壳聚糖抗菌凝胶促进宫颈微波手术创面愈合78例  

Effect of Chitosan Antibacterial Gel on Promoting Wound Healing After Cervical Microwave Operation with Seventy-eight Patients

作　　者：张顺然 尹平[2] 张志安[3] 朱树香[1] 陈素华[1] ZHANG Shunran;YIN Ping;ZHANG Zhian;ZHU Shuxiang;CHEN Suhua(Department of Perinatal Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Gynaecology Huanggang Central Hospital,Hubei Province,Huanggang 438000,China)

机构地区：[1]华中科技大学同济医学院附属同济医院围产医学科,武汉430030 [2]华中科技大学同济医学院公共卫生学院,武汉430030 [3]湖北省黄冈市中心医院妇科,黄冈438000

出　　处：《医药导报》2023年第5期680-685,共6页Herald of Medicine

基　　金：武汉市科技项目(2015whkjxmpp07)。

摘　　要：目的 观察壳聚糖抗菌凝胶促进慢性宫颈炎患者宫颈微波手术治疗后创面愈合的作用。方法 将接受宫颈微波手术的慢性宫颈炎患者149例随机分成治疗组78例和对照组71例。治疗组分别在手术后、手术第1周和4周时使用壳聚糖抗菌凝胶涂覆在宫颈创面处。对照组手术后不予特殊用药。两组患者均于手术后、手术第1,4,8和12周进行随访检查,观察宫颈创面水肿、结痂、脱痂、愈合情况、阴道出血量以及分泌物性状,记录不良反应及实验室指标。结果 与对照组比较,治疗组手术后创面愈合时间平均缩短1.83周(P<0.01);治疗组手术后第4周阴道出血发生率为56.41%,明显低于对照组的77.46%(P<0.01),同时手术后第1周及第4周治疗组出血量更少(P<0.01),出血持续时间更短(P<0.01);治疗组手术后第1,4,8周炎性分泌物的发生率分别为89.74%,26.92%,2.56%,均明显低于对照组的100.00%,56.34%,19.72%(均P<0.01);治疗组手术后第1周及第4周宫颈黏膜水肿的发生率分别为15.38%和6.41%,均明显低于对照组的73.24%和32.39%(P均<0.01);治疗组手术后第4周宫颈黏膜结痂率为42.31%,第8周脱痂率为51.28%,均明显高于对照组的22.54%和13.33%(均P<0.05)。治疗过程中未发现与用药相关的明显不良事件及实验室指标异常改变。结论 壳聚糖抗菌凝胶具有促进慢性宫颈炎患者宫颈微波手术后创面愈合、减轻手术后并发症的作用。Objective To observe the effect of chitosan antibacterial gel on promoting wound healing in patients with chronic cervicitis after cervical microwave operation.Methods A total of 149 patients with chronic cervicitis who received cervical microwave operation were randomly divided into a treatment group(78 cases)and a control group(71 cases).The cervical wounds were coated with chitosan antibacterial gel in the treatment group in postoperative,1,and 4 weeks respectively.No special medication was given in the control group after the operation.The patients in both groups were followed up in postoperative,in 1,4,8,and 12 weeks after the operation.The edema,scab formation,scab removal,healing,vaginal bleeding,and secretion characteristics of the cervical wound were observed,and the adverse reactions and laboratory indexes were recorded.Results Compared with the control group,the average time of wound healing in the treatment group was shortened by 1.83 weeks(P<0.01).The incidence of vaginal bleeding in 4 weeks after the operation in the treatment group was 56.41%,which was significantly lower than that in the control group(77.46%,P<0.01).Meanwhile,in 1 and 4 weeks after the operation,the amount of bleeding was less(P<0.01)and the duration of bleeding was shorter(P<0.01)in the treatment group than those in the control group.The incidence of inflammatory secretion in 1,4,and 8 weeks after the operation in the treatment group was 89.74%,26.92%,and 2.56%respectively,significantly lower than that in the control group(100.00%,56.34%,19.72%,all P<0.01).The incidence of cervical mucosal edema in 1 and 4 weeks after the operation in the treatment group was 15.38%and 6.41%respectively,significantly lower than that in the control group(73.24%,32.39%,all P<0.01).The incidence of scab formation of cervical mucosa in 4 weeks after the operation in the treatment group was 42.31%and that of scab removal in 8 weeks was 51.28%,which were significantly higher than those in the control group(22.54%and 13.33%,all P<0.05).No obvious adverse

关 键 词：壳聚糖抗菌凝胶 宫颈炎 慢性 微波手术 创面愈合 

分 类 号：R984[医药卫生—药品] R711.32[医药卫生—药学]