聚焦超声对宫颈持续高危型HPV感染治疗的疗效研究
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摘要
目的探讨聚焦超声治疗宫颈高危型人乳头瘤病毒(HPV)感染的安全性和有效性,为宫颈持续高危型HPV感染的治疗探寻安全有效的微创治疗模式。方法选择该院465例持续高危型HPV感染的慢性宫颈炎患者,分A组(聚焦超声治疗)、B组(干扰素泡腾阴道上药治疗)、C组(单纯随访对照),比较3组治疗后3、6个月的宫颈评分及高危型HPV转阴率。结果 A、B组治疗后3、6个月宫颈评分较C组有明显改善,且两组HPV感染治疗有效率高于C组,其中A组3、6个月HPV治疗有效率(82.01%、91.01%)明显高B组(62.50%、75.00%),差异有统计学意义(P<0.05)。结论聚焦超声治疗宫颈高危型HPV感染转阴率高,可降低高危型HPV持续感染致宫颈癌的风险。
Objective To explore the safety and efficacy of focused ultrasound on the treatment of cervical persistent high-risk HPV infection,and to explore the safe and effective minimally invasive treatment.Methods 465 cases of chronic cervicitis with persistent high-risk HPV infection were selected and divided into group A(focused ultrasound therapy),group B(interferon effervescent at vagina),group C(only followed-up as controls).Cervical score and the negative conversion ratio of high-risk HPV after 3 and 6 months were compared in these groups.Results Compared with group C,cervical score of group A and B significantly improved after 3 and 6 months.And the effective rate of HPV treatment in the two groups was higher than that in group C.The effective rate of HPV infective treatment at 3-and 6-month in group A(82.01%,91.01%)was significantly higher than that in group B(62.50%,75.00%),the difference was statistically significant(P<0.05).Conclusion Focused ultrasound in the treatment of cervical high-risk HPV infection has a high negative conversion ratio,which reduces the risk of persistent infection.
Objective To explore the safety and efficacy of focused ultrasound on the treatment of cervical persistent high-risk HPV infection,and to explore the safe and effective minimally invasive treatment.Methods 465 cases of chronic cervicitis with persistent high-risk HPV infection were selected and divided into group A(focused ultrasound therapy),group B(interferon effervescent at vagina),group C(only followed-up as controls).Cervical score and the negative conversion ratio of high-risk HPV after 3 and 6 months were compared in these groups.Results Compared with group C,cervical score of group A and B significantly improved after 3 and 6 months.And the effective rate of HPV treatment in the two groups was higher than that in group C.The effective rate of HPV infective treatment at 3-and 6-month in group A(82.01%,91.01%)was significantly higher than that in group B(62.50%,75.00%),the difference was statistically significant(P<0.05).Conclusion Focused ultrasound in the treatment of cervical high-risk HPV infection has a high negative conversion ratio,which reduces the risk of persistent infection.
引文
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[6]王谨言,王艳华,关晓梅.苦参、蛇床子、苍术等中药制剂联合干扰素α-2b治疗宫颈HPV感染的临床效果研究[J].实用临床医药杂志,2017,21(21):195-196.
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[14]方莉,叶红,许媛,陈莹,等.四川东北部地区女性高危型人乳头瘤病毒感染情况分析[J].检验医学与临床,2017,14(3):352-354.
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[17]胡佳贞.人乳头瘤病毒感染分型检出情况与宫颈细胞学异常程度的关系[J].中国妇幼保健,2018,33(4):767-770.
[18]ROBINSON W R,HAMILTON C A,MICHAELS S H,et al.Effect of excisional therapy and highly active antiretroviral therapy on cervical intraepithelial neopasia in women infected with human imune deficiency virus[J].Am J Obstet Gynecol,2001,184(4):538-543
[19]刘青云,徐成康.辛复宁栓剂配合聚焦超声治疗重度宫颈糜烂的疗效观察[J].现代中西医结合杂志,2011,20(02):154-155.
[20]陈伟峰,吴坤宝,连治国,等.人乳头瘤病毒疫苗研究进展[J].中国新药杂志,2015,24(20):2369-2375,+2400.
[21]郭菊芳.聚集超声与射频治疗宫颈炎症相关疾病的临床随机对照研究[D].重庆:重庆医科大学,2014.
