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 参见附件。

  【摘要】 目的： 探讨宫颈上皮内瘤变冷刀锥切治疗的效果及术后高危型HPV的消退情况。方法：对2007-2010年在本院诊断为149例宫颈上皮内瘤变患者行宫颈冷刀锥切治疗，对患者随访资料进行分析。结果：6个月治愈率为95.9%，术后持续存在率2.7%，术后1年复发率2.0%，2-4年无复发。术前高危型HPV感染的宫颈上皮内瘤变患者术后6、12、24个月清除率分别为84.1%、92.1%、96.4%。结论：宫颈冷刀锥切是宫颈上皮内瘤变的一种重要诊断及治疗方法，术后高危型HPV大部分消退，但高度宫颈上皮内瘤变患者，术后前两年需密切随访。

 【关键词】宫颈上皮内瘤变，宫颈冷刀锥切，人乳头瘤病毒

 Analysis of cold knife conization for treatment of cervical intraepithelial neoplasia.

 Yao Yao Shan Chen zhongdong

 Department of Gynecology ,The Chen Zhou Hospital ,Nan Hua Uniwersity, Chen Zhou 423000,Hu Nan ,China

 【Abstract】 Objective To investigate the effect of cold knife conization(CKC) for treatment of cervical intraepithelial neoplasia(CIN),and the clearance of high-risk human papillomavirus(HPV)after the treatment.Methods A study was conducted on 149 women who underment cold knife for cervical intraepithelial neoplasia from 2007 to 2010 in our hospital.Results The cure rate in this study was 95.9% after first 6 month,The resideual CIN was identified in 4% patient after the treatment.The recurrent CIN occurred in 2.0% patient after the treatment,none in the 2nd,3rd and4th year.Among those who were high-risk HPV infected before the treatment,the clearance rate of high-risk HPV was 84.1%、92.1% and 96.4% after treatment 6 months,12 months 24 months.Conclusion CKC is one of the important methods on diagnosis and treatment of CIN. Most high-risk HPV is cleaned after the treatment. High-grade CIN need follow-up in the first two years after the treatment.

 【Keywords】 Cervical intraepithelial neoplasia, cold knife conization, human papillomavirus

 【中图分类号】R711.74 【文献标识码】B 【文章编号】1007-8231(2011)11-1918-02

 前言

 近年来随着宫颈细胞学检查、人乳头瘤病毒检测的普遍开展，宫颈上皮内瘤变早期发现率明显提高，年轻、有生育要求及生活治疗要求高者的患者更倾向于宫颈冷刀锥切治疗，因此该治疗方法的有效性、安全性及术后HPV消退情况成为人们关注的热点，于是对近4年我院因宫颈上皮内瘤变行宫颈冷刀锥切的149例患者进行回顾性分析，具体如下。

 1 资料与方法

 1.1 临床资料 2007-2010年本院149例因宫颈多点活检病理诊断为宫颈上皮内瘤变患者行宫颈锥切治疗，所有手术切缘均干净，术后随访1-4年。患者年龄在19-55岁，宫颈病变程度：CINI22例，CIN II66例 CIN III61例。术前有139例患者高危型HPV感染，根据锥切病检结果及随访资料，了解患者宫颈冷刀锥切的效果及术后HPV消除等情况。

 1.2 研究方法

 1.2.1 CINI、CIN II者切除碘阴性区外2-3mm宫颈组织，深达1.5-2mm， CIN III者切除碘阴性区外5mm宫颈组织 ......