摘要
目的探讨Leep刀电切术治疗宫颈良性病变的疗效。方法对一年来在我院门诊经宫颈刮片、电子阴道镜、宫颈活组织检查初步诊断的各种宫颈良性疾病276例在局麻下用高频宫颈环形电切刀行环形电切术治疗。通过观察术中反应、术中出血量、手术时间、术后恢复情况、切除标本病理检查状况综合分析。结果276例患者在局麻下除6例患者感下腹坠痛，27例局部有灼热感外，其余243例均无不适；平均出血量5—6mL；平均手术时间7．3分钟；术后随访1—6月，术后10天开始阴道少量血性分泌物，持续5—20天不等，9例术后10～12天出血量接近月经量，持续2天来院就诊为创面痂层脱落，用球形电极电凝止血，1例术后13天突然阴道大量流血，检查发现一小动脉活动出血，经双极电凝止血治愈。266例术后1～2月宫颈外形恢复正常形态，6例术后3月宫颈口见黄豆大息肉形成，4例尖锐湿疣术后2月阴道局部复发行二次Leep刀电切术。结论宫颈Leep刀电切术对宫颈病变可同时进行诊断和治疗，具有术中痛苦少、出血少、时间短，只需局部麻醉，很少出现术后病死率，操作简单，可在门诊进行治疗，治疗宫颈良性病变安全高效，并可保留患者生育功能，值得推广。
Objective To observe therapeutic effect of Leep electrosurgical excision for treatment of cervical benign diseases. Methods 276 cases of different cervical benign diseases diagnosed by cervical smear cytological examination, electrocolposcopy, and cervical biopsy in the out-patient department of our hospital in the last year were treated with Leep electrosurgical excision under local anesthesia. The patient＇s response during operation, amount of bleeding in operation, operation time, postoperative recovery, and pathological examination results of the specimen resected were reviewed. Results Among 276 cases, 243 patients hadn＇t any discomfort except 6 cases of fall pain in the lower abdomen and 27 cases of some burning feeling in a limited area. The average amount of bleeding during the operation was 5 to 6 mL. The average operation time was 7.3 minutes. All the patients were followed-up for 1 to 6 months after the operation. Starting from the tenth day after the operation, the patients had small amount of blood effusion from vagina, persisting 5 to 20 days. Nine cases had almost menstrual amount of vaginal bleeding on the 10th to the 12th day after operation and the vaginal bleeding lasted two days. These nine patients were diagnosed as decrustation of the wound and their bleeding was stopped by round electrode coagulation. One ease had sudden vaginal bleeding on the 13th day after operation due to the active bleeding of a small artery and the bleeding was eventually stopped by double-electrode coagulation. The cervices of 266 patients recovered to normal shape within one to two months after operation. Six patients developed polyps in the os of cervix as large as a soybean at the third month after operation. Four cases of condyloma acuminatum recurred at the second month after operation and were treated again by Leep electrosurgical excision. Conclusion Leep electrosurgical excision can be used to diagnose and treat cervical benign diseases with small amount of bleeding in operation and short operation time. Furthermore, only local anesthesia is needed. The death rate after operation is extremely low compared with other techniques. It is very easy to operate and the operation can be done in the out-patient department. Leep electrosurgical excision is safe and effective for treatment of the cervical benign diseases, and the fertility of the patient can be preserved. Therefore, it is worthy to be popularized in clinic.
出处
《中国妇幼健康研究》
2007年第3期250-251,共2页
Chinese Journal of Woman and Child Health Research
关键词
高频电刀电切术
宫颈病变
临床观察
治疗
Leep electrosurgical excision
cervical lesion
clinical observation
treatment
