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目的探讨低度宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)CO2激光治疗后应用壳聚糖妇科生物功能敷料或云南白药的临床效果。方法收集2012年1月至2014年6月就诊于北京老年医院和广安门医院门诊经宫颈细胞学及HPV-DNA-阴道镜-宫颈活检三阶梯方法证实的低度宫颈上皮内瘤变(CIN1)116例,行CO2激光治疗。39例治疗后应用壳聚糖妇科生物功能敷料(妇炎消组),34例治疗后应用云南白药(云南白药组),43例单纯常规治疗(对照组)。治疗后1、2、4、8周及6个月随访,比较3组阴道出血量、出血时间、阴道排液量、排液时间、过敏反应及宫颈愈合情况。结果妇炎消组和云南白药组阴道排液时间明显短于对照组(P<0.01),妇炎消组阴道出血量明显少于对照组(P=0.010),阴道出血时间明显短于对照组(P=0.006),治疗后6个月宫颈愈合满意率妇炎消组97.4%(38/39),云南白药组97.1%(33/34),对照组81.4%(35/43),3组间宫颈愈合情况差异有显著性(χ2=8.649,P=0.013)。结论 CO2激光治疗后应用壳聚糖妇科生物功能敷料或云南白药可以减少宫颈创面渗出及出血,促进创面愈合,不良反应轻,值得临床研究及应用。
Objective To investigate the clinical effect of chitosan gynecological functional dressing or Yunnanbaiyao after cervical intraepithelial neoplasia (CIN) CO2 laser treatment. Methods A retrospective analysis of cervical intraepithelial neoplasia (CIN1) and cervical intraepithelial neoplasia (CIN1) confirmed by cervical cytology and HPV-DNA-colposcopy-cervical biopsy three-step method from January 2012 to June 2014 in Beijing Outpatient Geriatric Hospital and Guang’anmen Hospital was conducted. 116 cases, line CO2 laser treatment. After treatment, 39 cases were treated with chitosan gynecological functional dressing (Fuyanxu group), 34 cases were treated with Yunnanbaiyao (Yunnanbaiyao group) and 43 cases with simple routine treatment (control group). At 1, 2, 4, 8 weeks and 6 months after treatment, vaginal bleeding, bleeding time, vaginal discharge, drainage time, allergic reaction and cervical healing were compared between the three groups. Results The vaginal discharge time of Fuyanxu group and Yunnanbaiyao group was significantly shorter than that of the control group (P <0.01). Fuyinxiao group had less vaginal bleeding than the control group (P = 0.010), vaginal bleeding time was significantly shorter than that of the control group (P = 0.006). The satisfactory rate of cervical healing in 6 months after treatment was 97.4% (38/39) in the group of cervical inflammation, 97.1% (33/34) in the Yunnan Baiyao group, 81.4% (35/43) in the control group, Cervical healing between the differences were significant (χ2 = 8.649, P = 0.013). Conclusion The application of chitosan gynecological bio-functional dressing or Yunnanbaiyao after CO2 laser treatment can reduce the exudation and bleeding of cervical wound, promote the healing of wounds and reduce the adverse reactions. It is worthy of clinical study and application.