摘要
目的探究点阵式CO2激光联合阴道后壁黏膜切除术对阴道松弛患者转化生长因子-β1(transforming growth factor-β1,TGF-β1),胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平及性生活的影响。方法选择2015年1月至2019年5月深圳市中西医结合医院妇科收治的120例阴道松弛患者,通过随机数字表法分为观察组和对照组(各60例)。对照组接受阴道后壁黏膜切除术治疗,观察组在对照组基础上行点阵式CO2激光治疗,术后随访6个月。比较术前、术后6个月阴道松紧度及健康指数、盆底肌力、性功能及血清TGF-β1、IGF-1水平。结果术后6个月观察组阴道松紧度Ⅰ级比例高于对照组(70.00%vs 46.67%,P<0.05);观察组阴道健康指数评分显著高于对照组(P<0.05)。术后6个月两组Ⅰ类纤维收缩时间延长,观察组长于对照组(P<0.05)。术后6个月两组Ⅰ类纤维强度、Ⅱ类纤维强度、Ⅱ类纤维收缩数量均显著高于术前(P<0.05),两组间比较Ⅰ类纤维强度术后6个月差异无统计学意义(P>0.05),其余指标观察组高于对照组(P<0.05)。术后6个月两组阴道润滑度、性生活满意度、性交疼痛评分均显著高于术前,观察组高于对照组(P<0.05)。术后6个月,两组血清TGF-β1、IGF-1水平较术前升高,观察组高于对照组(P<0.05)。结论在阴道后壁黏膜切除术的基础上,联用点阵式CO2激光可提高阴道松弛患者血清TGF-β1、IGF-1水平,促进组织修复,提高盆底肌力,改善阴道松紧度、健康指数,提高患者性功能,值得临床推广应用。
Objective To explore the effect of dot-matrix CO2 laser combined with posterior vaginal mucosal resection on the levels of transforming growth factor-β1(TGF-β1),insulin-like growth factor-1(IGF-1)and sexual life in patients with vaginal relaxation.Methods From January 2015 to May 2019,120 patients with vaginal laxity admitted to Department of Gynecology,Shenzhen Integrated Traditional Chinese and Western Medicine Hospital were randomly assigned to the observation group and the control group(each group with 60 cases).The control group received vaginal posterior mucosal resection,and the observation group received dot-matrix CO2 laser treatment based on the control group,and were followed up for 6 months after surgery.The vaginal tightness and health index,pelvic floor muscle strength,sexual function and serum TGF-β1 and IGF-1 levels were compared before and 6 months after surgery.Results The proportion of vaginal tightnessⅠin the observation group was higher than that in the control group 6 months after surgery(70.00%vs 46.67%,P<0.05);the vaginal health index score in the observation group was significantly higher than that in the control group(P<0.05).6 months after operation,the contraction time of classⅠfibers was prolonged,and the observation group was longer than the control group(P<0.05).At 6 months after operation,both groups,Ⅰfiber strength,Ⅱfiber strength,andⅡfiber shrinkage were significantly higher than before surgery(P<0.05).There was no significant difference inⅠfiber strength between the two groups after 6 months(P>0.05),the rest of the observation group was higher than the control group(P<0.05).6 months after surgery,the vaginal lubrication,sexual life satisfaction,and sexual intercourse pain scores were significantly higher than before surgery,and the observation group was higher than the control group(P<0.05).6 months after surgery,the serum TGF-β1 and IGF-1 levels in the two groups were higher than those before the operation,and the observation group was higher than the control group(P<0.05).Conclusion On the basis of mucosal resection of posterior vaginal wall,combined use of dot-matrix CO2 laser can increase serum TGF-β1,IGF-1 levels in patients with vaginal relaxation,promote tissue repair,improve pelvic floor muscle strength,improve vaginal elasticity and health,improves the patient’s sexual function and is worthy of clinical application.
作者
刘琼芬
周丹
王红桂
柯妍
容春凤
LIU Qiongfen;ZHOU Dan;WANG Honggui;KE Yan;RONG Chunfeng(Department of Gynecology,Shenzhen Integrated Traditional Chinese and Western Medicine Hospital,Shenzhen Guangdong 518104,P.R.China)
出处
《中国计划生育和妇产科》
2021年第1期54-58,共5页
Chinese Journal of Family Planning & Gynecotokology
