Ferenczy A
Obstet Gynecol. 1985 Dec;66(6):793-8.
Two hundred ninety-four women with cervical intraepithelial neoplasia were treated once with either cryotherapy or laser vaporization. Treatment results were controlled for grade, size, and distribution of cervical intraepithelial neoplasia. Cervical intraepithelial neoplasia measuring less than 3 cm in diameter without extension into the endocervix had similar low failure rates (4 to 5%), regardless of histologic grade or instrument used. Carbon dioxide laser produced comparatively better results for lesions larger than 3 cm in diameter (92%) and those with up to 5 mm extension into the endocervical canal (89%), compared with 62 and 50%, respectively, with cryotherapy. Complications after cryo- and laser therapy were 0.6 and 7.4%, respectively, and included bleeding and pelvic inflammatory disease. Tailoring treatment modalities according to cervical intraepithelial neoplasia size and location rather than using a single treatment approach provides for the most cost-effective and therapeutically rewarding clinical practice.
294名宫颈上皮内瘤变患者接受了一次冷冻疗法或激光汽化治疗。治疗结果根据宫颈上皮内瘤变的分级、大小和分布进行对照。直径小于3厘米且未累及宫颈管内膜的宫颈上皮内瘤变，无论组织学分级或使用的仪器如何，失败率都较低（4%至5%）。对于直径大于3厘米的病变（92%）以及累及宫颈管内膜达5毫米的病变（89%），二氧化碳激光治疗的效果相对较好，而冷冻疗法的相应比例分别为62%和50%。冷冻和激光治疗后的并发症发生率分别为0.6%和7.4%，包括出血和盆腔炎。根据宫颈上皮内瘤变的大小和位置调整治疗方式，而非采用单一治疗方法，可提供最具成本效益且治疗效果最佳的临床实践。
