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宫颈上皮内瘤变中利普刀与冷冻疗法的比较

LEEP Verses Cryotherapy in CIN.

作者信息

Singh Abha, Arthur Bhavna, Agarwal Vivek

机构信息

Department of Obstetrics and Gynaecology, Pt. J.N.M. Medical College & Dr. B.R.A.M Hospital, E8, Shankar Nagar, Raipur, CG India.

出版信息

J Obstet Gynaecol India. 2011 Aug;61(4):431-5. doi: 10.1007/s13224-011-0048-1. Epub 2011 Sep 22.

Abstract

OBJECTIVE

To compare the effectiveness and safety profile of LEEP (Loop Electrosurgical Excision Procedure) verses cryotherapy in the treatment of CIN.

MATERIAL AND METHOD

Women with abnormal pap smears were subjected to VIA and VILLI followed by colposcopy. A total of 200 cases were included in this prospective study. Once the diagnosis of CIN was confirmed on histopathology, the women were subjected to either cryotherapy or LEEP randomly. They were follow up at 1, 6 and 12 months. At 12 months follow up, cervix was subjected to VIA, VILLI and colposcopy. Chi square test was used to analyze the data.

OBSERVATIONS

The efficacy of cryotherapy was found to be 88% and that of LEEP was 94% which is not significantly different. The overall cure rate of symptoms was 82 and 79% in cryosurgery and LEEP group, respectively.

CONCLUSION

Although LEEP was associated with higher cure rates but the difference is not significant statistically. Either method if used appropriately gives good results in treatment of CIN lesions, however, LEEP seems to have an edge over cryotherapy when used on severe lesions.

摘要

目的

比较宫颈环形电切术(LEEP)与冷冻疗法治疗宫颈上皮内瘤变(CIN)的有效性和安全性。

材料与方法

对巴氏涂片异常的女性进行醋酸肉眼观察法(VIA)和碘试验(VILLI),随后进行阴道镜检查。本前瞻性研究共纳入200例病例。经组织病理学确诊为CIN后,将这些女性随机分为冷冻治疗组或LEEP组。在1个月、6个月和12个月时对她们进行随访。在12个月随访时,对宫颈进行VIA、VILLI和阴道镜检查。采用卡方检验分析数据。

观察结果

发现冷冻疗法的有效率为88%,LEEP的有效率为94%,两者差异无统计学意义。冷冻治疗组和LEEP组症状的总体治愈率分别为82%和79%。

结论

虽然LEEP的治愈率较高,但差异无统计学意义。如果使用得当,两种方法在治疗CIN病变方面都能取得良好效果,然而,在治疗严重病变时,LEEP似乎比冷冻疗法更具优势。

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