摘要
目的应用超声E-cervix宫颈弹性成像技术评估HSIL及其不同锥切方式对育龄期女性宫颈机能的影响,为临床采取手术方式的选择及是否采取预防性措施提供参考。方法回顾性分析2011年5月-2022年12月于浙江大学医学院附属妇产科医院就诊并确诊为HSIL的患者114例及进行锥切手术治疗的患者103例为研究对象,并根据病理结果分为CINII组65例,CINIII组49例,根据不同锥切方式分为宫颈环形电切术(LEEP)组59例和宫颈冷刀锥切术(CKC)组44例。同期纳入56例宫颈正常者作为对照组。各组均由PACS系统获得超声E-cervix宫颈弹性成像参数,包括弹性对比指数(ECI)、硬度比值(HR)、宫颈外口应变率(EOS)、宫颈内口应变率(IOS)及其比值(IOS/EOS)、宫颈长度(CL)。比较各组间宫颈弹性参数的差异。结果①CKC组的ECI、IOS、EOS均高于其他各组,HR低于其他各组;LEEP的EOS高于CINII组、CINIII组(P<0.05)。②CKC组、LEEP组、CINII组、CINIII的CL均比对照组短(P<0.05)。结论HSIL患者宫颈变短,也许可以作为超声诊断宫颈癌前病变的辅助条件。锥切术后患者宫颈变短,但CKC术后宫颈整体硬度也降低,宫颈机能受损,对于育龄期HSIL患者手术方式的选择更倾向于LEEP手术。超声E-cervix弹性成像技术可以全面监测育龄期HSIL患者锥切术前、后宫颈长度及软硬度的改变,值得临床推广应用。
Objective To evaluate the effect of HSIL and its different conization methods on the cervical incompetence of women of childbearing age by using ultrasonic E-cervix cervical elastography,and provide reference value for the selection of surgical methods and whether to take preventive measures.Methods A retrospective analysis was made of 114 patients with HSIL who were diagnosed in our hospital from May 2011 to December 2022 and 103 patients who underwent conization.According to the pathological results,they were divided into CINII group(65 cases)and CINIII group(49 cases).According to different conization methods,they were divided into LEEP group(59 cases)and CKC group(44 cases).At the same time,56 patients with normal cervix were included as the control group.The parameters of ultrasonic E-cervix cervical elastic imaging were obtained by PACS system in all groups,including elastic contrast index(ECI),hardness ratio(HR),strain value of external cervical os(EOS),strain value of internal cervical os(IOS),its ratio(IOS/EOS),and cervical length(CL).Compare the difference of cervical elasticity parameters between groups.Results①The ECI,IOS and EOS of CKC group were higher than those of other groups,and HR was lower than those of other groups;the EOS of LEEP was higher than that of CINII group and CINIII group(P<0.05).②The CL of CKC group,LEEP group,CINII group and CINIII group were shorter than those of the control group(P<0.05).Conclusion The cervical shortening in HSIL patients may be an auxiliary condition for ultrasonic diagnosis of cervical precancerous lesions.After conization,the cervix of the patients becomes shorter,the overall hardness of the cervix after CKC is also reduced,and the cervical function is damaged.For HSIL patients of childbearing age,the choice of surgical method is more inclined to LEEP surgery.Ultrasound E-Cervix elastic imaging technology can comprehensively monitor the changes of cervical length,soft and hardness in HSIL patients of childbearing age before and after conization,which is worthy of clinical application.
作者
刘安宁
Liu Anning(Obstetrics and Gynecology Hospital Affiliated to Zhejiang University School of Medicine,Hangzhou,Zhejiang 310000,China)
出处
《首都食品与医药》
2023年第13期67-70,共4页
Capital Food Medicine
