宮頸高頻電波刀環切術聯合氯喹那多—普羅雌烯陰道片治療宮頸病變臨床分析

巫婉嫻 韓蓉珍

【摘要】目的：研究宮頸高頻電波刀環切（LEEP）術聯合氯喹那多-普羅雌烯陰道片治療宮頸病變的術后創口組織恢復情況及并發癥的發生情況。方法：將我院2013年1月至2014年12月因宮頸病變在婦科門診進行宮頸LEEP術的患者122例，按隨機數字表達將納入病例分為觀察組和對照組，每組61例；對照組患者進行宮頸LEEP術后無其他處理，觀察組在術后給予氯喹那多-普羅雌烯陰道片；觀察兩組患者第2周、第4周、第6周、第8周的水腫、上皮修復、脫痂情況，陰道流液量及分泌物清潔程度，感染、出血、宮頸狹窄情況。結果：兩組患者的上皮修復情況在第6周、第8周比較具有統計學差異（P<0.05）；兩組患者的脫痂情況在第6周時具有統計學差異（P<0.05）；在進行宮頸LEEP術后都會出現陰道流液增多現象，為淡紅色或淡黃色液體，兩組患者在第4周、第6周、第8周比較具有統計學差異（P<0.05）；觀察組分泌物的清潔度大部分均保持Ⅰ°～Ⅱ°，對照組分泌物清潔度相對較差，容易引起細菌感染。觀察組無感染、出血、宮頸狹窄等并發癥發生，對照組有4例患者出現脫痂出血，感染患者2例，宮頸粘連狹窄者2例，兩組比較具有統計學差異（P<0.05）。結論：在進行LEEP術后聯合氯喹那多-普羅雌烯陰道片進行治療能明顯增強上皮組織的修復能力，加快創傷組織的結痂速度，減少陰道流液量，提高陰道分泌物的清潔程度，降低感染、出血、宮頸粘連、狹窄等并發癥的發生率。

【關鍵詞】氯喹那多-普羅雌烯陰道片；宮頸高頻電波刀環切術；宮頸病變

Curative effect of cervical LEEP combined chlorquinaldol-promestriene on cervical lesionsWU Wanxian1， HAN Rongzhen2. 1. Department of Obstetrics and Gynecology， Jiangyin City Traditional Chinese Medicine Hospital， Wuxi 214400， Jiangsu， China； 2. Department of Obstetrics， Suzhou Municipal Hospital， Suzhou 215001， Jiangsu， China

【Abstract】Objectives： To explore the condition of tissue recovery and complications of the cervical LEEP combined with chlorquinaldol-promestriene in the treatment of cervical lesions. Methods： 122 patients received cervical LEEP due to cervical lesions in our hospital from January 2013 to December 2014 were divided into observation group and control group according randomly， each of 61 cases. The control group was treated with cervical LEEP while the observation group was given promestriene after cervical LEEP. The condition of edema， epithelial repair， scabs， amount of vaginal discharge and discharge clean degree， infection， hemorrhage， cervical stenosis of the patients in the two groups in 2 weeks， 4 weeks， 6 weeks， 8 weeks later were compared. Results： There was statistical difference between the two groups of patients in epithelial repair situation in 6 weeks， 8 weeks （P< 0.05）. There was statistical difference between the two groups of patients in the scabs situation （P<0.05）. There would be an increase in vaginal discharge， most reddish or yellowish. There was statistical difference between the two groups in 4 weeks，6 weeks， 8 weeks （P<0.05）. The purity of the observation group most remained Ⅰ°～ Ⅱ °， and the cleanliness of the control group was relatively poor， which was easier to be infected. There was no infection， hemorrhage， cervical stenosis of observation group， while 4 patients of scab， 2 cases of infection， 2 cases of cervical adhesion stenosis in the control group， with statistical difference between the two groups （P<0.05）. Conclusion： The cervical LEEP combined with chlorquinaldol-promestriene can significantly enhance the capacity of epithelial tissue repair， speed up the organization of scabby， reduce the amount of vaginal discharge， increase the degree of vaginal cleaning， reduce the incidence of complications such as infection， bleeding， cervical adhesion and et al.

【Key words】Chlorquinaldol-promestriene； Cervical LEEP； Cervical lesions

【中圖分類號】R711.74【文獻標志碼】A

隨著現代社會的開放及女性自我保護意識的減弱，宮頸病變的發病率呈不斷增加趨勢，全國患有宮頸病變的女性患者超過60%，宮頸病變的良性病變有宮頸上皮內瘤變（CIN I ～ Ⅲ級）和慢性宮頸炎（宮頸腺囊腫、宮頸肥大、宮頸糜爛、宮頸息肉等）[1]。CIN是一種與宮頸浸潤癌有密切聯系的癌前病變，在25～35歲婦女中尤其常見，近年來發病呈年輕化趨勢，對于CINⅡ ～ Ⅲ，若能及早進行診斷及治療，能明顯降低宮頸癌的發病率[2]。高頻電波刀宮頸電圈環切術（Loop electrosurgical excision procedure，LEEP）以其創傷小、操作簡單、止血效果好、患者恢復快、可獲得進行病理檢查的完好組織標本等優點，成為治療CIN的首選治療方式。盡管LEEP手術方法的諸多優點，然而它也有一些手術無法避免的缺點：感染、周圍組織粘連、術后復發、術后手術瘢痕、黏液性狀的改變、術后出血、分泌物增多、宮頸管變窄等[3，4]。……