妇产科学
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氨甲环酸治疗宫颈异位症的临床研究——机构经验

尼哈加尔格

背景：宫颈异位是因各种不适而就诊于妇科 OPD 的女性中的常见病症，其本身可能是原因或以其他方式存在。目前可用的治疗方式有电凝、冷冻烧灼、激光烧灼和药物治疗。大多数这些手术都需要很高的学习曲线，并伴有副作用，而且成本高昂。此外，异位的常规治疗长期以来一直存在争议，目前也没有相应的指南。氨甲环酸因其易于应用、可用性和最低成本而可能成为一种有效的替代品。

目的：评价局部氨甲环酸治疗宫颈糜烂的疗效和安全性。

方法：共选取符合本研究纳入和排除标准的宫颈糜烂患者75例。患者被随机分为两组。局部涂抹氨甲环酸（A组，n=38）或聚维酮碘溶液（B组，n=37）5分钟，保持体位不变15分钟，每天给药，连续10天。所有患者均在第2周和第4周末以及3个月后进行随访，以了解是否完全康复，缓解慢性盆腔疼痛、复发性阴道炎、接触性出血和白带等症状以及可能的副作用。

Results: In group A, all 7 and 20 patients complaining of chronic pelvic pain and contact bleeding respectively were cured of it (100% cure). For the other symptoms such as recurrent vaginitis and vaginal discharge, cure rates were 81.25% and 87.5% respectively. In group B, the cure was seen only in vaginal discharge with 12 patients getting cured out of 33 (36.36%) and no response in other symptoms. Side effect in the form of vaginal irritation was found only in group B in 17 patients (45.94%) whereas none were observed in group A who received the tranexamic acid application. We observed a positive correlation between cervical erosion and tranexamic acid application in terms of healing and side effects.

结论：氨甲环酸应用是一种有前景的治疗有症状女性宫颈糜烂的新方法。