compared with unused patients (624 cases). The combined recombinant human The negative conversion rate of interferon alpha-2b vaginal effervescent capsule anti-human papillomavirus (HPV) was 92.04% (532/578) at 6 months after operation, while the unused negative conversion rate was only 77.83% (179/230) The difference was statistically significant (P <0.05). Conclusion LEEP is a simple, safe and effective method for the treatment of cervical lesions in clinic. It has important diagnostic and therapeutic value. LEEP combined with the use of chitosan cervical film scrape off less bleeding, fewer complications, cervical wound healing time is shortened; combined with recombinant human interferon α-2b vaginal effervescent capsules, HPV negative conversion rate was significantly increased.