超脉冲CO_2激光系统治疗妇科外阴白斑的临床疗效分析
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摘要
目的探讨用超脉冲CO_2激光系统治疗妇科外阴白斑的临床疗效。方法选择2016年12月至2018年3月在我院门诊接受治疗的70例外阴白斑患者,随机等分为激光治疗组和药物治疗组,每组各35例。激光治疗组采用超脉冲CO_2激光多功能工作平台,使用9×9的pixelift手具对外阴白斑病变部位进行治疗,每月一次,连续治疗3个月;药物治疗组给予维生素E霜、2%丙酸睾丸酮鱼肝油软膏涂抹患处,每日3~4次,连续治疗3个月。比较两组患者疗程结束一个月后的治疗效果及主观满意度。结果激光治疗组患者总有效率为82.86%,其中治愈6例、显效23例、无效1例;药物治疗组患者总体有效率为25.71%,其中治愈1例、显效8例、无效16例。激光治疗组患者的总体有效率、治愈例数、显效例数均显著高于药物治疗组(P<0.05),而无效例数则显著低于药物治疗组(P<0.05)。激光治疗组患者的总体满意度显著高于药物治疗组(97.14%vs.57.14%)(P<0.05)。结论采用超脉冲CO_2激光治疗外阴白斑的临床疗效显著优于常规药物疗法,具有定位精确、疗效确切、损伤小等优势,值得推广。
Objective:To investigate the clinical efficacy of ultrapulsed CO_2 laser system in the treatment of gynecological leukoplakia.Methods:Seventy patients with vulva leukoplakia were treated in our hospital from December 2016 to March 2018.The patients were randomly divided into laser treatment group and drug treatment group,35 patients for each group.The patients in laser treatment group were treated with ultrapulsed CO_2 laser once a month for 3 months,while the drug treatment group was treated with vitamin E cream and 2%testosterone propionate cod liver oil ointment 3-4 times per day for 3 months.The treatment effect and subjective satisfaction were compared between the two groups.Results:The total effective rate of laser treatment group was 82.86%,of which 6 patients were cured;23 patients had significant therapeutic effects and 1 patient was ineffective.The total effective rate of drug treatment group was 25.71%,of which one patient was cured;another 8 patients had significant therapeutic effects and 16 patients were ineffective.The total effective rate,the number of patients cured and the number of patients with significant therapeutic effect in the laser treatment group were significantly higher than those in the drug treatment group(P<0.05),and the number of patients withinvalid treatment was significantly lower than that in the drug treatment group(P<0.05).The overall satisfaction of the laser treatment group(97.14%)was significantly higher than that of the drug treatment group(57.14%)(P<0.05).Conclusions:The clinical efficacy of ultrapulsed CO_2 laser system in treatment of vulvar leukoplakia is significantly superior to conventional drug therapy.It has the advantages of precise positioning,exact curative effect and small damage,which is worthy of promotion.
Objective:To investigate the clinical efficacy of ultrapulsed CO_2 laser system in the treatment of gynecological leukoplakia.Methods:Seventy patients with vulva leukoplakia were treated in our hospital from December 2016 to March 2018.The patients were randomly divided into laser treatment group and drug treatment group,35 patients for each group.The patients in laser treatment group were treated with ultrapulsed CO_2 laser once a month for 3 months,while the drug treatment group was treated with vitamin E cream and 2%testosterone propionate cod liver oil ointment 3-4 times per day for 3 months.The treatment effect and subjective satisfaction were compared between the two groups.Results:The total effective rate of laser treatment group was 82.86%,of which 6 patients were cured;23 patients had significant therapeutic effects and 1 patient was ineffective.The total effective rate of drug treatment group was 25.71%,of which one patient was cured;another 8 patients had significant therapeutic effects and 16 patients were ineffective.The total effective rate,the number of patients cured and the number of patients with significant therapeutic effect in the laser treatment group were significantly higher than those in the drug treatment group(P<0.05),and the number of patients withinvalid treatment was significantly lower than that in the drug treatment group(P<0.05).The overall satisfaction of the laser treatment group(97.14%)was significantly higher than that of the drug treatment group(57.14%)(P<0.05).Conclusions:The clinical efficacy of ultrapulsed CO_2 laser system in treatment of vulvar leukoplakia is significantly superior to conventional drug therapy.It has the advantages of precise positioning,exact curative effect and small damage,which is worthy of promotion.
