LEEP 术和子宫全切术治疗宫颈高级别上皮内瘤变的效果比较

樊丽萍1 ，张忠明2

（1.陕西省扶风县人民医院妇产科，陕西 宝鸡，722200；2.西安交通大学第一附属医院妇产科，陕西 西安，710061）

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摘要：

目的 比较宫颈环形电切术（LEEP）和全子宫切除术对宫颈高级别上皮内瘤变（CIN II~III）的治疗效果。方法 对扶风县人民医院妇产科经阴道镜活检病理确诊的310例CIN II~III患者，按治疗方式分成LEEP治疗组（220例）和全子宫切除组（90例），比较不同术式的术后病理分级变化、疗效及复发等情况。结果 LEEP组与全子宫切除组病理检查与术前阴道镜活检病理诊断一致性均较好。LEEP治疗组和全子宫切除组的治愈率分别为94.55%和96.67%，两组无显著差异（P>0.05）。平均随访24个月，LEEP组复发3例（1.36%）；全子宫切除术组复发1例（1.11%），两组无显著差异（P>0.05）。结论 恰当合理的 LEEP术和全子宫切除术对宫颈高级别上皮内瘤变均有很高的治愈率；LEEP术操作简单、损伤更小、保全子宫，可以弥补基层医院阴道镜下活检病理诊断的不足，对明确诊断和满意治疗具有更大的临床意义。

关键词：宫颈高级别上皮内瘤变；宫颈环形电切术；全子宫切除术

中图分类号：R737.33文献标志码：A文章编号：2096-1413(2017)08-0075-02

Comparative analysis of the efficiency of LEEP and hysterectomy in the treatment of high grade cervical intraepithelial neoplasia
FAN Li-ping 1, ZHANG Zhong-ming 2
(1. Department of Gynecology and Obstetrics, Fufeng County People`s Hospital, Baoji 722200; 2. Department of Gynecology and Obstetrics, the First Affiliated Hospital of Xi`an Jiaotong University, Xi`an 710061, China)

ABSTRACT: Objective To compare the therapeutic effect of loop electrosurgical excision procedure (LEEP) and hysterectomy in the treatment of high grade cervical intraepithelial neoplasia (CIN II-III). Methods Three hundred and ten cases of patients with CIN II-III were diagnosed by the colposcopically directed biopsy, which were divided into LEEP group (220 cases) and hysterectomy group (90 cases) according to the treatment methar. The changes of postoperative pathological grading, curative effect and recurrence were compared. Results The cure rate of LEEP group and hysterectomy group were respectively 94.55% and 96.67%, there was no significant difference (P>0.05). After a mean follow-up of 24 months, there were 3 (1.36%) recurrent cases in the LEEP group and 1 (1.11%) recurrent case in the hysterectomy group, there was no significant difference (P>0.05). Conclusion Appropriate and reasonable LEEP and hysterectomy for the treatment of CIN II-III have a high cure rate. LEEP is simple to operate, which has less damage to the patients and keep intact of the womb in the treatment of CIN II-III. It could remedy some deficiency of colposcopically directed biopsy pathology in the primary hospital and had greater clinical significance for definite diagnose and satisfactory treatment.
KEYWORDS: high grade cervical intraepithelial neoplasia (CIN II-III); loop electrosurgical excision procedure (LEEP); hysterectomy

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