Cervical cryosurgery

Cervical cryopreservation is the use of refrigerant (usually liquid nitrogen), so that local lesions repeatedly freeze-thaw, necrosis or degeneration and shedding, and then through tissue repair to achieve therapeutic purposes. Its characteristics: 1. During the freezing, the microcirculation in the tissue is blocked, and the local bleeding is less during the operation and postoperative; 2. The rapid rewarming after rapid freezing and freezing has greater lethality to the cells; 3. After the frozen part is healed There is no scar on the part, which is especially suitable for the treatment of cervical lesions in women. Treatment of diseases: cervical intraepithelial neoplasia chronic cervicitis Indication 1. Chronic cervicitis. 2. Cervical endometriosis. 3. Mild and moderate cervical intraepithelial neoplasia (cin i, ii grade). Contraindications 1. Acute vulva, vagina, cervix or (and) pelvic inflammatory disease. 2. Severe cervicitis, did not rule out malignant changes. Preoperative preparation 1. routine cervical smear examination to find cancer cells, suspicious clinical and cytological examination, cervical biopsy should be performed. 2. People with acute genital inflammation should be treated with anti-inflammatory treatment. 3. Forbidden sex for 3 days before surgery. Surgical procedure 1. Position: The position of the stone. 2. Disinfection: routinely disinfect the vulva, vagina, cervix, and fully expose the cervix. 3. Cervical freezing: According to the extent of cervical lesions and lesions of the external cervix, choose a suitable cryoprobe so that the frozen coverage slightly exceeds the lesion range by 2 mm. Press the freezing probe against the lesion, start the freezer, use 3-3-3 method or 3-5-3 method, that is, when the local temperature is -180 °C, calculate the time, freeze for 3 min, wait for its natural rewarming 3 to 5 min, repeated freezing for 3 min. After natural rewarming, the cryoprobe and speculum should be taken out after the probe and the cervical tissue are completely detached. It is strictly forbidden to forcibly tear the probe before it completely separates from the cervix to avoid tissue damage and bleeding. complication 1. Bleeding: more common. The predilection site is about 6 o'clock in the posterior lip of the cervix. A small amount of bleeding can be used to stop the bleeding with a large cotton swab or to disperse the laser beam to > 2mm, burn the hemorrhage and surrounding, and make the blood vessels coagulate; if there is more bleeding, it can be blocked with vaginal tampon or gauze, and taken out after 24 hours. 2. Postoperative pelvic infection: manifested as lower abdominal pain, cervical greenish black, secretions with odor, anal examination of uterine tenderness, local or systemic anti-inflammatory treatment. 3. Postoperative cervix stenosis: Use a vascular clamp to separate the membrane of the adhesion, and if necessary, cervical dilatation.