改善阴道微生态对高级别子宫颈鳞状上皮内病变患者行宫颈环形电切术后宫颈管粘连的影响  

Effect of improving vaginal microecology on cervical duct adhesion in patients with high-grade cervical squamous intraepithelial lesions after loop electrosurgical excision procedure

作　　者：王静 陈欢 林萍 多亚莉 WANG Jing;CHEN Huan;LIN Ping;DUO Yali(Departmen of Gynaecology,People′s Hospital of Hengshui(Harrison International Peace Hospital),Hengshui 053000,Hebei,China;Central Laboratory,People′s Hospital of Hengshui(Harrison International Peace Hospital),Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院(哈励逊国际和平医院)妇科,河北衡水053000 [2]衡水市人民医院(哈励逊国际和平医院)中心实验室,河北衡水053000

出　　处：《中国性科学》2024年第9期53-57,共5页Chinese Journal of Human Sexuality

基　　金：衡水市科技计划项目(2021014095Z)。

摘　　要：目的探讨改善阴道微生态对高级别子宫颈鳞状上皮内病变(HSIL)患者行宫颈环形电切术(LEEP)后宫颈管粘连的影响。方法选取2021年11月至2023年1月衡水市人民医院收治的210例行LEEP的HSIL患者作为研究对象,根据随机数字表法分为对照组与试验组,每组105例。术后,对照组采用雌三醇软膏治疗,试验组采用雌三醇软膏联合乳杆菌活菌胶囊治疗,连续治疗10 d。比较两组术后宫颈粘连发生率、手术前后阴道微生态情况、阴道分泌物功能酶活性。结果试验组宫颈粘连发生率低于对照组,差异具有统计学意义(P<0.05)。术后2周,试验组pH 3.8~4.5、阴道菌群密度Ⅰ~Ⅱ级、阴道微生态正常率均高于对照组,差异具有统计学意义(P<0.05)。术后6周,试验组唾液酸酶(SNA)活性阳性率低于对照组,差异具有统计学意义(P<0.05);术后12周,试验组过氧化氢(H_(2)O_(2))、白细胞酯酶(LE)、SNA活性阳性率均低于对照组,差异具有统计学意义(P<0.05)。结论临床上给予LEEP术后HSIL患者乳杆菌治疗,可降低术后宫颈粘连发生率,改善阴道微生态,调节阴道分泌物功能酶活性。Objective To investigate the effect of improving vaginal microecology on cervical duct adhesion in patients with high-grade cervical squamous intraepithelial lesions(HSIL)after loop electrosurgical excision procedure(LEEP).Methods A total of 210 patients with HSIL underwent LEEP admitted to People′s Hospital of Hengshui from November 2021 to January 2023 were selected as the study objects,and were divided into control group and experimental group according to random number table method,with 105 cases in each group.After operation,the control group was treated with estriol ointment,and the experimental group was treated with estriol ointment combined with lactobacillus live capsule for 10 days.The incidence of postoperative cervical adhesion,vaginal microecology and functional enzyme activity of vaginal secretions before and after surgery were compared between the two groups.Results The incidence of cervical adhesion in experimental group was lower than that in control group,the difference was statistically significant(P<0.05).At 2 weeks after surgery,pH 3.8-4.5,vaginal flora densityⅠ-Ⅱand normal incidence of vaginal microecology in experimental groups were higher than those in control group,with statistical significances(P<0.05).At 6 weeks after surgery,the positive rate of sialidase(SNA)activity in experimental group was lower than that in control group,and the difference was statistically significant(P<0.05).At 12 weeks after surgery,the positive rates of hydrogen peroxide(H_(2)O_(2)),leucocyte esterase(LE)and SNA activity in experimental groups were all lower than those in control group,and the differences were statistically significant(P<0.05).Conclusions Clinical treatment of Lactobacillus therapy in patients with HSIL after LEEP can reduce the incidence of postoperative cervical adhesions,improve vaginal microecology and regulate the functional enzyme activity of vaginal secretions.

关 键 词：宫颈鳞状上皮内病变 宫颈环形电切术 乳杆菌活菌胶囊 宫颈粘连 阴道微生态 

分 类 号：R711[医药卫生—妇产科学]