中西药联合应用治疗宫颈高级别上皮内瘤变的临床观察

Clinical Observation on the Combined Application of Traditional Chinese Medicine and Western Medicine Treating the Cervical High-grade Intraepithelial Neoplasia

目的观察宫颈高级别上皮内瘤变运用超高频电切刀(LEEP刀)手术中三种辅助方法的近期及远期疗效,并找出最佳方案。方法收集符合条件的宫颈高级别上皮内瘤变患者135例,随机分为A组、B组和C组。A组45例,在宫颈LEEP术中予以高频电刀电凝止血,干纱布压迫止血;B组43例,在宫颈LEEP术中予以高频电刀电凝止血,再用云南白药粉末涂于创面并用干纱布压迫止血;C组47例,在宫颈LEEP术前先在4点注入稀释后的肾上腺素溶液10mL(1∶200),后行宫颈LEEP术,再用云南白药粉末涂于创面并用干纱布压迫止血。观察术中出血量、手术时间;术后并发症(出血量、发热和感染)、阴道排液时间及伤口愈合情况;远期阴道出血情况、宫颈黏连、狭窄和4~6个月后宫颈防癌双筛情况。结果C组在术中出血量明显减少,手术时间缩短,手术并发症少,阴道排液时间短,晚期阴道出血少,远期并发症少。结论宫颈上皮内高级别瘤变患者采取C组的手术治疗方案是最优方案。

OBJECTIVE To observe the short-term and long-term curative effects of three auxiliary methods in the operation of cervical high-grade intraepithelial neoplasia using LEEP knife,and to find out the optimized method. METHODS 135 patients with high-grade cervical intraepithelial neoplasia were randomly divided into group A,group B and group C. In group A,45 patients were treated with high frequency electrocoagulation and hemostasis during cervical LEEP surgery,and dry gauze was pressed to stop bleeding. In group B, 43 patients were treated with high-frequency electrocoagulation and hemostasis during cervical LEEP surgery,and Yunnan White Pow. der was applied to the wound and compressed with dry gauze to stop bleeding. 47 patients in group C were injected with 10 mL of diluted epinephrine solution(1∶200)at 4 o’clock before cervical LEEP surgery,followed by cervical LEEP surgery,and then Yunnan White Powder was applied to the wound and compressed with dry gauze to stop bleeding. Intraoperative blood loss and operation time were ob. served. Postoperative complications(blood loss, fever and infection), vaginal drainage time and wound healing;long-term vaginal bleeding,cervical adhesion stenosis and cervical cancer prevention after 4 to 6 months. RESULTS In group C,the amount of intraopera. tive bleeding was significantly reduced,the operative time was shortened,the operative complications were fewer,the vaginal drainage time was shorter,the late vaginal bleeding was less,and the long-term complications were fewer. CONCLUSION For patients with highgrade cervical intraepithelial neoplasia,surgical treatment of group C was the optimal program.