二氧化碳激光手术治疗宫颈上皮内瘤变。

Carbon dioxide laser surgery for cervical intraepithelial neoplasia.

作者信息

Wright V C

出版信息

Lasers Surg Med. 1984;4(2):145-52. doi: 10.1002/lsm.1900040204.

DOI:10.1002/lsm.1900040204

PMID:6472027

Abstract

During 1977-1983, 787 consecutive referred cases of CIN were treated by vaporization of a dome-shaped defect, by excision of a cylindrical specimen, or a combination of procedures where 48% were CIN III. Vaporization was used for 72% of CIN I, 76% of CIN II, and 64% of CIN III cases. Less than 15% of vaporization and all excision cases were done in hospital under anesthesia; 11% had delayed bleeding requiring attention (admission was required in 2%); 100% of CIN I, 96% of CIN II, and 96% of CIN III cases were cured. Persistent disease was diagnosed at the first (96%) or second (4%) visit. Subsequent treatment included laser and less than 1% hysterectomy. Overall cure for laser surgery was 99.5%. Sixty-eight patients subsequently became pregnant; outcomes were normally distributed. Treatment success is related to adequate volume of tissue removed.

摘要

在1977年至1983年期间，787例连续转诊的宫颈上皮内瘤变（CIN）病例采用穹顶状缺损汽化、圆柱形标本切除或联合手术进行治疗，其中48%为CIN III级。CIN I级病例中72%采用汽化治疗，CIN II级病例中76%采用汽化治疗，CIN III级病例中64%采用汽化治疗。汽化治疗和所有切除病例中，不到15%在医院麻醉下进行；11%出现延迟性出血需要处理（2%需要住院）；CIN I级病例的治愈率为100%，CIN II级病例为96%，CIN III级病例为96%。持续性疾病在首次就诊时诊断出96%，第二次就诊时诊断出4%。后续治疗包括激光治疗，不到1%的患者接受了子宫切除术。激光手术的总体治愈率为99.5%。68例患者随后怀孕；妊娠结局呈正态分布。治疗成功与切除足够量的组织有关。