Efficacy evaluation and influencing factors analysis of combined estrogen in the treatment of labial adhesion in children

结合雌激素治疗幼女阴唇粘连的效果评价及影响因素分析

In the present study, we aimed to assess the effect of combined estrogen cream on young girls’ labial adhesions, and to identify the possible factors affecting the treatment outcome. We retrospectively included 123 children with labial adhesions.Variables were collected, including treatment outcomes, conjugated estrogen usage, and dosage, whether it was combined with manual or surgical separation, whether to use erythromycin, and whether to be accompanied with vulvitis. Chi-square test, Fisher’s exact test, and t-test were used to analyze the correlation between influencing factors and treatment outcome in univariate analysis.We used logistic regression analysis to explore the key influencing factors. The use of conjugated estrogen in combination with manual or surgical separation(P = 0.001), and the degree of labial adhesions(P = 0.011) had significant effects on the final treatment outcome.The frequency of conjugated estrogen treatment, whether erythromycin was used in combination during treatment, and whether the children were accompanied by vulvitis had no significant effect on the treatment outcome(P > 0.05). After the logistic regression,we found that whether it was combined with manual or surgical separation(P = 0.000, OR = 0.078, 95% CI = 0.030–0.203), and the degree of labial adhesions in children(P = 0.003, OR = 5.324, 95% CI = 1.767–16.041) were independently related to the effect of conjugated estrogen treatment. The therapeutic effect of conjugated estrogen alone was better for mild adhesion. However,severe adhesions need to consider with manual or surgical separation in combination with conjugated estrogen treatment. It is not recommended to combine erythromycin with routine clinical treatment. Conjugated estrogen once a day can also achieve a good therapeutic effect.

观察结合雌激素乳膏治疗幼女阴唇粘连的效果,挖掘影响治疗效果的可能因素。回顾性纳入2018年10月至2019年10月广州市妇女儿童医疗中心收治的123例阴唇粘连患儿。采集患儿治疗结局、结合雌激素用法用量、治疗期间是否同时联合了手法或手术分离、是否联合使用红霉素、是否伴发外阴炎、不良反应等变量信息。采用χ;检验、Fisher检验和t检验分析结合雌激素治疗阴唇粘连的各个变量与治疗结局的相关性。继而采用逻辑回归分析这些变量与结局的关系,挖掘可能的影响因素。患儿使用结合雌激素联合手法分离或手术分离(P=0.001),以及阴唇粘连的程度(P=0.011)这两个变量对最终治疗结局有显著性影响。结合雌激素治疗频次(P=0.202)、治疗期间是否联合使用红霉素(P=0.787)、患儿是否伴发外阴炎(P=1.000),均对治疗结局无显著性影响。Logistic回归分析得知是否联合手法或手术分离(P=0.000,OR=0.078,95%CI=0.030–0.203)、患儿阴唇粘连程度(P=0.003,OR=5.324,95%CI=1.767–16.041)与结合雌激素治疗效果独立相关。患儿轻度粘连时单用结合雌激素治疗效果较好,重度粘连需要考虑手法或手术分离联合结合雌激素治疗效果更佳。不建议临床常规合用红霉素治疗。结合雌激素用药频次为每日一次也能取得较好的治疗效果。本文结论可为结合雌激素临床治疗阴唇粘连提供参考或依据。