宫颈上皮内瘤变术后联合氯喹那多/普罗雌烯的临床应用  

Clinical Observation of Combined Therapy of Chlorquinaldol / Promestriene after Loop Electrosurgical Excison Procedure in Treating Cervical Intraepithelial Neoplasia

作　　者：宋志琴[1] 王蔼明[1] 

机构地区：[1]海军总医院妇产科,北京100048

出　　处：《医学综述》2014年第23期4372-4374,共3页Medical Recapitulate

摘　　要：目的观察宫颈上皮内瘤变术后应用氯喹那多/普罗雌烯,减少术后并发症,促进上皮愈合的情况。方法将2009年3月至2012年5月海军总医院妇科门诊收治的384例因宫颈上皮内瘤变行宫颈高频电波刀切除术(LEEP)的患者采用随机数字表法分成两组,氯喹那多/普罗雌烯组(观察组)195例,口服抗生素组(对照组)189例,其中观察组于术后第2日阴道填塞氯喹那多/普罗雌烯1片,每日1次,连用18 d,对照组术后常规口服抗生素3 d。术后2周观察阴道分泌物、创面脱痂及出血情况;术后4、6、8周观察宫颈上皮修复情况,术后3个月复查液基薄层细胞学与阴道镜,了解病变的改善情况。结果术后2周,观察组患者宫颈创面均完全脱痂,观察组创面脱痂率显著高于对照组(100%vs 22.22%,P<0.01)。观察组宫颈创面出血率显著低于对照组(5.64%vs 53.97%,P<0.01)。观察组无阴道清洁度异常发生,阴道清洁度正常率显著高于对照组(100%vs 57.14%,P<0.01)。术后4周复查,观察组在宫颈创面的修复情况显著优于对照组(P<0.01)。术后6周和术后8周,观察组痊愈率及上皮完全成熟度方面均显著高于对照组(72.31%vs 42.32%,96.41%vs86.77%,P<0.01)。结论氯喹那多/普罗雌烯可明显减少LEEP术后出血、感染等并发症,缩短宫颈上皮愈合时间。Objective To observe the effect of chlorquinaldol/promestriene therapy in decreasing incidence rate of postoperative complications and promoting epithelial healing after surgical operation for patients with cervical intraepithelial neoplasia（CIN）. Methods A total of 384 women with CIN underwent cervical loop electrosurgical excisions procedure （LEEP） in Navy General Hospital of PLA from Mar. 2009 to May 2012 were randomly divided into two groups：patients in the observation group （195 cases） were treated with chlorquinaldol/promestriene from the second day after operation, 1 pill/d for 18 days, vaginal plugging ; patients in the control group（ 189 cases） were treated with oral antibiotics for 3 days. The following indexes were compared ：the signs of vaginal secretion, wound decrustation and bleeding 2 weeks after operation, the effects of epithelial healing 4/6/8 weeks after operation,and Thin-Cytologic Test（TCT） and colposcopy were rechecked 3 months after operation. Results The incidence rate of wound decrustation 2 weeks after operation was significantly greater in the observation group than the control group（ 100% vs 22.22% ,P 〈0.01 ）, all wound scabs of patients in observation group were dropped out completely. The incidence rate of cervical wound hemorrhage was much lower in the observation group than the control group （ 5.64% vs 53.97 %, P 〈 0.01 ）. The rate of normal vaginal cleanliness was remarkably higher in the observation group than the control group（100% vs 57.14% ,P 〈0.01 ）. There was no incidence of abnormal vaginal cleanliness in observation group. Four weeks after operation ,the wound healing status in the observation group were far better than the control group（ P 〈 0. O1 ）. Six and eight weeks after operation, both the recovery rate and the completely epithelial maturity degree of the observation group exceeded that of the control group dramatically （72.31% vs 42.32% ,96.41% vs 86.77%, P 〈 0. 01 ）. Conclusion The combined medication of chlor

关 键 词：宫颈上皮内瘤变 宫颈电波刀切除术 氯喹那多/普罗雌烯 术后并发症 

分 类 号：R713.44[医药卫生—妇产科学]