苦参膜与rhEGF凝胶分别联合云南白药用于宫颈LEEP术后创面的临床观察  

Clinical Observation of Oxymatrine Membrane,rh EGF Gel Combined with Yunnan Baiyao for Postoperative Cervical Wound after LEEP

作　　者：缪雪阳[1] 夏同霞[1] 缪炜烈[2] 陈大勇[1] 付立仙[1] 孙颖[1] 

机构地区：[1]遵义医学院附属医院,贵州遵义563003 [2]遵义医学院附属肿瘤医院,贵州遵义563003

出　　处：《中国药房》2017年第6期752-755,共4页China Pharmacy

基　　金：遵义市科技计划课题(No.遵市科合社字[2014]69号)

摘　　要：目的:探讨苦参膜与rh EGF凝胶分别联合云南白药用于宫颈环形电切(LEEP)术后创面的临床疗效和安全性。方法:300例宫颈上皮内瘤样病变(CIN)Ⅱ、Ⅲ级患者,依宫颈CIN分级分层,在各层中进行随机抽样,分为A、B、C组(每组均为100例)。A组患者在常规LEEP术后,用0.9%氯化钠注射液清洗创面,创面喷洒云南白药粉末,仅术后1次;B组患者在A组治疗的基础上加用重组人表皮生长因子(rh EGF),术后每周1次,连用3周;C组患者在A组治疗的基础上加用苦参膜,术后每晚1片,连用2周。观察各组患者术后出血情况、出血持续时间、术后出血停止后再次出血情况及持续时间、术后排液持续时间、创面愈合情况及不良反应发生情况。结果:B组患者术后出血率、出血持续时间≥7 d发生率和出血停止后再次出血率显著低于A组;C组患者术后出血时间≥7 d发生率显著低于A组,术后排液持续时间≤7 d的比例显著高于A组,8~13 d的比例显著低于A组;B、C组患者早期创面愈合率均显著高于A组,差异均有统计学意义(P<0.05)。B、C组上述各项指标比较,差异均无统计学意义(P>0.05)。各组患者治疗期间均无明显不良反应发生。结论:苦参膜与rh EGF凝胶分别联合云南白药用于LEEP术后创面的早期愈合情况均好于单用云南白药,且不增加不良反应的发生,但苦参膜与rh EGF凝胶两者疗效相当。OBJECTIVE：To explore the clinical efficacy and safety of oxymatrine membrane,rh EGF gel respectively combined with Yunnan baiyao for postoperative cervical wound after LEEP. METHODS：300 patients with cervical intraepithelial neoplasia（CIN）Ⅱ and Ⅲ were divided into group A,B,C（100 cases in each group）based on CIN grading and stratification and random sampling in each stratification. After conventional LEEP,patients in group A were cleaned the wound by 0.9% Sodiumchloride injection,spraying Yunnan baiyao powder,once only after surgery;patients in group B were additionally given recombinant human epidermal growth factor（rh EGF） on the basis of group A,once every week after surgery,for 3 weeks;patients in group C were additionally given oxymatrine membrane on the basis of group A,1 tablet every evening after surgery,for 2 weeks.Postoperative bleeding,bleeding duration,rebleeding and duration after postoperative bleeding stopped,postoperative drainage duration,the incidence of adverse reactions in 3 groups were observed. RESULTS：The patients of postoperative bleeding,bleeding time ≥7 d and rebleeding after stopping bleeding in group B were significantly lower than group A;the incidence of bleeding time ≥7 d in group C was significantly lower than group A,the proporition of postoperative drainage duration for less than 7 d was significantly higher than group A,for 8-13 d was significantly less than group A;early wound healing rate in group B and group C were significantly better than group A,with statistical significances（P〈0.05）. There were no significant differences in above-mentioned indexes in group B and group C（P〈0.05）,and there were no obvious adverse reactions in 3 groups. CONCLUSIONS：Oxymatrine membrane and rh EGF gel respectively combined with Yunnan baiyao have better healing than Yunnan baiyao alone,do not increase the incidence of adverse reactions,while there is no significant difference in oxymatrine membrane and rh EGF gel.

关 键 词：宫颈环形电切术 云南白药 重组人表皮生长因子 苦参膜 创面 

分 类 号：R713.4[医药卫生—妇产科学]