[22]王智彪.聚焦超声治疗技术在妇科领域的研究与应用[J].中华妇产科杂志,2006,41(9):638-640.
[2]雷红.人乳头瘤病毒与宫颈癌发病相关性研究[J].中医药临床杂志,2016,28(3):324-327.
[3]任汐鹰,江路,冷方达,等.子宫颈癌前病变及人乳头瘤病毒感染患者心理状况评估[J].中国妇产科临床杂志,2017,18(6):565-568.
[4]PETRY K U,HORN J,LUYTEN A,et al.Punch biopsies shorten time to clearance of high-risk human papillomavirus infections of the uterine cervix[J].BMC Cancer,2018,18(1):318-324.
[5]ZHANG W,ZHANG A,SUN W,et al.Efficacy and safety of photodynamic therapy for cervical intraepithelial neoplasia and human papilloma virus infection:a systematic review and meta-analysis of randomized clinical trials[J].Medicine(Baltimore),2018,97(21):e10864.
[6]王谨言,王艳华,关晓梅.苦参、蛇床子、苍术等中药制剂联合干扰素α-2b治疗宫颈HPV感染的临床效果研究[J].实用临床医药杂志,2017,21(21):195-196.
[7]杨燕梅,刘明晖,曾千红,等.聚焦超声治疗技术在妇科病变中的应用价值[J].中国临床研究,2013,26(1):41-42.
[8]唐郢,周琦,王冬.聚焦超声治疗宫颈HPV感染的初步研究[J].重庆医科大学学报,2011,36(5):624-626.
[9]杨君,王彬,刘玉明,等.聚焦超声治疗合并高危型HPV感染的宫颈疾病可行性研究[J].中国超声医学杂志,2013,29(5):446-449.
[10]GIORGI R P,CHINI F,BISANZI S,et al.Distribution of high and low risk HPV types by cytological status:apopulation based study from Italy[J].Infect Agent Cancer,2011,6:2.
[11]樊萍,尹遇春,杨艳,等.聚焦超声治疗高危型人乳头状瘤病毒持续感染宫颈炎的临床研究[J].检验医学与临床,2015,12(12):1689-1691.
[12]蔡和伶,肖筱,周玲.聚焦超声治疗宫颈高危型人乳头瘤样病毒感染的临床应用[J].临床超声医学杂志,2011,13(2):118-120.
[13]杨赟平,杨双双,张莉萍.重庆地区妇女高危型HPV感染现状及年龄的分层分布[J].重庆医学,2013,42(3):249-250.
[14]方莉,叶红,许媛,陈莹,等.四川东北部地区女性高危型人乳头瘤病毒感染情况分析[J].检验医学与临床,2017,14(3):352-354.
[15]HOOI D J,LISSENBERG-WITTE B I,DE KONING MN C,et al.High prevalence of high-risk HPV genotypes other than 16and 18in cervical cancers of curacao:implications for choice of prophylactic HPV vaccine[J].Sex Transm Infect,2018,94(4):263-267.
[16]CHELIMO C,WOULDES T A,CAMERON L D,et al.Risk factors for and prevention of human papillomaviruses(HPV)genital warts and cervical cancer[J].J Infect,2013,66(3):207-217C.
[17]胡佳贞.人乳头瘤病毒感染分型检出情况与宫颈细胞学异常程度的关系[J].中国妇幼保健,2018,33(4):767-770.
[18]ROBINSON W R,HAMILTON C A,MICHAELS S H,et al.Effect of excisional therapy and highly active antiretroviral therapy on cervical intraepithelial neopasia in women infected with human imune deficiency virus[J].Am J Obstet Gynecol,2001,184(4):538-543
[19]刘青云,徐成康.辛复宁栓剂配合聚焦超声治疗重度宫颈糜烂的疗效观察[J].现代中西医结合杂志,2011,20(02):154-155.
[20]陈伟峰,吴坤宝,连治国,等.人乳头瘤病毒疫苗研究进展[J].中国新药杂志,2015,24(20):2369-2375,+2400.
[21]郭菊芳.聚集超声与射频治疗宫颈炎症相关疾病的临床随机对照研究[D].重庆:重庆医科大学,2014.
[22]王智彪.聚焦超声治疗技术在妇科领域的研究与应用[J].中华妇产科杂志,2006,41(9):638-640.