宫颈环形电切术(LEEP)联合致康胶囊治疗子宫颈上皮内瘤变的临床观察

Clinical Observation on Loop Electrosurgical Excision Procedure(LEEP) Combined Zhikang Capsure for Cervical Intraepithelial Neoplasia.

目的:观察宫颈环形电切术(LEEP)联合致康胶囊治疗子宫颈上皮内瘤变的临床疗效。方法:选择我院行宫颈环状电切术的患者128例,随机分为观察组(68例)和对照组(60例),观察组术后给予静脉抗炎治疗3天,术后第7天创面局部使用致康胶囊药粉,隔天1次,共6次。对照组术后仅静脉抗炎治疗3天,局部不做特殊处理。记录两组患者阴道排液时间、阴道出血量及创面愈合时间。将两组切下标本行病理检查,并与术前阴道镜病理检查的结果比较。结果:LEEP术后病理诊断结果与术前电子阴道镜下活检结果一致率为79.58%,其中升级10.16%,降级12.5%;治疗组术后阴道排液量少于月经量62例,占91.2%;对照组术后阴道排液量少于月经量45例,占75.0%,两组比较差异有统计学意义(P<0.05)。治疗组平均阴道流血时间(7.36±1.82)天,对照组平均阴道流血时间为(12.38±1.24)天,两组比较差异有统计学意义(P<0.01)。治疗组创面愈合时间为(3.35±0.67)周,对照组创面愈合时间为(5.78±1.03)周,两组比较差异有统计学意义(P<0.01)。结论:LEEP手术对子宫颈上皮内瘤变具有较好的诊断和治疗作用;致康胶囊能减少宫颈环行电切术后阴道出血和排液,缩短阴道流血和创面愈合的时间,能明显减少宫颈环形电切术后的并发症,有效地促进创面愈合。宫颈环形电切术联合致康胶囊治疗宫颈上皮内瘤变,疗效肯定,可减轻术后不良反应。

Objective：To study the effect of combining LEEP and zhikang capsure to treat CIN. Methods： 128 patients were randomly divided into two groups,experimental group（68 patients）and control group（60 patients）.The obeservation group were given intravenous anti- inflammatory treatment for 3 days,and from the seventh day afer the surgery, the zhikang capsure was used locally, the control group were given intravenous anti-inflammatory treatment for 3 days only.The vaginal bleeding and fluid and the wound healing time were observed. The specimens cut by LEEP from the two groups were accepted pathological examination,and compared the results with preoperative diagnosis by biopsy under colposcopy. Results： The consistent rate of pathology diagnosis after LEEP and the preoperative diagnosis by biopsy under colposcopy were 79.58%,while 10.16% of them upgrade, 12.5% dowmgrade.the vagina fluid of 62 patients in the experimental group were less than menstrual flow,accounting for 91.2%,while 45 patients in the control group were less than the menstrual flow, accounting for 75.0%,the curative effect has the significance difference（P〈0.05）.the average time of vaginal bleeding for experimental group were（7.36^-1.82）d,while for control group were（1 2.38±1.24）days, the curative effect has the significance difference（P〈0.01）.the wound healing time for the experimental group were（3.35±0.67）weeks,while for control group were（5.78±1.03）weeks,the curative effect has the significance difference（P〈0.01）. Conclusion：LEEP is a effective method for the diagnosis and treatment of CIN.zhikang capsure can reduce the vaginal bleeding and fluid,shorten the vaginal bleeding time and the healing time,can significantly reduce the complications of LEEP and promote the healing of wound.LEEP combined with zhikang capsure is a effective treatment for CIN,and can reduce the compliments caused by the surgery.