云南白药粉在宫颈冷刀锥切术中的临床应用

目的:探讨云南白药粉在宫颈冷刀锥切(CKC)术中宫颈创面处理的临床应用效果.方法:121例子宫颈上皮内瘤样病变(CIN)Ⅲ级患者采用CKC治疗,并随机分为术后缝合组(对照组)60例和非缝合采用云南白药粉填塞组(观察组)61例.对照组CKC术后创面电灼后改良Sturmdorf法缝合成形;观察组创面电灼后用云南白药粉4 g喷洒并纱条填塞.至少随访2年.观察术后出血量、术后出血时间、平均阴道排液时间及继发出血、宫颈感染和宫颈狭窄等并发症情况.结果:观察组手术历时、术中及术后出血量低于对照组(P＜0.01);术后平均出血时间、平均阴道排液时间两组无显著性差异;观察组术后继发出血5例(8.2％),对照组4例(6.6％);无显著性差异;随访期间两组均未出现宫颈感染和宫颈狭窄.结论:CKC术不缝合创面、电灼后云南白药粉喷洒并纱条填塞止血,可明显缩短手术时间,减少术中出血量,术后创面再出血的发生率低,不增加术后感染与宫颈管狭窄等并发症,值得推广.

Postoperative Applications of Yunnan Baiyao Powder in Cervical Cold Knife Conization

Objective:To investigate the clinical applications of Yunnan Baiyao powder (YBP) after cervical cold knife conization (CKC). Method:One hundred and twenty one cases of cervical intraepithelial neoplasia(CIN) grade III treated with CKC were randomly divided into postoperative suture group (control group, n=60) and non-suture YBP packing group (observation group, n=61). The control group was treated with CKC postoperative wound electrocautery, then followed by improved Sturmdorf law suture forming. The observation group was treated with wound electrocautery, and then given 4 g of YBP for spray and gauze. They were followed up for 2 years. The amount of postoperative bleeding, postoperative bleeding time, the average vaginal discharge fluid time and subsequent bleeding, cervical infections and cervical stenosis and other complications were observed. Result:The surgical duration, intraoperative and postoperative bleeding in the observation group were less than those in the control group (P<0.01). The mean bleeding time and the average time of vaginal discharge had no significant difference between the two groups; 5 patients (8.2%) had postoperative secondary bleeding in the observation group while the control group were 4 cases (6.6%), and there were no significant differences; during the follow-up period, there were no cervical infection and cervical stenosis. Conclusion:CKC without suture wound and YBP after electrocautery for stopping bleeding can significantly reduce the operation time, reduce the intraoperative blood loss, it has low incidence of postoperative wound bleeding again. However, it does not increase postoperative infection and cervical canal stenosis and other complications. YBP is worth to be promoted for the application.