点阵二氧化碳激光用于外阴皲裂和萎缩的疗效和安全性  

Efficacy and safety of fractional carbon dioxide laser for fissures and atrophy of vulva

作　　者：李静然[1] 赵丽君[1] 赵超[1] 李明珠[1] 张薇[1] 赵昀[1] 王建六[1] 魏丽惠[1] LI Jingran;ZHAO Lijun;ZHAO Chao;LI Mingzhu;ZHANG Wei;ZHAO Yun;WANG Jianliu;WEI Lihui(Department of Obstetrics and Gynecology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院妇产科,100044

出　　处：《中国妇产科临床杂志》2022年第6期595-598,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：中国整形美容协会专项基金(FRPR201601-01)。

摘　　要：目的探讨点阵二氧化碳(CO_(2))激光治疗外阴皲裂和萎缩的疗效及安全性。方法回顾性分析2016年1月至2021年12月北京大学人民医院妇科103例外阴皲裂或合并萎缩患者的临床资料,其中采用点阵CO_(2)激光治疗患者75例(激光组),采用普罗雌烯阴道胶囊或加0.1%糠酸莫米松乳膏治疗患者28例(对照组)。应用视觉模拟评分法(VAS)评估患者治疗前后外阴皲裂、萎缩和疼痛程度,并进行比较。结果激光组治疗后1个月患者外阴皲裂改善率(89.34%,67/75)与对照组(67.86%,19/28)比较,差异有统计学意义(P<0.05);激光组治疗后1个月外阴疼痛评分[(1.00±0.90)分]与对照组[(1.50±1.11)分]比较,差异有统计学意义(P<0.05)。激光组平均疗效维持时间[(18.57±9.60)个月]与对照组[(7.31±7.14)个月]比较,差异有统计学意义(P<0.05),激光组治疗后6个月后复发率(32.79%,20/61)与对照组(33.34%,8/24)比较,差异无统计学意义(P>0.05)。激光组24~48 h局部轻度不适/充血或肿胀13例(17.34%),对照组用药后有刺痛感10例(35.72%),均无需治疗;激光组无激光损伤、感染、创面不愈合等严重并发症。结论点阵CO_(2)激光可作为外阴皲裂和萎缩治疗的新方法,近期疗效较好,恢复快,安全性良好,但长期疗效需要进一步观察。Objective To investigate the efficacy and safety of fractional carbon dioxide(CO_(2))laser in the treatment of vulvar fissures and atrophy.Methods A total of 103 patients with vulvar fissures or combined with atrophy in Peking University People’s Hospital from February 2017 to December 2021 were retrospectively analyzed.Among them,75 patients were treated with fractional laser(laser group),and 28 cases(control group)were treated with Promestriene suppository and/or with 0.1%Mometasone Furoate cream.Visual analogue scale(VAS)was used to evaluate the degree of fissures,atrophy and vulvar pain before and after treatment.Results One month after laser treatment,the improvement rate of fissures in the laser group(89.34%,67/75)was significantly higher than that in the control group(67.86%,19/28)(P<0.05);There was significant difference in vulvodynia score[(1.00±0.90,1.50±1.11)]between the two groups after treatment(P<0.05).The average maintenance time of treatment in laser group[(18.57±9.60)months]was significantly higher than that in control group[(7.31±7.14)months](P<0.05).There was no significant difference in the recurrence rate between the laser group(32.79%,20/61)and the control group(33.34%,8/24)after 6 months(P>0.05).There were 13 cases(17.34%)of local mild discomfort/slight congestion or swelling within 24 to 48 hours in the laser group,and 10 cases(35.72%)of stinging pain in the control group.There were no serious complications such as laser injury,infection,and wound nonhealing.Conclusions Fractional CO_(2)laser can be used as a new method for the treatment of fissures and atrophy of vulva.It has good short-term efficacy,rapid recovery,and good safety,but the long-term efficacy needs to be further observed.

关 键 词：点阵二氧化碳激光 外阴皲裂 外阴萎缩 外阴痛 疗效 

分 类 号：R711.72[医药卫生—妇产科学]