低度宫颈上皮内瘤变CO_2激光治疗后应用壳聚糖妇科生物功能敷料或云南白药的临床分析

Clinical analysis of application of chitosan gynecologic functional biological dressing or Yunnanbaiyao of lowgrade cervical intraepithelial neoplasia after CO_2 laser treatment

目的探讨低度宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)CO2激光治疗后应用壳聚糖妇科生物功能敷料或云南白药的临床效果。方法收集2012年1月至2014年6月就诊于北京老年医院和广安门医院门诊经宫颈细胞学及HPV-DNA-阴道镜-宫颈活检三阶梯方法证实的低度宫颈上皮内瘤变(CIN1)116例,行CO2激光治疗。39例治疗后应用壳聚糖妇科生物功能敷料(妇炎消组),34例治疗后应用云南白药(云南白药组),43例单纯常规治疗(对照组)。治疗后1、2、4、8周及6个月随访,比较3组阴道出血量、出血时间、阴道排液量、排液时间、过敏反应及宫颈愈合情况。结果妇炎消组和云南白药组阴道排液时间明显短于对照组(P<0.01),妇炎消组阴道出血量明显少于对照组(P=0.010),阴道出血时间明显短于对照组(P=0.006),治疗后6个月宫颈愈合满意率妇炎消组97.4%(38/39),云南白药组97.1%(33/34),对照组81.4%(35/43),3组间宫颈愈合情况差异有显著性(χ2=8.649,P=0.013)。结论 CO2激光治疗后应用壳聚糖妇科生物功能敷料或云南白药可以减少宫颈创面渗出及出血,促进创面愈合,不良反应轻,值得临床研究及应用。

Objective To investigate the clinical effect of Chitosan gynecologic functional biological dressing and Yunnanbaiyao in the treatment of low-grade cervical intraepithelial neoplasia（CIN1）after CO2 Laser therapy. Methods 116 patients with CIN1 confirmed by cervical cytology,HPV-DNA-colpscopy-Cervical biopsy and were treated with CO2 Laser during January 2012 and June 2014 in Beijing Geriatric hospital and Guanganmen hospital enrolled this study. The patients were randomly divided into three groups： Fuyanxiao group（n=39） was applied chitosangynecologic functional biological dressing for a week after the CO2 Laser therapy;Yunnanbaiyao group（n=34） was given Yunnanbaiyao for a week after the CO2 Laser therapy;and control group（n=43） received routine treatment. The three groups were followed up at 1, 2, 4, 8 weeks and 6 months after the procedure, and the amount and time of vaginal bleeding, amount and time of vaginal discharge, allergic reaction, and conditions of cervical healing were compared among the groups. Results No patients were lost during 6-month follow-up. The vaginal discharge time of Fuyanxiao group and Yunnanbaiyao group was significantly shorter than the control group（P〈0.01）. The amount and time of vaginal bleeding in Fuyanxiao group were significantly less than those in control group（P=0.010, P=0.006）. The rate of cervical wound healing in the control group was low, and the difference between the 3 groups was significant after 6 months [97.4%（38/39）vs 97.1%（33/34）and 81.4%（35/43）,χ2=8.649,P=0.013]. Conclusions Application of Fuyanxiao or Yunnan Baiyao after CO2 Laser therapy for CIN1 can significantly reduce wound bleeding, vaginal discharge and adverse reaction, promote cervical healing, and we recommend it to be widely researched and used.