子宫切除术后患者阴道局部使用欧维婷预防残端感染和促进残端愈合的临床研究

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目的观察欧维婷对全子宫切除术后患者预防残端感染和促进残端愈合方面的影响。方法选择2013年7月-2015年6月广西壮族自治区妇幼保健院收治的90例子行宫全切术患者,将其随机分为对照组30例、甲硝唑组30例和欧维婷组30例,术后第5天做血常规检查,与术前比较血常规中白细胞数(white blood cell,WBC)、中性粒细胞比率(neutrophilratio,NGR)的水平变化。阴道停药后3 d对各组患者进行临床评价,分别检查各组患者阴道清洁度、阴道p H值、细菌性阴道病(BV)、阴道脱落细胞成熟指数及阴道残端愈合情况,并通过连续性随访,了解甲硝唑组和欧维婷组阴道局部用药后,有无药物不良反应。结果甲硝唑组和欧维婷组术后第5天WBC和NGR超出正常值的人数少对照组,但差异均无统计学意义(P均>0.05);对照组术后阴道清洁度异常率显著高于甲硝唑组和欧维婷组(P均<0.01),且甲硝唑组显著高于欧维婷组(P<0.05);对照组术后阴道p H值阳性率显著高于甲硝唑组和欧维婷组(P均<0.01),且欧维婷组显著低于甲硝唑组(P<0.05);对照组术后BV发生率显著高于甲硝唑组和欧维婷组(P均<0.01),且欧维婷组显著低于甲硝唑组(P<0.05);欧维婷组术后阴道残端愈合率显著高于对照组和甲硝唑组(P均<0.05)。结论欧维婷可降低子宫切除术后患者术后阴道清洁度异常率、阴道p H值、BV发生率,提高阴道残端愈合率,且其效果优于甲硝唑组。与甲硝唑对比,欧维婷除有效预防阴道残端感染发生外,还可提高阴道脱落细胞成熟指数,促进术后阴道残端愈合。子宫切除术术后患者阴道局部应用欧维婷药物安全,无明显全身性毒副作用。 Objective To observe the effect of Orvilli on the prevention of stump infection and the promotion of stump healing in patients after hysterectomy. Methods From July 2013 to June 2015, 90 cases of subtotal hysterectomy in Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital were randomly divided into control group (30 cases), metronidazole group (30 cases) and Ouwei Ting group (30 cases) Blood routine examination was performed on the fifth day after the operation, and compared with preoperative blood level of white blood cells (WBC) and neutrophil ratio (NGR). After 3 days of vaginal withdrawal, the clinical evaluation of each group was performed. The vaginal cleanliness, vaginal p H value, bacterial vaginosis (BV), vaginal exfoliated cell maturation index and vaginal stump healing were examined in each group, Continuous follow-up to understand the metronidazole group and Ouwei Ting group vaginal local drug use, with or without adverse drug reactions. Results The number of WBC and NGR beyond normal in the metronidazole group and the Ouwei Ting group was lower than that in the control group on the fifth postoperative day, but the difference was not statistically significant (all P> 0.05). The abnormal rate of vaginal cleanliness in the control group was significantly higher (P <0.01), and the metronidazole group was significantly higher than Ouwei Ting group (P <0.05); the positive rate of postoperative vaginal p H in the control group was significantly higher than the metronidazole group and Ouwei Ting (P <0.01). The BV in Ouwei Ting group was significantly lower than that in metronidazole group (P <0.05). The incidence of postoperative BV in control group was significantly higher than that of metronidazole group and Ouwei Ting group (P <0.01) Group was significantly lower than the metronidazole group (P <0.05); Ouwei Ting group postoperative vaginal stump healing rate was significantly higher than the control group and the metronidazole group (P all <0.05). Conclusion Oviving can reduce the postoperative hysterectomy postoperative vaginal cleanliness abnormality rate, vaginal p H value, the incidence of BV, improve the healing rate of vaginal stump, and the effect is better than the metronidazole group. Compared with metronidazole, Ouwei Ting in addition to effectively prevent the occurrence of vaginal stump infection, but also improve the index of vaginal exfoliated cells to promote postoperative vaginal stump healing. Hysterectomy postoperative vaginal application Ouwei Ting drug safety, no obvious systemic side effects.
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