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目的观察不同宫颈锥切方法治疗宫颈上皮内瘤变Ⅲ级患者的临床效果。方法从医院收治的宫颈上皮内瘤变Ⅲ级患者中选取55例实施分组治疗,对照组25例采取宫颈环电切术治疗,观察组30例则采取宫颈冷刀锥切术治疗。观察2组手术持续时间、手术出血量;术后3个月内复查病灶残留情况;统计术后>3个月发现的宫颈上皮内瘤复发率及人乳头瘤病毒感染率。结果与对照组比较,观察组手术持续时间明显延长,术中出血量显著增加(P均<0.01)。观察组宫颈上皮内瘤复发率、人乳头瘤病毒感染率均低于对照组(P<0.05);2组患者术后并发症发生率比较差异无统计学意义(P>0.05)。结论对宫颈上皮内瘤变Ⅲ级患者实施宫颈冷刀锥切术治疗效果更为显著,但宫颈环电切术的创伤更小,安全性更高,故手术方式应依据患者的具体情况合理选择。
Objective To observe the clinical effect of different methods of cervical conization in the treatment of grade Ⅲ cervical intraepithelial neoplasia. Methods Fifty-five patients with cervical intraepithelial neoplasia who were admitted to our hospital were divided into three groups. The control group, 25 cases were treated by cervical ring electrosurgical excision, while the other 30 cases were treated by cold-necked conization. The duration of operation and blood loss of operation were observed in 2 groups. Residual lesions were reviewed within 3 months after operation. The recurrence rate of cervical intraepithelial neoplasia and infection rate of human papillomavirus were found after 3 months. Results Compared with the control group, the duration of operation in the observation group was significantly prolonged and the amount of bleeding during operation was significantly increased (all P <0.01). The recurrence rate of cervical intraepithelial neoplasia and the infection rate of human papillomavirus in the observation group were lower than those in the control group (P <0.05). The incidence of postoperative complications in the two groups had no significant difference (P> 0.05). Conclusions Cervical intraepithelial neoplasia grade Ⅲ patients with cervical cold knife conization is more effective, but the cervical circumcision is less invasive and more secure, so the surgical approach should be based on the specific circumstances of patients with a reasonable choice .