| 89 | 0 | 114 |
| 下载次数 | 被引频次 | 阅读次数 |
目的:分析注射用尖吻蝮蛇血凝酶联合明胶海绵在宫颈冷刀锥切术中的临床疗效。方法:选取2023年6月—2024年5月于宜昌市中心人民医院就诊的子宫颈上皮内瘤变Ⅲ级及早期宫颈癌患者194例。所有患者均接受宫颈冷刀锥切术,根据宫颈创面纱布取出后的治疗方案不同,随机分为明胶海绵组(n=68)、明胶海绵+血凝酶组(n=60)及对照组(n=66),分析三组患者的临床疗效。结果:术后一周,明胶海绵+血凝酶组患者白细胞介素-6(IL-6)水平明显低于对照组[(5.97±2.50) ng/L vs(7.67±3.41)ng/L](P<0.05)。与另外两组相比,明胶海绵+血凝酶组患者IL-10水平显著升高,创面出血、创面感染及创面愈合不满意人数均明显降低(均P<0.05)。结论:注射用尖吻蝮蛇血凝酶联合明胶海绵在宫颈冷刀锥切术后能显著改善止血效果,防止创面感染,降低炎症反应,有助于促进患者术后宫颈创面愈合。
Abstract：Objective: To analyze the clinical efficacy of the combination of haemocoagulase agkistrodon for injection and gelatin sponge in the treatment of cervical cold knife conization. Methods: A total of 194 patients with cervical intraepithelial neoplasia grade Ⅲ and early cervical cancer who visited Yichang Central People's Hospital from June 2023 to May 2024 were selected. All patients underwent cervical cold knife conization, and were randomly divided into three groups based on different treatment plans after the removal of the cervical wound gauze, gelatin sponge group(n=68), gelatin sponge + hemocoagulase group(n=60), and control group(n=66). The clinical outcomes of the three groups were analyzed. Results: One week after surgery, the interleukin-6(IL-6) level in the gelatin sponge + hemocoagulase group was significantly lower than that in the control group [(5.97±2.50) ng/L vs(7.67±3.41) ng/L](P<0.05). Compared with the other two groups, the IL-10 level in the gelatin sponge + hemocoagulase group was significantly increased,and the number of patients with wound bleeding, wound infection, and unsatisfactory wound healing were significantly reduced(all P<0.05).Conclusion: The combination of haemocoagulase agkistrodon for injection and gelatin sponge can improve hemostatic effects significantly, prevent wound infection, reduce inflammatory responses, and help promote postoperative cervical wound healing in patients undergoing cervical cold knife conization.
[1]Bray F,Laversanne M,Sung H,et al.Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer Clin,2024,74(3):229-263.
[2]郑荣寿,陈茹,韩冰峰,等2022年中国恶性肿瘤流行情况分析[J].中华肿瘤杂志,2024,46(3):221-231.
[3]Cohen A,Jhingran A,Oaknin A,et al.Cervical cancer[J].Lancet,2019,393(10167):169-182.
[4]Shen X,Cheng Q,Ren F P,et al.The burden of cervical cancer in China[J].Front Oncol,2022,12:979809.
[5]Perkins B,Guido R S,Castle P E,et al.2019ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors[J].Low Genit Tract Dis,2020,24(2):102-131.
[6]Davidesko S,Meirovitz M,Shaco-Levy R,et al.Positive pathological margins after loop electrosurgical excision procedure Management and outcome[J].Eur Surg Oncol,2023,49(5):1031-1036.
[7]刘莉,陈丽梅,陶祥,等1502例子宫颈HSIL患者行LEEP锥切术后随访半年的临床结局及术后病灶残留的危险因素分析[J].中华妇产科杂志,2017,52(11):751-756.
[8]Grubman J,Meinhardt S,Nambiar A,et al.Specimen fragmentation and loop electrosurgical excision procedure and cold knife cone biopsy outcomes[J].Low Genit Tract Dis,2020,24(1):27-33.
[9]Zeng Y,Liang M R,Li L Y,et al.Comparison of the efficacy and complications of different surgical methods for cervical intraepithelial neoplasia[J].Eur Gynaecol Oncol,2012,33(3):257-260.
[10]宿玉成.可吸收性明胶海绵[J].中国口腔种植学杂志,2024,29(5):428.
[11]米鹏程,黄莹,孔焕育,等尖吻蝮蛇血凝酶止血作用的机制[J].中国新药杂志,2013,22(11):1315-1319.
[12]任玉玲.冷刀宫颈锥切联合4点缝合法用于治疗宫颈上皮内瘤样变168例临床分析[J].中国医药指南,2012,10(4):120-121.
[13]林娜.护理干预对Leep刀宫颈锥切术治疗宫颈疾病的影响及效果观察[J].现代诊断与治疗,2023,34(6):939-941.
[14]血凝酶在急性出血临床应用专家组.血凝酶在急性出血性疾病中应用的专家共识[J].中华急诊医学杂志,2018,27(2):137-140.
[15]罗卓荆,吕国华脊柱外科围手术期出血防治专家共识[J].中国脊柱脊髓杂志,2021,31(5):475-480.
[16]中国医师协会整合医学分会呼吸专业委员会.内科胸腔镜诊疗规范[J].中华肺部疾病杂志(电子版),2018,11(1):6-13.
[17]肖雪,苏瑞亚·帕力哈提,周敏,等下消化道出血的临床诊治现状与指南解读[J].四川大学学报(医学版),2022,53(3):367-374.
[18]非创伤性出血急诊处理专家组.非创伤性出血的急诊处理专家共识/意见[J].中华急诊医学杂志,2017,26(8):850-856.
[19]石光,庞建新,孔焕育,等尖吻蝮蛇血凝酶药效评价及其作用机制[J].中国新药杂志,2010,19(18):1706-1709.
[20]崔思秋,王志.矛头蝮蛇血凝酶对膀胱癌TURBT术后止血的应用价值[J].华夏医学,2024,37(1):128-133.
[21]李俊福,朱佳,姜娟,等胶原蛋白海绵对大鼠拔牙后牙槽窝愈合过程的影响[J].上海口腔医学,2023,32(3):241-245.
[22]邢芙玲,刘渊婕不同方式子宫颈锥切术治疗高级别宫颈上皮内瘤变疗效及术后妊娠[J].中国计划生育学杂志,2020,28(6):831-834.
[23]Qin L,Li X Y,Wang J W,et al.Improved diagnosis of chronic hip and knee prosthetic joint infection using combined serum and synovial IL-6 tests[J].Bone Joint Res,2020,9(9):587-592.
[24]Saraiva M,Vieira P,O'Garra A.Biology and therapeutic potential of interleukin-10[J].Exp Med,2020,217(1):e20190418.
基本信息:
中图分类号:R737.33
引用信息:
[1]姜志军,王娜娜,周园红,等.注射用尖吻蝮蛇血凝酶联合明胶海绵在宫颈冷刀锥切术中的临床疗效分析[J].巴楚医学,2025,8(03):107-111.
基金信息:
湖北省自然科学基金项目（2024AFB832）
2025-09-28
2025-09-28