【摘要】 目的 探讨宫颈病变冷刀锥切成型术中采用亚甲蓝作为标识剂鉴别正常组织与病变组织的方法，对减少切缘阳性和术后宫颈机能不全的作用。方法 选择2019年～2021年我院行宫颈冷刀锥切术的186例宫颈病变患者，采用亚甲蓝用于宫颈冷刀锥切术96例，应用传统方法90例，比较两组患者术后的切缘阳性率、锥底高度和锥体直径；对其并发症发生率进行统计分析。结果 ①术中情况比较：研究组锥切高度低于照组低，且术中出血少于对照组，差异均有统计学意义。②术后情况比较：包括宫颈管粘连率、切缘阳性率、宫颈机能不全发生率及术后感染率，研究组均低于对照组，有统计学意义。③两组患者术后3个月的宫颈塑形情况、满意TCT结果比较研究组均高于对照组，差异有显著性（P＜0.05）。结论 宫颈病变冷刀锥切宫颈成型术中采用亚甲蓝，可以减少切缘阳性和术后宫颈机能不全发生，尤其对于有生育要求的女性是值得推广应用的方法。

【Abstract】 Objective To explore the method of methylene blue for differentiating normal tissue from pathological tissue in cervical lesions by cold knife conical cutting,to reduce the cut edge positive and the role of postoperative cervical insufficiency.Methods 186 cases of cervical lesions treated with cold knife conization in our hospital from October 2019 to June 2021 were selected.Methylene blue was used in 96 cases of cervical conical resection with cold knife and 90 cases with traditional method. The positive rate of surgical margin, cone base height and cone diameter were compared between the two groups.The incidence of complications was statistically analyzed. Results Intraoperative comparison:The conical incision height of the study group was lower than that of the radiography group, and the intraoperative bleeding was less than that of the control group, the differences were statistically significant.②Comparison of postoperative conditions:Including cervical canal adhesion rate, positive margin, incidence of cervical insufficiency and postoperative infection rate, the study group were lower than the control group, with statistical significance.③Cervical shaping and satisfactory TCT results in 3 months after operation were significantly higher in the study group than in the control group (P < 0.05).Conclusion Methylene blue was used in cold knife conical resection of cervical lesions,it can reduce the occurrence of positive margin and postoperative cervical insufficiency,in particular, it is worth popularizing and applying the method for women with fertility requirements.

绝经后宫颈病变与阴道微环境相关性的研究