超脉冲CO_(2)点阵激光治疗外阴白色病变的临床疗效分析

Clinical efficacy analysis of ultra-pulsed CO_(2)dot array laser treatment for white lesions of vulva

目的探讨超脉冲CO_(2)点阵激光治疗外阴白色病变的可行性和有效性。方法选择2021年1月至2022年1月于我院宫颈疾病诊治中心就诊的外阴白色病变患者60例,经阴道镜下外阴活组织病理学检查排除恶性病变,按不同病理类型分层分别采用随机数字表法均衡分配至超脉冲CO_(2)点阵激光治疗组和高强度聚焦超声治疗组,每组30例,观察两组患者治疗期间及治疗后症状、体征的变化,并对两种治疗方案的效果进行对比分析。结果超脉冲CO_(2)点阵激光和高强度聚焦超声两种治疗方式均能有效治疗外阴白色病变,且激光治疗组治愈率(53.3%vs.16.7%)和总有效率(96.7%vs.90.0%)均显著优于超声治疗组(P<0.05)。激光治疗组患者在术中无明显不良反应,术后无须特殊处理;超声治疗组在术中出现5例烫伤,治疗区皮肤出现水泡、疼痛明显,治疗后局部水肿明显、消退速度较慢,另有7例患者出现皮下结节。结论超脉冲CO_(2)点阵激光技术治疗外阴白色病变具有创面损伤小、疗效确切、术后并发症少、治疗安全等优点,不影响正常工作和生活,值得临床上推广应用。

Objective:To explore the feasibility and efficacy of ultra-pulsed CO_(2)dot array laser for treatment of white lesions of vulva.Methods:A total of 60 patients with white lesions of vulvae were treated in the center of diagnosis and treatment of cervical disease of our hospital from January 2021 to January 2022.All patients were excluded from malignant lesions by biopsy of vulva under colposcopy.The patients were stratified according to different pathological types and evenly allocated to the ultra-pulse CO2 laser treatment group and the high intensity focused ultrasound treatment group using a random number table method,with 30 patients in each group.The symptoms and signs of patients during and after treatment were observed,and the clinical effect of two treatments were analyzed and compared.Results:Both ultra-pulse CO2 laser and high intensity focused ultrasound can effectively treat white lesions of vulva.The cure rate(53.3%vs.16.7%)and total effective rate(96.7%vs.90.0%)of the ultra-pulsed CO_(2)laser group were significantly higher than those of the ultrasound group(P<0.05).In the ultra-pulsed CO_(2)laser treatment group,there was no obvious adverse reaction during the operation,and no special treatment was needed after the operation.In the ultrasound treatment group,there were 5 cases of scald during the operation,and the skin in the treatment area had obvious blisters and pain.After treatment,the local edema was obvious and subsided slowly,and 7 patients had subcutaneous nodules.Conclusions:The treatment of white lesions of vulva with ultra-pulsed CO2 laser technology has the advantages of minimal wound damage,definite therapeutic effect,less postoperative complications,and safe treatment.It does not affect the normal work and life,so it is worthy of clinical application.