Campagnutta E, Parin A, De Piero G, Giorda G, Gallo A, Scarabelli C
Department of Surgical Gynecological Oncology, CRO, Aviano, PN, Italy.
Clin Exp Obstet Gynecol. 1999;26(2):127-30.
The increasing incidence of VAIN especially in young women, the frequent relapses, and renewed interest in maintaining sexual function have prompted gynecologists to a conservative management of the disease. Over the last decades, surgery, 5-fluorouracil, chemosurgery, electrocautery and cryotherapy were used. Carbon dioxide laser ablation therapy of VAIN has been reported from various authors with different results. From June 1991 through December 1998, 39 patients affected by VAIN were treated with laser surgery (35 vaporizations and 4 excisions). To achieve complete elimination of all lesions, seven patients had two vaporizations and one patient three. One patient was submitted to six combined repeated treatments. Five patients were not evaluable and three presented persistence of VAIN. One patient died because of AIDS. The remaining 30 patients, treated with laser surgery, were lesion free: 7 patients were negative at 12-24 months, 10 at 24-36 months and 13 at 37-90 months. No important complications occurred. Sexual function was not compromised. Carbon dioxide laser is a safe and efficacious tool in the treatment of pre-neoplastic lesions of the vagina.
阴道上皮内瘤变（VAIN）发病率不断上升，尤其是在年轻女性中，且复发频繁，同时人们对维持性功能的兴趣再度增加，这促使妇科医生对该疾病采取保守治疗。在过去几十年里，曾采用过手术、5-氟尿嘧啶、化学外科手术、电灼术和冷冻疗法。不同作者报道了二氧化碳激光消融治疗VAIN的不同结果。从1991年6月至1998年12月，39例VAIN患者接受了激光手术治疗（35例汽化术和4例切除术）。为了完全消除所有病变，7例患者接受了两次汽化术，1例患者接受了三次汽化术。1例患者接受了六次联合重复治疗。5例患者无法评估，3例患者VAIN持续存在。1例患者因艾滋病死亡。其余30例接受激光手术治疗的患者无病变：7例在12 - 24个月时呈阴性，10例在24 - 36个月时呈阴性，13例在37 - 90个月时呈阴性。未发生重大并发症。性功能未受影响。二氧化碳激光是治疗阴道癌前病变的一种安全有效的工具。
