实用医学杂志2026，Vol.42Issue(12)：2161-2169,9.DOI:10.3969/j.issn.1006-5725.2026.12.010
CO2激光与宫颈环形电切术治疗宫颈高级别上皮内病变的疗效比较及影响因素分析
Comparison of the curative effects and analysis of influencing factors between CO2 laser and loop electro-surgical excision procedure in the treatment of high-grade cervical intraepithelial lesions
摘要
Abstract
Objective This study was designed to compare the peri-operative indicators,efficacy,and influencing factors between carbon dioxide(CO2)laser therapy and loop electrosurgical excision procedure(LEEP)in treating cervical intraepithelial neoplasia grade 2(CIN2)patients with fertility requirements.Methods We retrospectively included 267 patients with pathologically-confirmed CIN2 from November 2021 to June 2024.Among them,154 patients received CO2 laser treatment,and 113 patients received LEEP treatment.We compared the peri-operative indicators,lesion remission rates at 6 and 12 months after surgery,high-risk human papillomavirus(HR-HPV)clearance rates,and cervical cytology(TCT)clearance rates between the two groups.Stratified analyses were carried out according to age and human papillomavirus(HPV)infection type,and multivariate logistic regression was employed to analyze the factors influencing the efficacy.Results The CO2 laser group exhibited significant advantages over the LEEP group in aspects such as operative time,intraoperative blood loss,postoperative bleed-ing duration,recovery time,complication rates,and treatment costs(P＜0.05).Nevertheless,at 6 and 12 months after the operation,the lesion remission rates were notably higher in the LEEP group when compared to the CO2 laser group(79.65％vs.68.83％,P=0.045;78.76％vs.66.23％,P=0.022).Moreover,the overall HPV clearance rate at 6 months after the operation was higher in the LEEP group(80.53％vs.70.13％,P=0.047),yet no significant difference was detected between the two groups at 12 months after the operation.Stratified analysis indicated that LEEP showed a more prominent early-efficacy advantage in patients aged 25-45 years.Multivariate analysis verified that multiple human papillomavirus(HPV)infections were an independent risk factor influencing postoperative lesion remission,whereas the treatment modality itself was not an independent influencing factor.Conclusions CO2 laser therapy presents significant advantages in terms of minimal invasiveness,rapid recovery,and effective cost control.In contrast,LEEP can lead to quicker early clearance of lesions in patients of reproductive age.Clinical decision-making ought to comprehensively take into account the patient's age,HPV infection status,and individualized requirements.Patients with multiple HPV infections need intensified postoperative monitoring.Future prospective studies with long-term follow-up are necessary to validate these conclusions.关键词
宫颈高级别上皮内瘤变2级/CO2激光/宫颈环形电切术/人乳头瘤病毒/疗效比较Key words
cervical intraepithelial neoplasia grade 2/CO2 laser/loop electrosurgical excision proce-dure/human papillomavirus/comparative efficacy research分类
医药卫生引用本文复制引用
易丹妮,郭芝亮,蔡春芳,詹望桃,沈青丽,王庆玲,石雪金,叶素琪,刘泽群..CO2激光与宫颈环形电切术治疗宫颈高级别上皮内病变的疗效比较及影响因素分析[J].实用医学杂志,2026,42(12):2161-2169,9.基金项目
广东省医学科研基金指令性课题(编号:C2021093) （编号:C2021093）
