重组人干扰素a-2b栓剂辅助宫颈电热圈环切术治疗CIN伴高危型HPV感染效果

Curative effect of loop electrosurgical excision procedure combined with recombinant human interferon a-2b suppository for treating patients with cervical intraepithelial neoplasia and high-risk human papillomavirus infection

目的:观察重组人干扰素a-2b栓剂辅助宫颈电热圈环切术(LEEP)治疗宫颈癌前病变(CIN)伴高危型人乳头瘤病毒(h-HPV)感染的临床疗效。方法:选取2022年6月-2023年6月本院治疗的伴h-HPV感染的CIN患者,随机分为联合组(78例)和对照组(80例)。两组均予以LEEP术治疗,联合组于LEEP术后加用重组人干扰素a-2b栓剂,对比两组临床疗效、围术期相关指标、h-HPV病毒载量、并发症以及术后3个月、6个月的h-HPV转阴率和复发率。结果:联合组创面愈合时间(41.09±4.95d)、阴道出血时间(11.43±1.62d)和阴道排液时间(13.81±1.56d)均短于对照组(44.17±5.63d、13.81±1.56d、19.34±5.45d),临床治疗总有效率(93.6%)高于对照组(81.3%),阴道持续出血、切口感染、宫颈粘连以及宫颈狭窄等术后并发症总发生率(5.1%)低于对照组(15.0%),术后3个月、6个月的h-HPV病毒载量(1.84±0.32 RLU/CO、1.15±0.27 RLU/CO)少于对照组(2.21±0.26 RLU/CO、2.07±0.45 RLU/CO),h-HPV转阴率(60.3%)高于对照组(41.3%),复发率(5.1%)低于对照组(16.3%)(均P<0.05)。结论:重组人干扰素a-2b栓剂辅助LEEP治疗CIN伴h-HPV感染临床效果提高,能有效促进患者创面愈合,提高h-HPV清除率,减少术后并发症,降低复发风险。

Objective:To observe the clinical curative effect of loop electrosurgical excision procedure(LEEP)combined with recombinant human interferon a-2b(rIL-a2b)suppository for treating patients with cervical intraepithelial neoplasia(CIN)and high-risk human papillomavirus(h-HPV)infection.Methods:From June 2022 to June 2023,the patients with CIN and h-HPV infection were selected and were randomly divided into control group(80cases)and study group(78cases)by the random number table method.The patients in the two groups were treated with LEEP surgery,while the patients in the study group were treated with rIL-a2b suppository after LEEP surgery additionally.The clinical efficacy,the perioperative related indicators,the HPV viral load,the complications rate,and the negative conversion rate and the recurrence rate of HPV infection in the 3rd month and the 6th month after surgery of the patients were compared between the two groups.Results:The wound healing time(41.09±4.95d),the vaginal bleeding time(11.43±1.62d)and the vaginal discharge time(13.81±1.56d)of the patients in the study group were significantly shorter than those(44.17±5.63d,13.81±1.56dand 19.34±5.45d)of the patients in the control group.The total effective rate of the clinical treatment(93.6%)of the patients in the study group was significantly higher than that(81.3%)of the patients in the control group,and the total incidence(5.1%)of postoperative complications,such as the continuous vaginal bleeding,the incision infection,the cervical adhesion and the cervical stenosis of the patients in the study group was significantly lower than that(15.0%)of the patients in the control group.The h-HPV viral load of the patients in the study group in the 3rd month(1.84±0.32RLU/CO)or in the 6th month(1.15±0.27RLU/CO)after surgery was significantly lower than that(2.21±0.26RLU/CO or 2.07±0.45RLU/CO)of the patients in the control group.The negative conversion rate of h-HPV infection(60.3%)of the patients in the study group was significantly higher than that(41.3%)of the patients in the control group,and the recurrence rate(5.1%)of h-HPV infection of the patients in the study group was significantly lower than that(16.3%)of the patients in the control group(all P<0.05).Conclusion:LEEP combined with rIL-a2bsuppository for treating the patients with CIN and h-HPV infection can increase their clinical effect,and which can effectively promote wound healing,improve the HPV clearance rate,reduce the postoperative complications and reduce the risk of recurrence of h-HPV infection of the patients.