摘要
目的分析冷刀-电刀-冷刀子宫颈锥切术与冷刀锥切术在子宫颈癌前病变治疗中的临床效果,并探讨治疗方式对患者生育功能的影响。方法方便选择2018年1月—2020年5月于该院进行诊治的66例子宫颈癌前病变患者为研究对象,依据单盲法分为参照组与观察组,每组33例。参照组患者施以的治疗方式为冷刀锥切术,观察组患者施以的治疗方式为冷刀-电刀-冷刀子宫锥切术,对两组患者手术指标、治疗效果、妊娠与分娩结局进行对比。结果观察组患者痊愈率为66.6%,高于参照组,但差异无统计学意义(χ^(2)=1.015,P=0.313);观察组患者妊娠率为96.9%,显著高于参照组,差异有统计学意义(χ^(2)=4.631,P=0.031);观察组术中出血量为(13.48±2.49)mL、手术时长为(28.86±3.25)min、转化区切除椎体长度Ⅰ型为(15.41±1.09)mm、Ⅱ型为(15.64±1.47)mm、Ⅲ型为(16.47±1.37)mm,明显优于参照组,差异有统计学意义(t=9.676、7.777、5.645、6.131、4.757,P<0.001)。结论冷刀-电刀-冷刀子宫颈锥切术与冷刀子宫颈锥切术均适用于子宫颈癌前病变的临床治疗,但冷刀-电刀-冷刀子宫颈锥切术操作方式可以改善手术指标,对患者生育能力的保留具有积极意义,值得研究推广。
Objective To analyze the clinical effects of cold knife-electric knife-cold knife cervical conization and cold knife conization in the treatment of cervical precancerous lesions,and discuss the influence of treatment methods on patients'fertility.Methods The 66 patients with cervical precancerous lesions who were diagnosed and treated in the hospital from January 2018 to May 2020 were conveniently selected as the research objects.According to the single-blind method,they were divided into the reference group and the observation group,with 33 cases in each group.The reference group treated patients with cold knife conization,and the observation group treated patients with cold knife-electric knife-cold knife hysterectomy.The surgical indicators,therapeutic effects,the outcome of pregnancy and childbirth of the two groups were compared.Results The recovery rate of patients in the observation group was 66.6%,which was higher than that of the reference group,but the difference was not statistically significant(χ^(2)=1.015,P=0.313);the pregnancy rate of patients in the observation group was 96.9%,and was significantly higher than that of the reference group,and the difference was statistically significant(χ^(2)=4.631,P=0.031);the intraoperative blood loss of the observation group was(13.48±2.49)mL,the operation time was(28.86±3.25)min,and the length of vertebral body resection in the transformation zone was(15.41±1.09)mm,typeⅡwas(15.64±1.47)mm,typeⅢwas(16.47±1.37)mm,significantly better than the reference group,the difference was statistically significant(t=9.676,7.777,5.645,6.131,4.757,P<0.001).Conclusion Cold knife-electric knife-cold knife cervical conization and cold knife cervical conization are both suitable for the clinical treatment of cervical precancerous lesions.However,the operation method of cold knife-electric knife-cold knife cervical conization can improve the surgical index,and has positive significance for the preservation of patient fertility,and it is worthy of research and promotion.
作者
林莉
冯继良
杜淑娟
陈美娟
LIN Li;FENG Jiliang;DU Shujuan;CHEN Meijuan(Department of Gynecology,the Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian Province,361001 China)
出处
《中外医疗》
2022年第4期58-61,共4页
China & Foreign Medical Treatment
关键词
冷刀
电刀
冷刀子宫颈锥切术
生育功能
手术指标
Cold knife
Electric knife
Cold knife cervical conization
Fertility
Surgical index
作者简介
林莉(1980-),女,本科,副主任医师,研究方向为妇科,子宫及卵巢良恶性肿瘤,宫颈病变。
