二氧化碳激光联合保妇康栓治疗阴道上皮内瘤变合并高危型人乳头状瘤病毒感染的临床研究

Clinical study of CO_2 laser combined with Baofukang suppository in the treatment of vaginal intraepithelial neoplasia with high risk HPV infection

目的探讨采用二氧化碳激光联合保妇康栓治疗阴道上皮内瘤变(VAIN)合并高危型人乳头状瘤病毒(HPV)感染的临床效果。方法选取确诊的140例VAIN合并高危型HPV感染患者,其中VAINⅠ40例,VAINⅡ42例,VAINⅢ58例。按患者就诊序号随机分为对照组60例,治疗组80例。对照组给予二氧化碳激光治疗后,使用聚甲酚璜醛栓;治疗组给予二氧化碳激光治疗后,使用保妇康栓。术后进行HPV、TCT及阴道镜检查,比较两组的临床疗效。结果两组VAINⅠ合并高危型HPV患者治愈率比较,差异无统计学意义(P﹥0.05);治疗组VAINⅡ及VAINⅢ合并高危型HPV患者治愈率高于对照组(P﹤0.05)。单独比较VAIN治愈率或HPV治愈率,治疗组均高于对照组。随着VAIN级别增高,激光治疗的次数相应升高。随访发现,对照组和治疗组已治愈患者复发率分别为15%和4%,差异无统计学意义(P﹥0.05);未治愈患者部分VAIN的级别无变化,部分VAIN的级别加重。结论二氧化碳激光联合保妇康栓治疗VAIN合并高危型HPV感染有较好疗效,可在临床推广使用。

Objective To study the clinical effect of CO2 laser combined with Baofukang suppository in patients with vaginal intraepithelial neoplasia （VAIN） and high risk of HPV infection. Method A retrospective analysis was per-formed in 140 patients with VAIN ＋ high risk of HPV infection, in which there were 40 cases of VAIN I, 42 cases of VAIN II, and VAIN III in 58 cases;of all patients, 60 cases were randomized into control group, while another 80 cases in study group, and the CO2 laser treatment was administered in both groups, followed by poly cresol sulfonic aldehyde sup-pository in control group while Baofukang suppository in study group. Postoperative HPV, TCT and colposcopy were car-ried out, and the clinical efficacy of the two groups were compared. Result For patients with VAIN I＋high risk of HPV infection in the two groups, the cure rates were similar （P〉0.05）;while those with VAIN II, VAIN III＋high risk of HPV infection in study group had higher cure rate than that of the control group （P〈0.05）. The study group was superior in cure rate of VAIN and HPV than that of control group, respectively. More laser therapy was needed as the VAIN grade ele-vated. And it was found during follow up that the relapse rate of cured patients in control and study group was 15%and 4%, respectively, with no significant difference observed （P〉0.05）; the VAIN grade in uncured patients remained the same, while deteriorated in some patients. Conclusion CO2 laser combined with Baofukang suppository is fairly effec-tive in the treatment of vaginal intraepithelial neoplasia with high-risk HPV infection, which is a regimen worthy of appli-cation.