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目的探讨电刀锥切术(EKC)在宫颈上皮内瘤变(CIN)与早期宫颈癌诊治中的临床效果。方法选取2010年1月—2014年2月收治的阴道镜活检诊断为CIN、原位癌(CIS)及早期浸润癌患者159例,其中行冷刀锥切术(CKC)74例(A组),行EKC手术85例(B组)。比较两组手术时间、出血量、锥高、锥宽、锥切病理结局、切缘阳性及术后并发症;随访9个月以上评估预后情况。结果 B组手术时间(23.36±6.64)min短于A组(30.23±7.24)min,出血量(75.23±13.15)ml少于A组(127.24±12.44)ml,并发症发生率(5.88%)低于A组(16.22%)(P<0.05)。两组锥切大小、锥切病理结局、切缘阳性、痊愈率均无明显差异(P>0.05)。结论 EKC与CKC具有同样准确的病理结局及切缘阳性判断,但出血少、省时、并发症少。
Objective To investigate the clinical effect of EKC in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN) and early cervical cancer. Methods A total of 159 patients with CIN, CIS and early invasive carcinoma diagnosed by colposcopy biopsy from January 2010 to February 2014 were enrolled. Among them, 74 patients underwent cold knife conization (CKC) (group A) , 85 cases of EKC surgery (B group). The operation time, bleeding volume, cone height, cone width, conization pathological results, positive margin and postoperative complications were compared between the two groups. The prognosis was evaluated after 9 months of follow-up. Results The operative time in group B was shorter than that in group A (30.23 ± 7.24) min, and the bleeding volume was (75.23 ± 13.15) ml less than that in group A (127.24 ± 12.44) ml. The complication rate was 5.88% In group A (16.22%) (P <0.05). There was no significant difference between the two groups in conization size, cone conization, positive margins and cure rate (P> 0.05). Conclusion EKC and CKC have the same accurate pathological findings and positive margins, but less bleeding, time-saving and less complications.