Townsend D E, Richart R M
CA Cancer J Clin. 1982 Mar-Apr;32(2):85-91. doi: 10.3322/canjclin.32.2.85.
The reintroduction of colposcopy and the introduction of outpatient therapy have significantly altered the management of the woman with an abnormal Pap smear. Routine conization is no longer considered mandatory, particularly for the lower grades of CIN. We estimate that over 10,000 gynecologists in North America have received instruction in colposcopy. Virtually every teaching hospital and medical center has colposcopy available. It is a valuable evaluative tool, particularly with the increasing risk of CIN in young women and the fact that more women are delaying childbearing until the third and fourth decades of life. The technique does, however, require a rigorous period of training, significant experience, and strict adherence to an established evaluation protocol. In the hands of the neophyte, the consequences of in-appropriate evaluation of the woman with an abnormal Pap smear can be tragic.
阴道镜检查的重新引入以及门诊治疗的开展，显著改变了对巴氏涂片异常女性的管理方式。常规锥形切除术不再被视为必要手段，尤其是对于低级别宫颈上皮内瘤变（CIN）而言。我们估计，北美有超过10000名妇科医生接受过阴道镜检查方面的培训。几乎每家教学医院和医疗中心都配备了阴道镜。它是一种有价值的评估工具，特别是鉴于年轻女性患CIN的风险不断增加，以及越来越多的女性将生育推迟到三四十岁这一事实。然而，这项技术确实需要一段严格的培训期、丰富的经验以及严格遵循既定的评估方案。在新手手中，对巴氏涂片异常女性进行不恰当评估的后果可能是悲惨的。
