二氧化碳激光与光动力治疗阴道上皮内瘤变患者的临床疗效对比分析  

Comparative Analysis of Efficacy of Carbon Dioxide Laser and Photodynamic Therapy for Vaginal Intraepithelial Neoplasia

作　　者：王阳阳 张云凤 牟婧祎 张一平 王悦 WANG Yangyang;ZHANG Yunfeng;MU Jingyi;WANG Yue(Department of Obstetrics and Gynecology,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou Henan 450003,China)

机构地区：[1]郑州大学人民医院河南省人民医院妇产科,河南郑州450003

出　　处：《实用妇产科杂志》2022年第7期520-524,共5页Journal of Practical Obstetrics and Gynecology

基　　金：郑州市科技惠民项目(编号:2020KJHM0020)。

摘　　要：目的:回顾性对比分析二氧化碳(CO_(2))激光与光动力疗法(PDT)治疗阴道上皮内瘤变(VaIN)的临床疗效,为VaIN患者的治疗提供参考。方法:选择2018年1月至2020年6月就诊于郑州大学人民医院,病理组织学确诊为VaIN且采用CO_(2)激光或PDT治疗的患者93例,其中CO_(2)激光组55例,PDT组38例,对比分析CO_(2)激光和PDT治疗VaIN的临床疗效。结果:CO_(2)激光组治疗后人乳头瘤病毒(HPV)转阴例数为46例(83.6%);PDT组治疗后HPV转阴例数为32例(84.2%),两组患者治疗6个月后HPV转阴率比较,差异无统计学意义(P>0.05)。CO_(2)激光组患者共43例(78.2%)治愈,其中阴道低级别鳞状上皮内病变(LSIL)患者25例(83.3%)治愈,阴道高级别鳞状上皮内病变(HSIL)患者18例(72.0%)治愈,PDT组患者共30例(78.9%)治愈,其中阴道LSIL患者18例(78.2%)治愈,阴道HSIL患者12例(75.0%)治愈。阴道LSIL及HSIL的病变治愈率在两组间差异无统计学意义(P>0.05),总治愈率在两组间差异无统计学意义(P>0.05)。CO_(2)激光组的患者1例出现阴道少量流血,1例出现阴道壁粘连;PDT组的患者4例出现阴道分泌物增多。CO_(2)激光组治疗6个月后有4例(7.27%)复发,PDT组治疗6个月后有2例(5.26%)复发。CO_(2)激光组复发率与PDT组差异无统计学意义(P>0.05)。两组患者治疗6个月时均无病变进一步进展。结论:CO_(2)激光治疗与光动力疗法治疗VaIN的疗效相比无差异,无明显不良反应,短期复发率低,两种治疗方法均值得在临床上推广应用。Objective:To retrospectively compare and analyze the clinical efficacy of CO_(2) laser and photodynamic(PDT)in the treatment of vaginal intraepithelial neoplasia(VaIN),so as to provide reference for the treatment of patients with VaIN.Methods:We selected 93 patients who were diagnosed as VaINby histopathologyand received PDT or CO_(2) laser treatment from January 2018 to June 2020 in the Zhengzhou University People's Hospital.Among them,38 cases were in the photodynamic group and 55 cases in the CO_(2) laser group.The clinical efficacyof photodynamic therapy and CO_(2) laser treatment of VaIN were analyzed and compared.Results:The number of HPV negative cases in CO_(2) laser group was 46 cases(83.6%).The number of HPV negative cases in PDT group was 32 cases(84.2%),and there was no significant difference in HPV negative rate between the two groups after 6 months of treatment(P>0.05).A total of 43 cases(78.2%)in the CO_(2) laser group were cured,including 25 cases(83.3%)with vaginal LSIL,18 cases(72.0%)with vaginal HSIL,and 30 cases(78.9%)in the PDT group were cured,including 18 cases(78.2%)with vaginal LSIL and 12 cases(75.0%)with vaginal HSIL.There was no significant difference in the cure rate of vaginal LSIL and HSIL between the two groups(P>0.05),and no significant difference in the total cure rate between the two groups(P>0.05).In the CO_(2) laser group,1 case had a small amount of vaginal bleeding and 1 case had vaginal wall adhesion.In PDT group,4 cases showed increased vaginal secretion.In the CO_(2) laser group,4 cases(7.27%)relapsed after 6 months of treatment,and in the PDT group,2 cases(5.26%)relapsed after 6 months of treatment.The recurrence rate of CO_(2) laser group was higher than that of PDT group,but the difference was not statistically significant(P>0.05).There was no further disease progression in both groups after 6 months of treatment.Conclusions:There is no difference between the efficacy of CO_(2) laser therapy and photodynamic therapy in the treatment of VaIN,with no obvious adverse reac

关 键 词：阴道上皮内瘤变 光动力疗法 CO_(2)激光治疗 人乳头瘤病毒 

分 类 号：R711.73[医药卫生—妇产科学]