绝经后女性阴道镜检查前阴道局部预处理的临床研究  

Clinical Study on Vaginal Pretreatment before Colposcopy for Postmenopausal Patients

作　　者：陈丽梅[1] 曹远奎 张宏伟[1] 宋昱[1] 汪清[1] 隋龙[1] CHEN Limei;CAO Yuankui;ZHANG Hongwei(Cervical Diseases Diagnosis and Treatment Centre,Obstetrics and Gynecology Hospital of Fudan University,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases,Shanghai 200011,China)

机构地区：[1]上海复旦大学附属妇产科医院宫颈及阴道早期疾病诊治中心上海市女性生殖内分泌相关疾病重点实验室,上海200011

出　　处：《实用妇产科杂志》2023年第4期287-291,共5页Journal of Practical Obstetrics and Gynecology

基　　金：上海市科学技术委员会科研计划项目(编号:16411950200)。

摘　　要：目的:评价雌激素阴道局部制剂和复方沙棘油栓对于绝经后女性行阴道镜检查前阴道局部预处理的作用。方法:选择2021年1月至2021年10月在上海复旦大学附属妇产科医院接受阴道镜检查的绝经后患者为研究对象,采用简单随机化方法分为A组(n=60例)、B组(n=90例),C组(n=90例)、D组(n=90例)。除A组为对照组,不使用药物,其他3组患者阴道镜检查前分别采用普罗雌烯阴道胶丸(B组)、雌激素软膏(C组)和复方沙棘油栓(D组)进行阴道局部预处理,其中B组、C组、D组再各自随机分成2组,其中60例用药1周为B1组、C1组、D1组,30例用药2周及用药1周后因碘染不满意延长用药2周为B2组、C2组、D2组,分析比较使用不同药物预处理后阴道镜检查充分率、醋酸试验满意率、碘染试验满意率、子宫颈高级别鳞状上皮内病变(HSIL)阴道镜诊断准确率和药物不良反应等情况。结果:本研究纳入的330例患者中,有4例患者因不适退出研究,最终纳入326例。(1)用药1周后,B1组(58例)、C1组(59例)、D1组(59例)与A组比较,阴道镜检查充分率、醋酸试验满意率和碘染试验满意率均有提高,差异有统计学意义(P<0.05)。(2)用药2周与用药1周比较,3种用药组的阴道镜检查充分率和HSIL阴道镜诊断准确率都有提高,但差异无统计学意义(P>0.05);3种用药组醋酸试验满意率有所提高,但仅B2组与B1组比较有显著性差异(P<0.01);3种用药组碘染试验满意度明显增加,且差异均有统计学意义(P<0.05)。(3)在药物不良反应方面,使用药物的3组患者在阴道局部不适和头晕、头痛方面,差异无统计学意义(P>0.05)。D组发生乳腺疼痛、压痛药物不良反应低于B组和C组,差异有统计学意义(P<0.05)。结论:绝经后患者阴道镜检查前局部用雌激素药膏或复方沙棘油栓1~2周均有助于提高阴道镜检查的醋酸试验和碘染试验的满意率,且局部用药2周碘染效果较1周更好。Objective:To evaluate the effect of vaginal topical pretreatment of estrogen and compound sea-buckthorn oil suppository in postmenopausal women for local vaginal pretreatment prior to colposcopy.Methods:Postmenopausal female who underwent colposcopy in Obstetrics and Gynecology Hospital of Fudan University from January 2021 to October 2021 were randomly divided into four groups.group A(n=60)was the control group with untreated before colposcopy.The other three groups of patients were treated before colposcopy locally with progesterone vaginal capsules(group B,n=90),estrogen ointment(group C,n=90),and compound sea-buckthorn suppository(group D,n=90)respectively.Among them,group B,C,and D were randomly divided into two groups,of which 60 cases were treated for one week were included as group B1,C1,and D1.30 cases were treated for two weeks were included as group B2,C2,and D2.Some patients were also included in groups B2,C2,and D2 because of dissatisfaction with iodine staining with one week's medication and then prolonged to two weeks.The colposcopy examination adequacy,acetic acid test satisfaction,iodine staining test satisfaction,col-poscopy diagnosis accuracy of cervical high-grade squamous intraepithelial lesions(HSIL),and adverse drug re-actions were analyzed and compared after different pretreatment.Results:Of the 330 patients included in this study,4 patients withdrew from the study due to adverse reaction,and 326 patients were finally included.①After one week of pretreatment,the adequacy rate of colposcopy,satisfaction rate of acetic acid test,satisfaction rate of iodine staining test were improved in group B1(58 cases),group C1(59 cases),group D1(59 cases)compared with group A,and the difference was statistically significant(P<0.05).②Comparing 2 weeks of treatment with 1 week of treatment,the adequacy rate of colposcopy and accuracy rate of HSIL colposcopy diagnosis were im-proved in all three groups,but there was no statistical difference(P>0.05).The satisfaction rate of acetic acid test improved in

关 键 词：绝经后 阴道镜检查 雌激素下降 阴道萎缩 复方沙棘油栓 

分 类 号：R737.33[医药卫生—肿瘤]