rhGM-CSF凝胶对LEEP治疗宫颈上皮内瘤变创面愈合的影响

The influence of rhGM-CSF gel to curing the CIN wound healing

目的 研究外用重组人粒细胞-巨噬细胞刺激因子（recombinant human granulocyte/macrophage colony-stimulating factor,rhGM-CSF）凝胶对子宫颈电热圈环切术（LEEP）治疗宫颈上皮内瘤变（CIN）术后创口愈合的影响.方法 选择CIN患者124例,分为治疗组（73例）和对照组（51例）,均用LEEP治疗,术后创口分别敷用rhGM-CSF凝胶和无菌纱布,观察两组创面愈合情况（阴道出血时间和出血量、创面止血结痂初步愈合时间）、疗效、并发症发生率,并统计分析数据.结果 治疗组和对照组阴道出血持续时间≤2周、2～3周、3～5周和＞5周的发生率分别为93.15％和23.52％、5.48％和41.18％、1.37％和17.39％、0.00％和13.73％,两组患者阴道出血量≤20 ml、21 ～49 ml和＞50 ml的发生率分别为91.78％和27.45％、8.22％和62.75％、0.00％和9.80％,两组患者创面愈合平均时间分别为（8.1±2.4）d和（17.7±3.5）d,差异均有统计学意义（P＜0.05）；6个月后随访,两组有效率分别为98.63％和86.27％（P＜0.05）;两组并发症发生率分别为1.37％和13.73％ （P＜0.05）.结论 rhGM-CSF可促进LEEP刀治疗CIN术后创面的愈合,减少并发症的发生率.

Objective To study the influence of external recombinant human granulocyte/macrophage colony-stimulating factor （rhGM-CSF） gel on wound healing after LEEP for curing the CIN.Methods 124 patients with CIN were selected and divided into two groups：the treatment group （73 cases） and the control group （51 cases）.Both two groups were treated by LEEP,and the wound were covered by rhGM-CSF gel and sterile gauze,respectively.And then,the wound healing status of these two groups （the bleeding time and amount of vagina,preliminary healing time of wound callusing）,curative effect and incidence of complications of these two groups were observed,and analyzed.Results The incidence of vaginal bleeding in both treatment group and control group whose bleeding time ≤2 weeks,〉2weeks but≤3weeks,〉3weeks but≤5 weeks,〉5 weeks were 93.15% vs 23.52%,5.48% vs 41.18%,1.37% vs 17.39% and 0.00% vs 13.73%,respectively.The incidence of vaginal bleeding amount in both groups whose amount ≤20 ml,21-49 ml and 〉50 ml were 91.78% vs 27.45%,8.22% vs 62.75% and 0.00% vs 9.80%,respectively.The average time for the wound healing of both groups were 8.1 ± 2.4 days and 17.7 ± 3.5 days,and these differences were all had statistical significance（P 〈0.05）.The effective rates were 98.63% and 86.27% （P 〈 0.05） when the patients were visited after 6 months.The incidence of complications were 1.37% and 13.73% （P 〈 0.05）,respectively.Conclusion rhGM-CSF could accelerate the wound healing of CIN patients after LEEP,and reduce the incidence of complications.