二氧化碳点阵激光治疗女性外阴硬化性苔藓短期疗效分析  

The Analysis of Short-Term Effect of Fractional Carbon Dioxide Laser in the Treatment of Vulvar Lichen Sclerosus

作　　者：吴能秀 李迎[1] 徐颖[1] 林超琴[1] WU Nengxiu;LI Ying;XU Ying;LIN Chaoqin(Department of GynecoIogy,Fujian Maternity and ChiId HeaIth HospitaI,School of Cinical Medicine for Women and Children,Fujian MedicaI University,Fuzhou 350001,China)

机构地区：[1]福建省妇幼保健院,福建医科大学妇儿临床医学院妇科,福州350001

出　　处：《福建医科大学学报》2023年第3期199-203,共5页Journal of Fujian Medical University

基　　金：福建省女性盆底健康管理项目(闽财指[2022]537号)。

摘　　要：目的探讨二氧化碳点阵激光治疗女性外阴硬化性苔藓(VLS)的疗效及安全性。方法选取2021年1月—2022年7月行二氧化碳点阵激光治疗的30例VLS患者为研究对象,依据Cattaneo临床症状体征评分进行疗效指数评价,采用视觉模拟评分法(VAS)对患者外阴瘙痒、皲裂及性交疼痛进行评分,并按10分制评估患者满意度。结果第1~3次治疗后1个月的评估结果显示,外阴瘙痒、皲裂及性交疼痛等症状持续改善,治疗前后VAS评分差别均有统计学意义;Cattaneo临床症状体征评分治疗前为(8.87±1.59)分,第1~3次治疗后1个月分别下降至(4.67±1.40)、(3.67±1.35)和(3.13±1.28)分,与治疗前比较,差别均有统计学意义。在3次激光治疗后1个月,临床治疗有效率达80%。患者满意度随治疗次数的增加显著提高,第3次治疗后1个月高达(8.18±1.65)分;绝经前与绝经后以及不同病程患者的疗效指数分析显示差别无统计学意义,但随着病程延长,临床有效率逐渐降低。所有患者治疗期间和后续随访期间均未出现副反应。结论二氧化碳点阵激光治疗能够显著改善VLS的症状及体征。Objective To investigate the clinical efficacy and safety of carbon dioxide fractional laser treatment for vulvar lichen sclerosus(VLS)in women.Methods Total 30 VLS patients who received carbon dioxide dot matrix laser treatment were included from January 2021 to July 2022.The efficacy was evaluated according to the Cattaneo clinical symptoms and signs scale before treatment and 1 month after each laser treatment.The visual analogue scale(VAS)was used to rate the severity of vulvar itching,chancroid and painful intercourse,and the patients satisfaction with the treatment results was assessed according to a 10-point scale.Results The VAS of the severity of vulvar itching,chancroid and painful intercourse was obvious improved,Compared to pre-treatment,the differences were statistically significant.Cattaneo clinical symptom score decreased from(8.87±1.59)to(4.67±1.40)after first treatments,(3.67±1.35)after second treatments,and(3.13±1.28)after the third treatments.Compared to pre-treatment,the differences were statistically significant(P<0.001).After three laser treatments,the clinical treatment efficiency reached 80%.Patient satisfaction increased significantly with the number of laser treatments:the satisfaction score improved to(8.18±1.65)at 1 month after the third treatment.Analysis of the efficacy index between premenopausal and postmenopausal patients and between the different disease stages showed no statistically significant differences,but the clinical efficacy rate gradually decreased with longer disease duration.No significant side effects were observed in all patients during the treatment period or during the follow-up.Conclusion Carbon dioxide fractional laser treatment for VLS is safe and effective in the short term and significantly improve VLS symptoms and signs.

关 键 词：外阴硬化性苔藓 二氧化碳点阵激光 疗效 

分 类 号：R711.34[医药卫生—妇产科学]