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目的多中心研究评价子宫颈环形电切术(loop electrosurgical excision procedure,LEEP)与CO2激光汽化治疗宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)2级的疗效、费用及术后生活质量。方法 选取宫颈活检病理证实的CIN2患者338例,分别采用LEEP术和CO2激光汽化治疗,术后3、6及12个月进行随访,记录疗效、并发症及费用,术后12个月填写生活质量问卷。结果 LEEP组195例患者,病变缓解174例(89.2%)、病变复发7例(3.6%);激光组143例患者,病变缓解124例(86.7%)、病变复发1例(0.70%),两组疗效比较差异无统计学意义(P>0.05)。LEEP组术后痊愈时间、手术次数、术中出血量及平均治疗费用与激光组比较差异有统计学意义(P<0.05),两组术后生活质量评分差异无统计学意义(P>0.05)。结论 LEEP与CO2激光汽化治疗CIN2是安全而有效的方法 ,治疗前疾病状态的准确评估及术后规范随访对CIN2的治疗具有重要作用。同时,妇科医生应加强对患者生活质量的重视。
Objective Multicenter study evaluated the efficacy, cost, and postoperative quality of life of cervical intraepithelial neoplasia (CIN) level 2 with LEEP and CO2 laser vaporization. Methods 338 cases with CIN2 confirmed by cervical biopsy were selected and treated with LEEP and CO2 laser vaporization respectively. The follow-up was performed at 3, 6 and 12 months after operation. The curative effect, complications and costs were recorded. The quality of life Questionnaire. Results Among 195 patients in LEEP group, 174 cases (89.2%) were alleviated and 7 cases (3.6%) were relapsed. Among 143 patients in laser group, 124 cases (86.7%) were alleviated and 1 case (0.70% There was no significant difference in the curative effect between the two groups (P> 0.05). There were significant differences between the two groups in postoperative quality of life (P> 0.05), the recovery time of LEEP group, the number of operations, the amount of intraoperative blood loss and the average cost of treatment were statistically significant (P <0.05) . Conclusion LEEP and CO2 laser vaporization of CIN2 is a safe and effective method. The accurate assessment of the disease state before treatment and the follow-up of postoperative follow-up are important for the treatment of CIN2. At the same time, gynecologists should pay more attention to the quality of life of patients.