激光联合重组人干扰素α-2b凝胶治疗阴道上皮内瘤样病变21例分析  

Analysis on 21 cases with vaginal intraepithelial neoplasia treated by laser combined with recombinant human interferon α-2b gel

作　　者：杨君[1] 周德平[1] 王彬[1] 刘玉明[1] 王敏[1] 

机构地区：[1]重庆市妇幼保健院,重庆市宫颈病特色专科,400013

出　　处：《中国妇幼保健》2013年第3期476-478,共3页Maternal and Child Health Care of China

基　　金：重庆市卫生局医疗特色专科建设项目〔渝卫科教[2009-71]号〕

摘　　要：目的:探讨阴道上皮内瘤变(VAIN)的临床特征及采用激光联合干扰素局部治疗的临床疗效。方法:选择2006年5月～2010年12月重庆市妇幼保健院宫颈专科门诊经组织学确诊的VAIN患者21例,总结其临床特征,分析人乳头瘤病毒(HPV)感染状况,采用激光联合阴道给药重组人干扰素α-2b凝胶治疗,随访12个月以上,评价临床疗效。结果:①21例VAIN患者高危型HPV感染率为100.00%,其中HPV16型感染最常见(61.90%,13/21);②病灶多呈多灶性分布(71.43%,15/21),主要位于阴道穹窿部及阴道侧壁上1/3段(90.48%,19/21);③激光联合干扰素局部治疗VAIN临床治愈率为80.95%(17/21),好转率为14.29%(3/21),无效率为4.76%(1/21),复发率为19.05%(4/21)。术后并发症少,无阴道壁瘢痕形成,无阴道大量出血,无阴道粘连发生。结论:高危型HPV感染与VAIN发生密切相关,激光联合干扰素局部用药治疗VAIN,安全有效,近期疗效明确,远期疗效仍需观察。Objective：To explore the clinical characteristics of vaginal intraepithelial neoplasia（VIN） and the clinical efficacy of laser combined with local treatment of recombinant human interferon α-2b gel.Methods：Twenty-one patients diagnosed as VIN definitely by histological examination in cervical special outpatient of the hospital from May 2006 to December 2010 were selected,then the clinical characteristics were summarized,the infection status of human papillomavirus（HPV） was analyzed;the patients were treated with laser combined with vaginal treatment with recombinant human interferon α-2b gel;all the patients were followed up more than twelve months,the clinical efficacy was evaluated.Results：The infection rate of high risk HPV in twenty-one patients with VIN was 100.00%,HPV16 was the most common type（61.90%,13/21）.Mulifocality was common（71.43%,15/21）,and most of focus was located in vaginal fornix and upper 1/3 of vaginal side wall（90.48%,19/21）.The clinical curative rate was 80.95%（17/21）,the improvement rate was 14.29%（3/21）,the ineffective rate was 4.76%（1/21）,and the recurrence rate was 19.05%（4/21）.The postoperative complications were few,no scar of vaginal wall,large vaginal bleeding,and vaginal adhesion occurred.Conclusion：High risk HPV infection is closely correlated with occurrence of VIN,laser combined with local treatment of interferon is safe and effective,the short-term efficacy is good,while the long-term efficacy needs observation.

关 键 词：阴道上皮内瘤变 激光 重组人干扰素Α-2B凝胶 人乳头状瘤病毒 

分 类 号：R711.73[医药卫生—妇产科学]