宫颈冷刀锥切术联合抗HPV生物蛋白敷料治疗HSIL合并高危型HPV感染的临床效果研究  

Clinical effect of cervical cold knife conization combined with anti-HPV bioprotein dressing on HSIL treatment complicated with high-risk HPV infection

作　　者：马莉 郭思宏 朱博熠 陈杰[1] MA Li;GUO Sihong;ZHU Boyi;CHEN Jie(Harbin Medical University Cancer Hospital,Harbin 150081,China;Heilongjiang University of Chinese Medicine)

机构地区：[1]哈尔滨医科大学附属肿瘤医院,哈尔滨150081 [2]黑龙江中医药大学

出　　处：《实用肿瘤学杂志》2021年第5期426-430,共5页Practical Oncology Journal

基　　金：北京癌症防治学会,癌症预防与诊治科研基金(编号:IZ学研字2019-1003);哈尔滨医科大学附属肿瘤医院海燕科研基金重点项目(编号:JJZD2019-06)。

摘　　要：目的探讨宫颈冷刀锥切术联合抗HPV生物蛋白敷料治疗宫颈高级别鳞状上皮内病变(High-grade squamous intraepithelial lesion,HSIL)合并高危型HPV感染的临床效果及应用价值。方法选择哈尔滨医科大学附属肿瘤医院2017年9月—2019年12月接收的220例确诊高危型HPV感染且病理证实为宫颈上皮内瘤变(Cervical intraepithelial neoplasia,CIN)Ⅱ~Ⅲ级的患者,随机分为观察组和对照组,对照组予以单纯宫颈冷刀锥切术(CKC)治疗,观察组予以CKC联合抗HPV生物蛋白敷料治疗,术后定期复查HPV、TCT并察看阴道分泌物,对两组疗效进行对比评价。结果观察组在术后6个月、9个月、12个月HPV转阴率为51.82%、70.00%、83.64%,治疗总有效率为62.73%、82.73%、91.82%,均高于对照组(P<0.05);观察组术后6个月、12个月复查TCT异常率均低于对照组(P<0.05);年龄<50岁的观察组与对照组患者间治疗总有效率对比无统计学差异(P>0.05),年龄≥50岁的观察组患者治疗总有效率均优于对照组(P<0.05);观察组在术后3个月、6个月、9个月及12个月阴道分泌物正常率为48.18%、64.55%、84.55%、92.73%,均高于对照组(P<0.05)。结论宫颈冷刀锥切术联合抗HPV生物蛋白敷料治疗HSIL合并高危型HPV感染临床效果显著,能够改善阴道环境,有效促进高危型HPV感染的消退,降低术后复发的风险,且高龄妇女更加受益。Objective The aim of this study was to investigate the clinical effect and application value of cold knife conization combined with anti-HPV bioprotein dressing in the treatment of high-grade squamous intraepithelial lesion(HSIL)complicated with high-risk HPV infection.Methods A total of 220 patients received by the Harbin Medical University Cancer Hospital from September 2017 to December 2019 diagnosed with high-risk HPV infection and pathologically confirmed to be cervical intraepithelial neoplasia(CIN)gradeⅡ~Ⅲwere randomly divided into observation group and control group.The control group was treated with CKC alone,and the observation group was treated with CKC combined with anti-HPV bioprotein dressings.After that,HPV,TCT and vaginal secretion were reviewed regularly,and the curative effects on the two groups were compared and evaluated.Results In the observation group,the negative rate of HPV in 6 months,9 months and 12 months after surgery were 51.82%,70.00%and 83.64%,respectively,and the total effective rates of treatment were 62.73%,82.73%and 91.82%,respectively,which were higher than those in the control group(P<0.05).The abnormal rate of TCT in the observation group at 6 months and 12 months after surgery was lower than that in the control group(P<0.05).There was no significant difference in the total effective rate for patients younger than 50 years old between the observation group and the control group(P>0.05).The total effective rate of treatment for patients≥50 years old in the observation group was better than that of the control group(P<0.05).The normal rates of vaginal secretion in the observation group at 3 months,6 months,9 months and 12 months after surgery were 48.18%,64.55%,84.55%,92.73%,respectively,which were higher than those of the control group(P<0.05).Conclusion The cervical cold knife conization combined with anti-HPV bioprotein dressing has a significant clinical effect in the treatment of HSIL combined with high-risk HPV infection.It can improve the vaginal environment,effect

关 键 词：人乳头瘤病毒 宫颈高级别鳞状上皮内病变 冷刀锥切术 抗HPV生物蛋白敷料 

分 类 号：R737.33[医药卫生—肿瘤]