摘要
目的：评价高频电波刀电圈切除术（LEEP）和冷刀宫颈锥切术（CKC）治疗宫颈上皮内瘤变的疗效和安全性。方法：计算机检索Embase（1966—2009年）、PubMed（1970～2009年）、cochrane library（2009，2Issue）和CBM（1978—2009年）、CNKI（1994—2009年）、VIP（1989—2009年）和万方数据库，收集LEEP和CKC治疗宫颈上皮内瘤变的随机对照试验。按照Cochrane系统评价方法，严格评价纳入研究质量，对同质研究采用RevMan5．0．1软件进行Meta分析。结果：共纳入6个随机对照实验，568个患者。Meta分析结果显示：LEEP组在手术时间和术中出血量方面，明显少于CKC组，但在宫颈狭窄、术后出血、复发率、治愈率和术后残余瘤和切缘阳性率方面比较，差异均无统计学意义（P〉0．05）。结论：由于LEEP的手术时间和术中出血量明显少于CKC，且患者痛苦小、术后恢复快、不麻醉、不住院的优势，因此LEEP仍值得在临床广泛推广，但尚需要开展高质量的随机对照试验进一步探讨。其相关妊娠并发症方面等长期随访的效果。
Objective： The efficacy and safety of loop electrosurgical excision procedureL （LEEP） and cold-knife conization （CKC） in the treatment of cervical intraepithelial neoplasia was evaluated. Methods：Embase （1966 to 2009 ）, PubMed （ 1970 to 2009 ）, Cochrane library （2009,2 lssue）, CBM （ 1978 to 2009 ） and Wanfang datebase were searched for randomized controlled trials. The quality of the included RCTs was evaluated according to the Cochrane Handbook for Systematic Reviews. Meta analysis was performed for the same quality RCTs by RevMan 5.0.1 software. Results：Six RCTs （568 patients） were included.. Meta a- nalysis revealed that LEEP group had significant less operation time and blood loss than the CKC group. However ,there were no significant differences in cervical stenosis, postoperative bleeding, recurrence rate, cure rate, postoperative residual tumor and positive cutting margin （ P 〉 0.05）. Conclusions： LEEP has the obvious advantages than CKC in less surgical time, blood loss and pain, faster postoperative recovery, non- narcotic and non-hospitalization, therefore, LEEP can be widely used in clinical work. However, high-quality randomized controlled trials are still needed to further assess the long-term complications, such as the effects on pregnancy.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2010年第7期516-519,共4页
Journal of Practical Obstetrics and Gynecology
