摘要
目的探讨乳杆菌活菌胶囊在宫颈癌前病变患者宫颈环形电切术(LEEP)术后预防宫颈管粘连的效果。方法前瞻性选取2021年9月至2024年9月在衡水市人民医院接受宫颈LEEP的90例宫颈癌前病变患者,按照随机数字表法将其分为观察组与对照组,每组各45例。观察组术后1周给予乳杆菌活菌胶囊治疗,对照组术后1周给予雌三醇乳膏治疗。比较两组患者阴道微生态指标(阴道分泌物的pH值及过氧化氢、唾液酸苷酶、白细胞酯酶水平)、血清炎症因子[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)]水平、生殖道感染发生率、宫颈管粘连发生率及不良反应发生率。结果治疗后,两组阴道pH值及过氧化氢、唾液酸苷酶、白细胞酯酶水平均较治疗前降低,其中观察组阴道pH值及过氧化氢、唾液酸苷酶、白细胞酯酶水平分别为4.42±0.59、(6.72±1.45)%、(3.92±0.67)IU/mL、(5.96±1.25)IU/mL,均低于对照组[4.93±0.62、(8.26±1.53)%、(4.61±0.75)IU/mL、(7.24±1.48)IU/mL],差异均有统计学意义(P<0.05)。治疗后,两组血清IL-1β、TNF-α、hs-CRP均较治疗前降低,观察组血清IL-1β、TNF-α、hs-CRP水平分别为(34.42±4.59)ng/mL、(44.89±6.45)ng/mL、(12.94±3.11)mg/L,均低于对照组[(39.84±4.96)ng/mL、(49.39±6.33)ng/mL、(16.48±3.45)mg/L],差异均有统计学意义(P<0.05)。观察组生殖道感染发生率、宫颈管粘连发生率分别为8.89%、6.67%,均显著低于对照组(26.67%、22.22%),差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论乳杆菌活菌胶囊能够有效改善宫颈癌前病变患者阴道微生态,降低生殖道感染及宫颈管粘连的发生率,具有良好的临床应用前景。
Objective To explore the effect of lactobacillus live bacteria capsules in preventing cervical canal adhesion in patients with cervical precancerous lesions after loop electrosurgical excision procedure(LEEP).Methods A total of 90 patients with cervical precancerous lesions who underwent LEEP in Hengshui People's Hospital from September 2021 to September 2024 were prospectively selected and divided into the observation group and the control group according to the random number table method,with 45 cases in each group.The observation group was treated with lactobacillus capsules 1 week after operation,and the control group was treated with estriol cream 1 week after operation.The guided microecological indicators(pH value of vaginal secretions and the levels of hydrogen peroxide,neuraminidase and leukocyte esterase),the levels of serum inflammatory factor[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)],the incidence of reproductive tract infections,the incidence of cervical tube adhesions,and the incidence of adverse reactions were compared between the two groups.Results After treatment,the levels of vaginal pH,hydrogen peroxide,sialidase and leukocyte esterase in the two groups were lower than those before treatment,the vaginal pH value,hydrogen peroxide,sialidase and leukocyte esterase levels in the observation group were 4.42±0.59,(6.72±1.45)%,(3.92±0.67)IU/mL,(5.96±1.25)IU/mL,respectively,which were lower than those in the control group[4.93±0.62,(8.26±1.53)%,(4.61±0.75)IU/mL,(7.24±1.48)IU/mL],the differences were statistically significant(P<0.05).After treatment,the levels of serum IL-1β,TNF-αand hs-CRP in the two groups were lower than those before treatment,and the levels of serum IL-1β,TNF-αand hs-CRP in the observation group were(34.42±4.59)ng/mL,(44.89±6.45)ng/mL,(12.94±3.11)mg/L,which were lower than those in the control group[(39.84±4.96)ng/mL,(49.39±6.33)ng/mL,(16.48±3.45)mg/L],the differences were statistically significant(P<0.05).The incidence of genital tract infection and cervical canal adhesion in the observation group were 8.89%and 6.67%,respectively,which were significantly lower than those in the control group(26.67%,22.22%),the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Lactobacillus live bacteria capsules can effectively improve the vaginal microecology of patients with cervical precancerous and reduce the incidence of reproductive tract infections and cervical adhesions,and have good clinical application prospects.
作者
林萍
王静
陈欢
赵宁
LIN Ping;WANG Jing;CHEN Huan(Department of Gynecology,Hengshui People's Hospital,Hengshui Hebei 053000,China)
出处
《临床和实验医学杂志》
2025年第10期1062-1066,共5页
Journal of Clinical and Experimental Medicine
基金
河北省卫生健康委员会项目(编号:20211492)
衡水市科技计划项目(编号:2021014095Z)。
关键词
宫颈疾病
乳杆菌活菌胶囊
宫颈癌前病变
环形电切术
宫颈管粘连
Uterine cervical diseases
Lactobacillus live bacteria capsules
Cervical intraepithelial neoplasia
Loop electrosurgical excision procedure
Cervical adhesions
