金梅 费小阳 张治芬 仝进毅 应红华

●临床研究

壳聚糖宫颈抗菌膜对宫颈物理治疗后创面修复的临床效果

金梅 费小阳 张治芬 仝进毅 应红华

目的 研究壳聚糖宫颈抗菌膜在宫颈物理治疗术后对创面愈合的治疗作用及安全性。方法将334例宫颈微波术患者和258例宫颈环形电切术患者均分为两组，实验组和对照组。两实验组术后给予壳聚糖宫颈抗菌膜治疗。对照组不使用壳聚糖官颈抗菌膜。观察各实验组和对照组阴道流液量、分泌物性状、持续时间及创面愈合时间，并综合评分。结果两实验组术后综合评分均明显优于两对照组，差异有统计学意义（均P＜0．05）；创面愈合时间均短于对照组，差异有统计学意义（P＜0．05）。两实验组无不良反应发生，无并发症发生。两对照组共有14例继发感染，6例大出血,10例肉芽增生。结论壳聚糖宫颈抗菌膜能减轻宫颈物理治疗术后阴道流液等症状，改善术后生活质量，缩短创面愈合时间，促进宫颈物理治疗后宫颈创面的愈合。

壳聚糖 子宫颈 外科治疗 创面愈合

【 Abstract】 ObjectiveTo assess the efficacy and safety of chitosan cervical antimicrobial films in postoperative wound healing after cervical physical therapy．MethodsTotal 592 patients received physical therapy for cervical lesions,including 334 cases underwent cervical microwave treatment and 258 patients underwent cervical loop electrosurgical excision procedure (LEEP)in our hospital．After physical therapy 170 cases in microwave group and 135 cases in LEEP group were randomly assigned to receive chitosan cervical antimicrobial film treatment(chitosan group);and 164 cases in microwave group and 123 cases in LEEP group were assigned as controls．The amount,properties and duration of vaginal discharges,duration of wound healing were observed and analyzed．ResultsThe postoperative comprehensive scores in chitosan group were significantly better than those in control group(P＜0．05),and the duration of wound healing in chitosan group were shorter than that in control group(P＜0．05)．No adverse reaction and complications were observed in chitosan group;while in control group,secondary infection occurred in 14 cases,massive bleeding in 6 cases and hyperplasia of granulation in 10 cases．ConclusionThe chitosan cervical antimicrobial films may alleviate postoperative symptoms,improve postoperative quality of life and promote cervical wound healing after cervical physical therapy．

宫颈柱状上皮异位（宫颈糜烂）、宫颈上皮内瘤变是临床常见宫颈疾病，治疗方法以物理治疗为主，包括微波、激光、超声聚焦、宫颈环形电切术（loop electrical excision procedure，LEEP）、冷冻等[1]。物理疗法术后普遍存在长期阴道流液、出血、继发感染、创面修复时间长等问题，严重影响患者术后生活质量。如何缩短创面愈合时间，减少阴道流血、流液，是医患双方共同关心的问题。一些临床研究发现宫颈壳聚糖抗菌膜能促进宫颈物理治疗后创面修复，减少阴道流液，控制术后并发症，解决患者的难言之苦，提高患者的生活质量[2-5]。……