Richardson A C, Lyon J B
Am J Obstet Gynecol. 1981 Aug 15;140(8):909-13. doi: 10.1016/0002-9378(81)90084-3.
Between January 1, 1968, and July 1, 1980, 377 of a total 412 patients with biopsy-proven cervical intraepithelial neoplasia (CIN) were seen in the private office of the authors and followed for more than 6 months after biopsy and the start of treatment. Thirty-five patients were lost to follow-up. Ninety-one were treated primarily by hysterectomy. The 286 patients in whom childbearing function was to be preserved were instructed, as soon as the diagnosis of CIN was confirmed, to use a mechanical barrier (the condom) throughout intercourse. In addition to the use of the condom, 40 of the 286 underwent surgical conization and 107 underwent cryosurgery. All of these 147 patients eventually showed cytologic and colposcopic regression of the disease. One hundred and thirty-nine patients were treated with the condom alone. One hundred and thirty-six of the 139 showed complete regression of the disease. Eighteen (6.2%) of the 286 patients had late recurrences of the disease; 12 of these experienced regression again with the resumption of the use of the condom. No patients showed progression of the disease while using the condom. All grades of CIN proved to be reversible. It is recommended that a mechanical barrier at intercourse be added to any program for conservative treatment of CIN.
在1968年1月1日至1980年7月1日期间,作者私人诊所共诊治了412例经活检证实为宫颈上皮内瘤变(CIN)的患者,其中377例在活检及开始治疗后进行了6个月以上的随访。35例患者失访。91例主要接受了子宫切除术治疗。对于286例需要保留生育功能的患者,一旦确诊CIN,即指导其在性交过程中全程使用机械屏障(避孕套)。除使用避孕套外,286例中的40例接受了手术锥切,107例接受了冷冻治疗。这147例患者最终均显示疾病的细胞学和阴道镜下消退。139例患者仅使用避孕套治疗。139例中的136例疾病完全消退。286例患者中有18例(6.2%)疾病出现晚期复发;其中12例在重新使用避孕套后疾病再次消退。在使用避孕套期间,没有患者疾病进展。所有级别CIN均被证明是可逆的。建议在任何CIN保守治疗方案中增加性交时使用机械屏障这一措施。