摘要
目的分析阴道上皮内瘤变(VaIN)患者临床特征,探索激光气化治疗术(Laser)对高级别VaIN的治疗效果。方法回顾性分析2015年12月至2019年12月该院初次诊断的VaIN临床资料,总结VaIN的临床特征。选择采用Laser作为初次治疗的高级别VaIN患者55例,按照治疗方案分为A组和B组。其中,A组35例为对照组,采用Laser作为初次治疗;B组20例为研究组,采用Laser作为初次治疗,同时术后1个月采用中药派特灵盥洗阴道。比较2组疗效。结果373例VaIN患者中,VaIN 1为315例,VaIN 2~3为58例,患者平均年龄为(45.63±12.14)岁。VaIN合并宫颈上皮内瘤变(CIN)者258例(占69.17%),合并外阴上皮内瘤变(VIN)者42例(占11.26%)。VaIN病灶位于阴道上1/3者260例(占69.71%),多灶性238例(占63.81%)。373例宫颈脱落细胞样本的人乳头瘤病毒(HPV)阳性率为93.03%(347/373)。2组Laser治疗方案总体有效率为85.45%(47/55),治愈率为61.82%(34/55),复发率为29.09%(16/55)。A组及B组有效率(80.00%、95.00%)比较,差异无统计学意义(P=0.103)。B组治愈率(80.00%)高于A组(51.43%),差异有统计学意义(P<0.05)。B组复发率(12.50%)低于B组(44.44%),差异有统计学意义(P<0.05)。结论VaIN常合并CIN或VIN,病灶多发,位置以阴道上1/3为主。Laser对高级别VaIN疗效好,但仍有一定复发,联合药物可能进一步降低复发率。
Objective To analyze the clinical characteristics of patients with vaginal intraepithelial neoplasia(VaIN),and explore the therapeutic effect of laser vaporization therapy(Laser)on high-grade VaIN.Methods The data of VaIN patients diagnosed for the first time in the hospital from December 2015 to December 2019 were retrospectively analyzed,and the clinical characteristics of VaIN were summarized.55 cases of high-grade VaIN patients who chose Laser as the initial treatment were divided into group A and group B according to the treatment plan.Among them,35 cases in group A were the control group,using Laser as the initial treatment;20 cases in group B were the research group,using Laser as the initial treatment,and the traditional Chinese medicine Petrane was used to wash the vagina one month after the operation.The efficacy of the two groups was compared.Results Among the 373 VaIN patients,315 were VaIN 1,and 58 were VaIN 2~3.The average age of the patients was(45.63±12.14)years.VaIN combined with cervical intraepithelial neoplasia(CIN)in 258 cases(69.17%),and vulvar intraepithelial neoplasia(VIN)in 42 cases(11.26%).VaIN lesions were located in the upper third of the vagina in 260 cases(69.71%),and 238 cases were multifocal(63.81%).The positive rate of human papillomavirus(HPV)in 373 cases of cervical exfoliated cell samples was 93.03%(347/373).The overall effective rate of the two groups of laser treatment programs was 85.45%(47/55),the cure rate was 61.82%(34/55),and the recurrence rate was 29.09%(16/55).Comparing the effective rates(80.00%,95.00%)between group A and group B,the difference was not statistically significant(P=0.103).The cure rate of group B(80.00%)was higher than that of group A(51.43%),and the difference was statistically significant(P<0.05).The recurrence rate of group B(12.50%)was lower than that of group B(44.44%),and the difference was statistically significant(P<0.05).Conclusion VaIN is often combined with CIN or VIN,with multiple lesions,mainly located in the upper third of the vagina.Laser has a good effect on high-grade VaIN,but there are still some recurrences.The combined drugs may further reduce the recurrence rate.
作者
朱小利
吴佳聪
杨棹霞
黄国琴
ZHU Xiaoli;WU Jiacong;YANG Zhaoxia;HUANG Guoqin(Department of Cervical,Maternal and Child Health Hospital Affiliated to Nantong University,Nantong,Jiangsu 226018,China)
出处
《现代医药卫生》
2021年第14期2374-2377,共4页
Journal of Modern Medicine & Health
基金
江苏省南通市科学技术局市级科技计划项目(GJZ17082)。
关键词
阴道上皮内瘤变
多灶性
高级别
激光气化
复发
Vaginal intraepithelial neoplasia
Multifocal
High grade
Laser vaporization
Recurrence
