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目的探讨宫颈环形电切术(LEEP)治疗宫颈炎及宫颈上皮内瘤变(CIN)1级的疗效。方法选择病理活检为宫颈炎(90例)及CIN1(74例)要求手术的患者进行LEEP,术后病理为CIN3、年龄大于40岁且无生育要求者行子宫全切术,余进行宫颈液基细胞学(TCT)检查随访和宫颈塑形满意度调查。结果 74例CIN1行LEEP,术后诊断炎症者3例,CIN1 55例,CIN2 12例,CIN34例;90例宫颈炎LEEP术后诊断炎症者78例,CIN1 9例,CIN2 3例。CIN3 4例行子宫全切术;其余160例术后3个月宫颈塑形满意度为95.0%(152/160)。64例最终诊断为CIN1者随访6个月后阴道镜活检仍为CIN1者2例,复发率为3.13%(2/64),治愈率为96.88%(62/64);81例最终诊断为宫颈炎患者随访3个月治愈率为95.06%(77/81)。阴道镜下宫颈活检诊断的总准确率为81.10%(133/164),CIN2/CIN3的漏诊率为11.59%。结论 LEEP治疗宫颈炎及CIN1治愈率高,宫颈塑形好,且能减少阴道镜下活检的漏诊。
Objective To investigate the efficacy of cervical ring excision (LEEP) in the treatment of cervicitis and cervical intraepithelial neoplasia (CIN) grade 1. Methods Pathological biopsy was performed on patients with cervicitis (90 cases) and CIN1 (74 cases) undergoing surgery for LEEP. Postoperative pathology was CIN3. Patients under 40 years of age who had no requirement for childbirth underwent hysterectomy. Cytology (TCT) follow-up and cervical shape satisfaction survey. Results 74 cases of CIN1 line LEEP, 3 cases of postoperative diagnosis of inflammation, CIN1 55 cases, CIN2 12 cases, CIN34 cases; 90 cases of cervicitis LEEP postoperative diagnosis of inflammation in 78 cases, CIN1, CIN2 in 3 cases. CIN3 4 routine hysterectomy; the remaining 160 cases of 3 months after cervical molding satisfaction was 95.0% (152/160). 64 cases finally diagnosed as CIN1 were followed up for 6 months, colposcopy biopsy was still CIN1 in 2 cases, the recurrence rate was 3.13% (2/64), the cure rate was 96.88% (62/64); the final diagnosis of 81 cases of cervical 3 months follow-up of patients with inflammation cure rate was 95.06% (77/81). The total accuracy of colposcopic biopsy under colposcopy was 81.10% (133/164), and the rate of misdiagnosis of CIN2 / CIN3 was 11.59%. Conclusion LEEP treatment of cervicitis and CIN1 high cure rate, good cervical shape, and can reduce the missed diagnosis of colposcopy biopsy.