【摘要】 目的探讨电子阴道镜检查在宫颈细胞学意义未明的不典型鳞状细胞(atypical squamous cell of undeter-mined significance,ASCUS)分流管理中的临床应用价值。方法对2006年7月至2008年7月在天津医科大学第二医院门诊行宫颈液基细胞学检查(TCT)结果为ASCUS的471例患者进行电子阴道镜检查,其中203例阴道镜诊断为宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)及以上病变者在可疑病变区取活检送病理检查;268例阴道镜检查为正常或慢性宫颈炎者给予阴道用药治疗1~3个疗程,3个月后复查宫颈涂片,4例细胞学仍异常者行阴道镜下取活检送病理检查,余264例细胞学阴性者定期复查宫颈细胞学。结果471例宫颈细胞学AS-CUS患者中,共行活体组织病理学检查207例(43.95%),检出宫颈上皮内瘤样病变(CINⅠ~Ⅲ)131例,宫颈癌4例,余264例避免了宫颈活检损伤,随访6~30个月复查宫颈细胞学均未发现异常。结论电子阴道镜结合宫颈细胞学检查可有效检出宫颈细胞学ASCUS中CIN及宫颈癌患者,可作为基层医院对ASCUS进行有效分流管理的方法。更多还原

【Abstract】 Objective To analysis the clinical value of colposcopy testing in the distribution and management of atypical squamous cell of undetermined significance.Methods 471 ASCUS patients diagnosed by cytological test,were inspected by colposcopy.Among them,203 patients diagnosed as CIN and higher degree by colposcopy were further biopsied under the colposcope,268 patients diagnosed as normal or chronic cervical inflammation were treated with drugs via vagina for 1～3 period and then were tested by cytology.4 patients remaining abnormal cytology were biopsied under the colposcope.The rest 264 cytological negative cases were followed up by cytology.Results Among patients investigated,207 patients were biopsied under the colposcope and 131 cases were diagnosed with CIN,4 cases with cervical cancer.The rest 268 cytological negative cases were followed up by cytology for 6～30 months without any abnormal findings.Conclusion colposcopy testing combined with cytology could effectively find CIN and cervical cancer cases among ASCUS patients,furthermore,the spirit and economic burden as well as the biopsy injury to cervix in low risk patients decreased markedly.It was an effective method for local hospital in the distribution and management of ASCUS.更多还原