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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。
Objective: To investigate the clinical effect of Yunnan Baiyao powder in the treatment of cervical wounds in cervical cold knife conization (CKC). Methods: 121 cases of cervical intraepithelial neoplasia (CIN) grade Ⅲ were treated with CKC and randomly divided into 60 cases of postoperative suture group (control group) and 61 cases of non - sutured Yunnan white powder stuffing group (observation group). In the control group, Sturmdorf suture was improved after electrosurgery on the wounds of the CKC. The wounds of the observation group were sprayed with 4 g of Baiyin powder and the gauze was stuffed. Follow up for at least 2 years. Postoperative bleeding, postoperative bleeding time, average vaginal discharge time and secondary bleeding, cervical infection and cervical stenosis were observed. Results: The duration of operation, intraoperative and postoperative bleeding in the observation group was lower than that in the control group (P <0.01). There was no significant difference in average bleeding time and average vaginal drainage time between the two groups in the observation group. Cases (8.2%), control group, 4 cases (6.6%); no significant difference; no cervical infection and cervical stenosis in both groups during follow-up. Conclusion: The wounds of CKC are not sutured, and the white powder of Yunnan Baiyun powder is sprayed and the gauze is stuffed to stop the bleeding after the electrocautery, which can shorten the operation time and reduce the amount of intraoperative bleeding. The incidence of postoperative wound rebleeding is low, without increasing postoperative infection and cervical Stenosis and other complications, it is worth promoting.