Townsend D E, Richart R M, Marks E, Nielsen J
Obstet Gynecol. 1981 Feb;57(2):145-9.
Factors relating to the inappropriate therapy of 66 cases of cervical cancer are reviewed. The patients are divided into 2 major categories: 1) 33 who underwent cryosurgery or hot cautery without colposcopy; 2) 9 who underwent colposcopy without outpatient therapy; and 3) 24 who underwent colposcopy followed by outpatient therapy. Of the patients who had outpatient therapy without colposcopy, the major indication for treatment was "cervicitis," and all had a normal Papanicolaou smear. Of the 33 patients who underwent colposcopy because of an abnormal Papanicolaou smear, the proper treatment evaluation was carried out in only 5. The endocervical curettage (ECC) was omitted in 17 patients; no biopsies were taken in 8 patients; and conization of the cervix was omitted in 3 patients who had a positive ECC. Recommendations are made to minimize the inappropriate use of the outpatient approach in patients with cervical disease.
本文回顾了66例宫颈癌不恰当治疗的相关因素。患者分为两大类：1）33例未行阴道镜检查就接受了冷冻手术或热烧灼治疗；2）9例接受了阴道镜检查但未进行门诊治疗；3）24例接受了阴道镜检查并随后进行了门诊治疗。在未行阴道镜检查就接受门诊治疗的患者中，主要治疗指征为“宫颈炎”，且所有患者巴氏涂片检查结果均正常。在因巴氏涂片异常而接受阴道镜检查的33例患者中，仅5例进行了正确的治疗评估。17例患者未进行宫颈管刮术（ECC）；8例患者未取活检；3例ECC结果阳性的患者未进行宫颈锥切术。本文提出了一些建议，以尽量减少宫颈疾病患者门诊治疗方法的不当使用。
