摘要
目的对高级别鳞状上皮内病变(HSIL)采用宫颈环形电切术(LEEP)治疗的临床价值进行分析。方法选取116例HSIL患者,根据手术方式不同分为对照组和观察组,其中行冷刀锥切术为对照组,而实施LEEP为观察组,每组58例。比较两组患者围术期指标、治疗效果、血清炎症因子[血清淀粉样物质A(SAA)、C反应蛋白(CRP)以及降钙素原(PCT)]水平、术后并发症发生情况、生活质量评分。结果观察组术中出血量(10.93±3.55)ml、切除组织面积(4.28±1.49)cm2小于对照组的(44.04±10.66)ml、(5.11±1.35)cm2,手术时间(10.15±2.42)min、切口愈合时间(22.18±5.09)d、住院时间(3.21±1.18)d均短于对照组的(28.01±5.64)min、(37.43±11.18)d、(6.31±1.76)d,差异有统计学意义(P<0.05)。观察组中无效3例、有效15例、显效40例,总有效率为94.83%;对照组中无效11例、有效19例、显效28例,总有效率为81.03%。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。术后,两组患者PCT、CRP、SAA水平均低于术前,且观察组PCT(0.31±0.05)ng/ml、CRP(10.02±2.56)mg/L、SAA(1.03±0.28)mg/L均低于对照组的(0.58±0.12)ng/ml、(15.38±3.11)mg/L、(3.54±0.62)mg/L,差异有统计学意义(P<0.05)。观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。观察组健康程度评分(95.98±3.21)分、躯体角色评分(94.86±3.09)分、躯体功能评分(95.11±3.27)分、心理健康评分(94.54±3.18)分、机体疼痛评分(96.87±3.36)分、社会功能评分(93.76±3.11)分、情感角色评分(93.95±3.02)分均高于对照组的(83.11±5.09)、(84.23±4.13)、(84.25±4.37)、(84.02±2.09)、(85.34±3.28)、(84.95±3.21)、(84.53±3.27)分,差异有统计学意义(P<0.05)。结论在HSIL患者的临床治疗中,与冷刀锥切术相比,LEEP优点确切,如并发症率少、恢复效率高等,可以提高治疗效果,改善患者生活质量,值得推广。
Objective To analyze the clinical value of loop electrosurgical excision procedure(LEEP)for the treatment of high-grade squamous intraepithelial lesions(HSIL).Methods A total of 116 patients diagnosed with HSIL were selected and divided into the control group and the observation group based on different surgical methods,with patients receiving cold knife conization as the control group,and those receiving LEEP as the observation group,58 cases per group.Comparison of perioperative indicators,therapeutic effects,levels of serum inflammatory factors[serum amyloid A(SAA),C-reactive protein(CRP),and procalcitonin(PCT)],occurrence of postoperative complications,and quality of life score between the two groups.Results In the observation group,the intraoperative blood loss was(10.93±3.55)ml and the area of excised tissue was(4.28±1.49)cm2,which were less than those in the control group[(44.04±10.66)ml and(5.11±1.35)cm2];the operation time was(10.15±2.42)min,the wound healing time was(22.18±5.09)d,and the length of hospital stay was(3.21±1.18)d,which were shorter than those in the control group[(28.01±5.64)min,(37.43±11.18)d,and(6.31±1.76)d];the difference was statistically significant(P<0.05).In the observation group,3 cases showed no improvement,15 cases were improved,and 40 cases showed marked improvement,yielding a total effective rate of 94.83%.In the control group,11 cases showed no improvement,19 cases were improved,and 28 cases showed marked improvement.The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After the operation,the levels of PCT,CRP,and SAA in both groups of patients decreased compared to those before the operation;the observation group had PCT of(0.31±0.05)ng/ml,CRP of(10.02±2.56)mg/L,and SAA of(1.03±0.28)mg/L,which were lower than those in the control group[(0.58±0.12)ng/ml,(15.38±3.11)mg/L,and(3.54±0.62)mg/L];the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The health status score in the observation group was(95.98±3.21)points,the physical role score was(94.86±3.09)points,the physical functioning score was(95.11±3.27)points,the mental health score was(94.54±3.18)points,the body pain score was(96.87±3.36)points,the social functioning score was(93.76±3.11)points,and the emotional role score was(93.95±3.02)points,which were higher than those in the control group[(83.11±5.09),(84.23±4.13),(84.25±4.37),(84.02±2.09),(85.34±3.28),(84.95±3.21),and(84.53±3.27)points];the difference was statistically significant(P<0.05).Conclusion In the clinical treatment of HSIL patients,LEEP has definite advantages,such as a lower complication rate and higher recovery efficiency compared with cold knife conization.It also can improve the therapeutic effect and enhance the quality of life of patients,and is worthy of promotion.
作者
汤恋花
龙滨
陈琳
高玉环
董怡君
TANG Lian-hua;LONG Bin;CHEN Lin(Gynecology Department,Guangzhou Medical University Affiliated Eighth Hospital,Guangzhou 510440,China)
出处
《中国实用医药》
2025年第20期24-28,共5页
China Practical Medicine
关键词
高级别鳞状上皮内病变
宫颈环形电切切除术
生活质量
High-grade squamous intraepithelial lesions
Loop electrosurgical excision procedure
Quality of life
