苦参膜与rhEGF凝胶分别联合云南白药用于宫颈LEEP术后创面的临床观察

摘要

OBJECTIVE:To explore the clinical efficacy and safety of oxymatrine membrane,rhEGF gel respectively com-bined with Yunnan baiyao for postoperative cervical wound after LEEP. METHODS:300 patients with cervical intraepithelial neo-plasia(CIN)Ⅱ and Ⅲ were divided into group A,B,C(100 cases in each group)based on CIN grading and stratification and random sampling in each stratification. After conventional LEEP,patients in group A were cleaned the wound by 0.9% Sodium chloride injection,spraying Yunnan baiyao powder,once only after surgery;patients in group B were additionally given recombi-nant human epidermal growth factor (rhEGF) on the basis of group A,once every week after surgery,for 3 weeks;patients in group C were additionally given oxymatrine membrane on the basis of group A,1 tablet every evening after surgery,for 2 weeks. Postoperative bleeding,bleeding duration,rebleeding and duration after postoperative bleeding stopped,postoperative drainage du-ration,the incidence of adverse reactions in 3 groups were observed. RESULTS:The patients of postoperative bleeding,bleeding time ≥7 d and rebleeding after stopping bleeding in group B were significantly lower than group A;the incidence of bleeding time ≥7 d in group C was significantly lower than group A,the proporition of postoperative drainage duration for less than 7 d was significantly higher than group A,for 8-13 d was significantly less than group A;early wound healing rate in group B and group C were significantly better than group A,with statistical significances (P0.05),and there were no obvious adverse reactions in 3 groups. CONCLU-SIONS:Oxymatrine membrane and rhEGF gel respectively combined with Yunnan baiyao have better healing than Yunnan baiyao alone,do not increase the incidence of adverse reactions,while there is no significant difference in oxymatrine membrane and rhEGF gel.%目的:探讨苦参膜与rhEGF凝胶分别联合云南白药用于宫颈环形电切(LEEP)术后创面的临床疗效和安全性.方法:300例宫颈上皮内瘤样病变(CIN)Ⅱ、Ⅲ级患者,依宫颈CIN分级分层,在各层中进行随机抽样,分为A、B、C组(每组均为100例).A组患者在常规LEEP术后,用0.9%氯化钠注射液清洗创面,创面喷洒云南白药粉末,仅术后1次;B组患者在A组治疗的基础上加用重组人表皮生长因子(rhEGF),术后每周1次,连用3周;C组患者在A组治疗的基础上加用苦参膜,术后每晚1片,连用2周.观察各组患者术后出血情况、出血持续时间、术后出血停止后再次出血情况及持续时间、术后排液持续时间、创面愈合情况及不良反应发生情况.结果:B组患者术后出血率、出血持续时间≥7d发生率和出血停止后再次出血率显著低于A组;C组患者术后出血时间≥7d发生率显著低于A组,术后排液持续时间≤7d的比例显著高于A组,8~13d的比例显著低于A组;B、C组患者早期创面愈合率均显著高于A组,差异均有统计学意义(P0.05).各组患者治疗期间均无明显不良反应发生.结论:苦参膜与rhEGF凝胶分别联合云南白药用于LEEP术后创面的早期愈合情况均好于单用云南白药,且不增加不良反应的发生,但苦参膜与rhEGF凝胶两者疗效相当.