【摘要】：目的探討點(diǎn)陣式CO_2激光治療外陰硬化性苔癬的療效及副作用。方法選擇北京大學(xué)人民醫(yī)院婦科門診外陰硬化性苔癬(vulvar lichen sclerosus,VLS)患者31例,采用CO_2激光治療儀治療VLS,共3~4次,每次間隔1個(gè)月。采用視覺模擬評(píng)分法(visual analogue scale,VAS)評(píng)估患者治療前后外陰瘙癢、干燥皸裂、性交痛程度,并比較評(píng)分結(jié)果。結(jié)果 31例患者中,第3次治療后1個(gè)月外陰瘙癢的改善率為90.32%(28/31)。第1、3次治療后1個(gè)月外陰瘙癢程度評(píng)分[(3.43±0.94)分,(1.93±0.62)分]與治療前[(8.07±1.97)分]比較,差異有統(tǒng)計(jì)學(xué)意義(P0.001);外陰干燥皸裂評(píng)分[(1.36±1.22)分,(0.64±0.84)分]與治療前[(3.50±1.79)分比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);第3次治療后1個(gè)月性交疼痛評(píng)分[(1.14±0.95)分]與治療前[(4.29±2.70)分]比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后12 h輕度疼痛2例,48 h局部輕度充血水腫6例,均無(wú)需治療,無(wú)其他嚴(yán)重不良反應(yīng)發(fā)生。隨訪時(shí)間3~7個(gè)月,9例皸裂全部改善。皮膚顏色變化4例(12.9%);6例因VLS不能性生活者,2例恢復(fù)。治療后總體滿意率96.77%(30/31)。結(jié)論點(diǎn)陣式CO_2激光可作為外陰硬化性苔癬治療的新方法,可明顯改善瘙癢、皮膚皸裂癥狀,操作簡(jiǎn)單,患者滿意度高,值得臨床推廣。
[Abstract]:Objective to investigate the efficacy and side effects of dot matrix CO_2 laser in the treatment of lichen sclerosus vulva. Methods 31 cases of vulva lichen sclerosus (vulvar lichen sclerosus,VLS) were treated with CO_2 laser therapy instrument for 3 times, with an interval of 1 month. Visual analogue score (visual analogue scale,VAS) was used to evaluate the degree of vulvar pruritus, dry chapped, sexual intercourse pain before and after treatment. Results the improvement rate of vulvar pruritus was 90.32% (28 / 31) 1 month after the third treatment. One month after the first third treatment, the score of pruritus of vulva [(3.43 鹵0.94), (1.93 鹵0.62)] was significantly higher than that before treatment [(8.07 鹵1.97)] (P0.001). The scores of chapped vulva [(1.36 鹵1.22), (0.64 鹵0.84)] were significantly different from those before treatment [(3.50 鹵1.79)] (P0.05). 1 month after the third treatment, the score of sexual intercourse pain [(1.14 鹵0.95)] was significantly higher than that before treatment [(4.29 鹵2.70)] (P0.05). There were 2 cases of mild pain 12 h after treatment and 6 cases of local mild hyperemia and edema at 48 h. No other serious adverse reactions occurred. The follow-up time was 3 ~ 7 months, 9 cases of chapped all improved. 4 cases (12.9%) had skin color change, 6 cases (6 cases) could not have sex because of VLS, 2 cases recovered. The overall satisfaction rate after treatment was 96.77% (30 / 31). Conclusion dot-matrix CO_2 laser can be used as a new method for the treatment of lichen sclerosus of vulva. It can obviously improve the symptoms of pruritus, chapped skin, simple operation, high patient satisfaction, and is worthy of clinical promotion.
【作者單位】： 北京大學(xué)人民醫(yī)院婦產(chǎn)科;
【分類號(hào)】：R758.6
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本文編號(hào)：2416693