引文
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[4]杨红.聚焦超声在治疗外阴白斑中的临床价值研究[J].内蒙古医学杂志,2017,49:1208-1209.
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[10]严月华,徐丽,卢忠,等.Pixel 2940激光治疗痤疮萎缩性瘢痕的疗效及对患者心理的影响[J].中国美容医学,2013,22:361-363.
[11]陈志刚,胡荣膺,伍凤岚.超脉冲CO2点阵激光与Nd:YAG激光治疗座疮凹陷性疲痕的临床疗效[J].中国医疗美容,2018,8:42-46.
[12]马丽,文辉才,简雪平,等.Pixel TM2940Er:YAG像束激光治疗浅表性瘢痕[J].中国美容整形外科杂志,2016,27:410-412.
[13]陆子君,殷俊涛.超脉冲CO2激光与藻酸双酯钠局部注射治疗睑黄瘤的疗效对比分析[J].现代诊断与治疗,2017,28:3644-3645.
[14]谭毅,陈燕,蔡桂容,等.新型Er:YAG激光治疗女性压力性尿失禁的临床观察[J].中国妇幼保健,2018,33:1935-1938.
[15]吕桃玉.制霉菌素联合维生素E外涂治疗1例口腔真菌感染的用药护理[J].海峡医药,2017,29:126.
[16]洪莉.CO2激光联合局部注射干扰素治疗尖锐湿疣的临床疗效观察[J].临床合理用药,2014,7:15-16.
[2]司徒仪.中西医结合妇产科学[M].北京:科学出版社,2003:414.
[3]王越,王昕.银丹膏联合远红外线外治法治疗外阴白斑临床疗效观察[J].辽宁中医药大学学报,2018,20:151-153.
[4]杨红.聚焦超声在治疗外阴白斑中的临床价值研究[J].内蒙古医学杂志,2017,49:1208-1209.
[5]张鲜梅,宋瑞芬.外阴白色病变术后复发中药治疗体会[J].生殖医学杂志,2007,16:283-284.
[6]张震宇.妇科手术用激光的工作原理、特性与应用[J].中国实用妇科与产科杂志,2016,32:607-608.
[7] Behroozan DS,Goldberg LH,Dai T,et al.Fractional photother-molysis for the treatment of surgical scars;a case report[J].J CoscrLet Laser Ther,2006,8:35-38.
[8] Cho SB,Lee SJ,Kang JM,et al.The efficacy and safety of 10600nm carbon dioxide fractional laser for acne Scars in Asian patients[J].Dermatol Surg,2009,35:1955-1961.
[9]董晶,汪清,郑瑞莲,等.C02激光气化治疗高级别阴道上皮内瘤变的价值[J].实用妇产科杂志,2014,30:208-211.
[10]严月华,徐丽,卢忠,等.Pixel 2940激光治疗痤疮萎缩性瘢痕的疗效及对患者心理的影响[J].中国美容医学,2013,22:361-363.
[11]陈志刚,胡荣膺,伍凤岚.超脉冲CO2点阵激光与Nd:YAG激光治疗座疮凹陷性疲痕的临床疗效[J].中国医疗美容,2018,8:42-46.
[12]马丽,文辉才,简雪平,等.Pixel TM2940Er:YAG像束激光治疗浅表性瘢痕[J].中国美容整形外科杂志,2016,27:410-412.
[13]陆子君,殷俊涛.超脉冲CO2激光与藻酸双酯钠局部注射治疗睑黄瘤的疗效对比分析[J].现代诊断与治疗,2017,28:3644-3645.
[14]谭毅,陈燕,蔡桂容,等.新型Er:YAG激光治疗女性压力性尿失禁的临床观察[J].中国妇幼保健,2018,33:1935-1938.
[15]吕桃玉.制霉菌素联合维生素E外涂治疗1例口腔真菌感染的用药护理[J].海峡医药,2017,29:126.
[16]洪莉.CO2激光联合局部注射干扰素治疗尖锐湿疣的临床疗效观察[J].临床合理用药,2014,7:15-16.