CAJ | 학술논문

目的：观察宫颈上皮内瘤变术后应用氯喹那多／普罗雌烯，减少术后并发症，促进上皮愈合的情况。方法将2009年3月至2012年5月海军总医院妇科门诊收治的384例因宫颈上皮内瘤变行宫颈高频电波刀切除术（ LEEP）的患者采用随机数字表法分成两组，氯喹那多／普罗雌烯组（观察组）195例，口服抗生素组（对照组）189例，其中观察组于术后第2日阴道填塞氯喹那多／普罗雌烯1片，每日1次，连用18 d，对照组术后常规口服抗生素3 d。术后2周观察阴道分泌物、创面脱痂及出血情况；术后4、6、8周观察宫颈上皮修复情况，术后3个月复查液基薄层细胞学与阴道镜，了解病变的改善情况。结果术后2周，观察组患者宫颈创面均完全脱痂，观察组创面脱痂率显著高于对照组（100％ vs 22．22％，P＜0．01）。观察组宫颈创面出血率显著低于对照组（5．64％ vs 53．97％， P＜0．01）。观察组无阴道清洁度异常发生，阴道清洁度正常率显著高于对照组（100％ vs 57．14％， P＜0．01）。术后4周复查，观察组在宫颈创面的修复情况显著优于对照组（P＜0．01）。术后6周和术后8周，观察组痊愈率及上皮完全成熟度方面均显著高于对照组（72．31％ vs 42．32％，96．41％ vs 86．77％，P＜0．01）。结论氯喹那多／普罗雌烯可明显减少LEEP术后出血、感染等并发症，缩短宫颈上皮愈合时间。
목적：관찰궁경상피내류변술후응용록규나다／보라자희，감소술후병발증，촉진상피유합적정황。방법장2009년3월지2012년5월해군총의원부과문진수치적384례인궁경상피내류변행궁경고빈전파도절제술（ LEEP）적환자채용수궤수자표법분성량조，록규나다／보라자희조（관찰조）195례，구복항생소조（대조조）189례，기중관찰조우술후제2일음도전새록규나다／보라자희1편，매일1차，련용18 d，대조조술후상규구복항생소3 d。술후2주관찰음도분비물、창면탈가급출혈정황；술후4、6、8주관찰궁경상피수복정황，술후3개월복사액기박층세포학여음도경，료해병변적개선정황。결과술후2주，관찰조환자궁경창면균완전탈가，관찰조창면탈가솔현저고우대조조（100％ vs 22．22％，P＜0．01）。관찰조궁경창면출혈솔현저저우대조조（5．64％ vs 53．97％， P＜0．01）。관찰조무음도청길도이상발생，음도청길도정상솔현저고우대조조（100％ vs 57．14％， P＜0．01）。술후4주복사，관찰조재궁경창면적수복정황현저우우대조조（P＜0．01）。술후6주화술후8주，관찰조전유솔급상피완전성숙도방면균현저고우대조조（72．31％ vs 42．32％，96．41％ vs 86．77％，P＜0．01）。결론록규나다／보라자희가명현감소LEEP술후출혈、감염등병발증，축단궁경상피유합시간。
Objective To observe the effect of chlorquinaldol/promestriene therapy in decreasing inci-dence rate of postoperative complications and promoting epithelial healing after surgical operation for patients with cervical intraepithelial neoplasia(CIN).Methods A total of 384 women with CIN underwent cervical loop electrosurgical excisions procedure ( LEEP) in Navy General Hospital of PLA from Mar .2009 to May 2012 were randomly divided into two groups:patients in the observation group(195 cases) were treated with chlorquinaldol/promestriene from the second day after operation,1 pill/d for 18 days,vaginal plugging;pa-tients in the control group(189 cases) were treated with oral antibiotics for 3 days.The following indexes were compared:the signs of vaginal secretion,wound decrustation and bleeding 2 weeks after operation,the effects of epithelial healing 4/6/8 weeks after operation,and Thin-Cytologic Test(TCT) and colposcopy were rechecked 3 months after operation.Results The incidence rate of wound decrustation 2 weeks after opera-tion was significantly greater in the observation group than the control group(100% vs 22.22%,P<0.01), all wound scabs of patients in observation group were dropped out completely .The incidence rate of cervical wound hemorrhage was much lower in the observation group than the control group (5.64% vs 53.97%,P<0.01).The rate of normal vaginal cleanliness was remarkably higher in the observation group than the control group(100% vs 57.14%,P<0.01).There was no incidence of abnormal vaginal cleanliness in observation group.Four weeks after operation,the wound healing status in the observation group were far better than the control group(P<0.01).Six and eight weeks after operation,both the recovery rate and the completely epi-thelial maturity degree of the observation group exceeded that of the control group dramatically(72.31% vs 42.32%,96.41% vs 86.77%,P <0.01).Conclusion The combined medication of chlorquinaldol/promestriene after cervical LEEP for patients with cervical intraepithelial neoplasia could decrease the inci-dence rate of postoperative complications,such as hemorrhage,infection and so on,and shorten the healing time of cervical epithelium.