Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
Department of Obstetrics and Gynecology, Kyungpook National University Chilgok Hospital, Daegu, 41404, Republic of Korea.
Sci Rep. 2020 Apr 7;10(1):6017. doi: 10.1038/s41598-020-62965-1.
It has been reported that chitosan has a hemostatic effect and an antibiotic activity. This study aimed to evaluate the efficacy and feasibility of using a chitosan tampon (Hemoblock-Tampon) in preventing hemorrhage and enhancing wound healing after the loop electrosurgical excision procedure (LEEP).This single-blind, prospective, randomized study included 62 consecutive patients who underwent LEEP for cervical intraepithelial neoplasia. A chitosan tampon (31 patients; treatment group), or a general tampon (31 patients; control group) was applied to the uterine cervix immediately after LEEP. One patient in the treatment group declined to participate in this study. Thus, 30 patients in the treatment group and 31 patients in the control group completed this study. For objective analysis of hemorrhage in the postoperative 2 weeks, the amounts of bleeding were checked daily with a pictorial blood assessment chart. We evaluated vaginal discharge, abdominal pain, and impairment in daily living during the postoperative 2 weeks using 5 visual analogue scale questionnaires.The bleeding count was significantly lower in the treatment group than in the control group (21.37 ± 16.86 vs. 40.52 ± 16.55, p = 0.0014). The sum of the scores of the 5 questionnaires was significantly lower in the treatment group than in the control group (6.53 ± 2.84 vs. 8.59 ± 2.88, p = 0.0079). The incidence of vaginal discharge was significantly lower in the treatment group than in the control group (20.0% vs. 48.4%, p = 0.0207). According to logistic regression, only the use of chitosan tampon reduced the risk of moderate to severe vaginal bleeding 2 weeks after surgery (Odd ratio, 0.213; 95% confidence interval, 0.06-0.76; p = 0.0172). Complete healing of the uterine cervix occurred in 86.7% of patients in the treatment group and in 61.3% of patients in the control group at 4 weeks after surgery (p = 0.0255).The use of chitosan tampons can reduce hemorrhage, vaginal discharge, abdominal pain, and impairment of daily living after LEEP. Moreover, chitosan tampon may help enhance wound healing.
据报道，壳聚糖具有止血和抗菌活性。本研究旨在评估壳聚糖棉塞（Hemoblock-Tampon）在预防宫颈环形电切术（LEEP）后出血和促进伤口愈合方面的疗效和可行性。
这是一项单盲、前瞻性、随机研究，共纳入 62 例因宫颈上皮内瘤变行 LEEP 的连续患者。LEEP 后即刻，将壳聚糖棉塞（31 例；治疗组）或普通棉塞（31 例；对照组）应用于子宫颈。治疗组中有 1 例患者拒绝参与本研究。因此，治疗组有 30 例患者和对照组有 31 例患者完成了本研究。为了对术后 2 周内的出血进行客观分析，使用图片血容量评估图表每天检查出血量。我们使用 5 个视觉模拟量表问卷评估术后 2 周内的阴道分泌物、腹痛和日常生活障碍。
治疗组的出血量明显低于对照组（21.37±16.86 与 40.52±16.55，p=0.0014）。治疗组 5 个问卷评分总和明显低于对照组（6.53±2.84 与 8.59±2.88，p=0.0079）。治疗组的阴道分泌物发生率明显低于对照组（20.0%与 48.4%，p=0.0207）。根据逻辑回归，只有使用壳聚糖棉塞可降低术后 2 周中度至重度阴道出血的风险（比值比，0.213；95%置信区间，0.06-0.76；p=0.0172）。治疗组有 86.7%的患者和对照组有 61.3%的患者在术后 4 周时宫颈完全愈合（p=0.0255）。
使用壳聚糖棉塞可减少 LEEP 后出血、阴道分泌物、腹痛和日常生活障碍。此外，壳聚糖棉塞可能有助于促进伤口愈合。
