| objective:Cervical intraepithelial neoplasia III including severely deformed and canser in sute. In this study, We study the intraepithelial neoplasia III deformed By comparing LEEP and cervical cold knife taper cut method in the treatment of CIN III of intraoperative and postoperative bleeding, length of time of surgery, with and without postoperative residual lesions, postoperative pathology and postoperative recurrence, and so on to analysis to get a better method for the treatment of CIN III. method:Retrospective analysis and comparison of our hospital in 2013-2015 confirmed by biopsy pathology for the clinical data of 120 cases of patients with CIN grade III, Which use the CKC treatment of 70 cases, 50 cases treated by LEEP. Collect patients of postoperative bleeding time postoperative pathological results, any focus vestigitai and postoperative follow-up have without relapse and other data, statistical analysis was conducted. If the return of cervical invasive carcinoma postoperative pathologic results,further generalized total hysterectomy, pelvic lymph node resection, etc. To review every 6 months after discharge follow-up cervical liquid based cytology and HPV detection. Cervical liquid based cytology revealed abnormal persons are once again with the cervical multi-point biopsy under colposcope, cytological examination is normal, but the person that HPV infection has been also biopsy under colposcope, parallel the ECC, in order to make clear whether CIN relapse. The judgment standard of the is study is :(1) After treatment, the resection specimen histopathological examination showed cut edge where there are still consider for residual CIN.(2) After treatment, postoperative half year is CIN shall be continuous deposit of CIN.(3) Postoperative pathology showed no residual, operation in the treatment of six months after inspection confirmed CIN there should be a relapse(4)After treatment and postoperative half year review CIN was not found, no contact with the symptom such as hemorrhage, did not see the cervical adhesion to cure such complications. result:Postoperative pathological revealed that decreased postoperative, pathological tip grade 43 people, the CKC group of 24 people, 19 people LEEP group; Preoperative postoperative pathology in 58 people, CKC group of 34 people, LEEP group of 24 people; Postoperative pathology not seen CIN lesions, only 16 people for inflammation,CKC group of 10 people, LEEP group of 6 people. Treatment of CIN III, USES the CKC surgical methods in treatment group, operation time is longer than using LEEP group, the CKC group average operation time was 35.8 ±6.4 min LEEP group operation time was 10.5±7.7 min. The CKC are more than the LEEP intraoperative bleeding and postoperative bleeding, the average blood loss was 58.6±7.4 ml CKC group, Applying the data for statistical processing, p < 0.05, the difference is statistically significant. According to postoperative pathological condition, adopt the CKC group operation way, postoperative patients with lesions residue and adopts the LEEP method, CKC group for 4 cases of postoperative cut edge positie LEEP group began cutting edge positive rCKC group 2 people, LEEP group 3 people, ate in 3 cases, because of the older, the two groups after pathological returns no fertility requirements and total hysterectomy in cut edge positie, CKC group of 14 people, respectively, LEEP group 9 people, according to the result of pathology, whole cut after chronic inflammation pathological results for four people, including 3 CKC group, LEEP group 1. Histological the results of after panhysterectomy, CIN II and the below, CKC group 2 people,LEEP group 3 people; CIN III CKC group 2 people,LEEP group 3 people; Infiltrating carcinoma CKC group 2 people, LEEP group 2 people; Chronic inflammation, CKC group 3 people, LEEP group 1 people, will be treated as the obtained data were statistically, P > 0.05, the difference is not statistically significant, Curative effect in the treatment of CIN level III CKC and LEEP has no obvious difference in total removal of lesion group, postoperative residual LEEP and CKC groups no significant statistical difference. The occurrence of postoperative complications, CKC group, 4 cases of postoperative hemorrhage in 2 cases. Postoperative cervical adhesion and 1 case of cervical insufficiency. LEEP group in 1 case, no cervical adhesion and cervical insufficiency, Statistical analysis, there was no statistically significant difference, indicating that both have the possibility of postoperative complication. Follow-up, lost to the number of 29 cases(16.7%), among which 9 cases, CKC LEEP group 20 cases. USES the CKC healers, postoperative follow-up during cervical liquid based cytology was abnormal in 3 patients(5.7%), HPV infection 0 cases, further in the cervical multi-point biopsy under colposcope, pathological results show CIN recurrence in 1 case. In the process of using LEEP treatment, follow-up found that cervical cytology performance test results was abnormal in 5 cases, HPV infection(3 cases), after cervical multi-point biopsy under colposcope, confirmed by pathology CIN lesions recurred in 2 cases, postoperative will be statistical data processing, p > 0.05, there was no statistically significant difference, CKC treatment of CIN III, the recurrence rate has no obvious statistical difference. Conclusion:The LEEP treatment of CIN III with less bleeding, shorter operation time, low cost of treatment, patients were more willing to accept. CKC and LEEP compare two treatments, although in terms of residual and postoperative recurrence of lesions there was no statistically significant difference between, but the CKC lesions residue rate was 5.7%, the recurrence rate was 1.7%, while the LEEP residual rate was 16.0%, the focus of the recurrence rate was 6.7%. Both have the possibility of postoperative complication. Integrated the above aspects, LEEP is effective in the treatment of CIN III measures. |
PDF Full Text Request