医用生物蛋白胶对LEEP治疗宫颈上皮内瘤变创口愈合的影响

Effects of Fibrin Glue on Wound Healing after the LEEP Treatment of Cervical Intraepithelial Neoplasia

目的研究医用生物蛋白胶对子宫颈电热圈环切术(loop electrosurgical excision procedure,LEEP)治疗宫颈上皮内瘤变,术后创口愈合的影响。方法选择符合诊断和手术条件的宫颈上皮内瘤变患者128例,分治疗组82例和对照组46例,均用LEEP治疗,术后创口分别敷用医用生物蛋白胶和无菌纱布,观察两组并发症(创面感染、肉芽生长、脱痂期出、宫颈管狭窄)发生率,阴道持续出血时间和出血量及创面愈合时间,术后2年疗效及复发率,并进行统计分析。结果两组的并发症发生率分别为2.44%和15.22%,阴道出血持续时间≤2周、>2周而≤3周、>3周而≤5周、≥5周的发生率分别为78.05%、23.91%、19.51%、50.00%和2.44%、17.39%、0.00%、8.70%,阴道出血量≤20ml、21～49ml、≥50ml的发生率分别为78.05%、34.78%、21.95%和52.17%、0.00%、13.04%,创面愈合平均时间分别为12.1±5.3天和18.4±4.8天,术后2年随访有效率分别为98.78%和86.96%,两组间比较均有显著差异(P<0.05)。结论医用生物蛋白胶可促进LEEP治疗宫颈上皮内瘤变创口的愈合,减少并发症,提高治愈率。

Objective To study the effect of fibrin glue on the wound - healing after the loop electrosurgical exicision procedure, LEEP treatment of cervical intraepithelial neoplasia. Methods All 128 patients with cervical intraepithelial neoplasia suit for diagnosis and surgical conditions were chosen. Then those patients were divided into two groups ：the treatment group with 82 patients and the control group with 46 patients. Both groups adopted LEEP treatment. Wound dressing after surgery was different. One group was fibrin glue and sterile gauze for another. The incidence of complications （wound infection, granulation, scab period, cervical stenosis） , the vaginal bleeding time and loss,the wound healing time,the treatment of effects and rate of relapse＇s after two years were observed. And statistical analysis were carried out. Results The complication rates for the two groups were 2.44% and 15.22%. The vaginal bleeding time ≤ 2 weeks, 〉 2 weeks but ≤3 weeks, 〉 3 weeks but ≤ 5weeks, the rates ≥5 weeks were 78.05% and 23.91% , 19.51% and 50.00% , 2.44% and 17.39% ,0.00% and 8.70% respectively. The vaginal bleeding loss≤20ml,21 ~ 49ml, ≥50ml and the related rates were 78.05% and 34.78% ,21.95% and 52.17% ,0.00% and 13.04% respectively. The average wound - healing time was 12.1± 5.3 days and 18.4 ± 4. 8 days. The cure rate after two years was 98.78% and 86.96% respectively. There was significant difference between the two groups （P 〈 0.05）. Conclusion Fibrin glue can promote the wound - healing after LEEP treatment of cervical intraepithelial neoplasia,reduce the complications and improve the cure rate.