宫颈环形电切术辅以保妇康栓治疗慢性重度宫颈炎伴宫颈上皮内瘤样病变Ⅰ、Ⅱ级患者效果及对预后影响

Clinical Effect of the Loop Electrosurgical Excision Procedure Supplemented with Baofukang Suppository in the Treatment of Chronic Severe Cervicitis with Cervical Intraepithelial Neoplasia GradeⅠandⅡand Its Influence on Prognosis

目的探讨宫颈环形电切术(loop electrosurgical excision procedure,LEEP)辅以保妇康栓治疗慢性重度宫颈炎伴宫颈上皮内瘤样病变(cervical intraepithelial neoplasias,CIN)Ⅰ、Ⅱ级患者的效果及对预后的影响。方法选取慢性重度宫颈炎伴CINⅠ、Ⅱ级93例,按照治疗方法不同将其分为研究组(48例)和对照组(45例)两组。研究组行LEEP后在常规治疗上给予保妇康栓辅助治疗,对照组行LEEP后给予常规治疗。观察比较两组治疗后临床效果及阴道排液、出血、创面愈合时间,治疗后3个月宫颈修复、宫颈狭窄和并发症发生情况,治疗前和治疗后3个月生活质量情况,以及治疗后6、12和18个月复发及高危型人乳头瘤病毒(HPV)转阴情况。结果治疗后,研究组临床总有效率97.92%高于对照组临床总有效率86.67%,阴道排液、出血及创面愈合时间均短于对照组,差异有统计学意义(P<0.05或P<0.01)。治疗后3个月,研究组宫颈修复情况优于对照组,轻度宫颈狭窄所占比例高于对照组,总并发症发生率低于对照组,差异均有统计学意义(P<0.05)。治疗后3个月,躯体功能、心理功能、社会功能及精神功能评分两组均较治疗前升高,研究组均高于对照组,差异有统计学意义(P<0.01)。治疗后18个月,研究组复发率低于对照组;治疗后6、12和18个月,研究组高危型HPV转阴率均高于对照组,差异有统计学意义(P<0.05或P<0.01)。结论LEEP辅以保妇康栓治疗慢性重度宫颈炎伴CINⅠ、Ⅱ级患者效果显著,可促进宫颈修复,减少术后并发症,提高患者生活质量及高危型HPV转阴率,降低复发率。

Objective To analyze the clinical effect of the loop electrosurgical excision procedure(LEEP)supplemented with Baofukang suppository in the treatment of chronic severe cervicitis with cervical intraepithelial neoplasia(CIN)gradeⅠandⅡand its influence on prognosis.Methods A total of 93 patients with chronic severe cervicitis combined with CIN grade I and II were selected.According to the difference in treatment methods,they were divided into research group(n=48)and control group(n=45).Patients in the control group were given conventional treatment after LEEP knife treatment,and patients in the research group were supplemented with auxiliary treatment of Baofukang suppository after LEEP knife treatment on the basis of conventional treatment.The clinical efficacy,vaginal drainage time,bleeding time and wound healing time after treatment were compared between the two groups.Cervical repair,cervical stenosis and complications at 3 months after treatment,quality of life before and at 3 months after treatment,and recurrence and high-risk human papilloma virus(HPV)negative conversion at 6,12,and 18 months after treatment were compared between the two groups.Results After treatment,the total effective rate of the research group was 97.92%,which was higher than 86.67%of the control group.The vaginal discharge time,bleeding time and wound healing time were shorter than those of the control group,and the difference was statistically significant(P<0.01).At 3 months after treatment,the cervical repair in the research group was better than that in the control group,the proportion of mild cervical stenosis was higher than that in the control group,and the total incidence of complications was lower than that of the control group(P<0.05).At 3 months after treatment,the scores of physical,psychological,social and mental function in the two groups were higher than those before treatment,and the scores of the research group were higher than those of the control group(P<0.01).At 18 months after treatment,the recurrence rate of the research group was lower than that of the control group.At 6,12,and 18 months after treatment,the negative conversion rate of high-risk HPV in the research group was higher than that of the control group,and the difference was statistically significant(P<0.05 or P<0.01).Conclusion LEEP supplemented with Baofukang suppository is effective in treating patients with chronic severe cervicitis and CIN gradeⅠandⅡ.It can promote cervical repair,reduce postoperative complications,improve the quality of life of patients and the negative conversion ratio of high-risk HPV,and reduce the recurrence rate.