Center for Diagnosis and Treatment of Cervical Diseases, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou, China.
Department of Pathology, Changzhou Maternal and Child Care Health Hospital, Nanjing Medical University, Changzhou, China.
Ann Palliat Med. 2020 Jul;9(4):2229-2236. doi: 10.21037/apm-20-1085.
White lesions of the vulva are a common vulvar disease of unclear etiology. Although a variety of treatments have been used to treat the disease in clinical practice, there is currently a lack of effective radical therapies. This study aimed to compare the feasibility and effectiveness of fractional ultrapulsed CO2 laser with that of high-intensity focused ultrasound in the treatment of white lesions of the vulva.
A total of 60 patients with pruritus vulvae who were treated at the Center for Diagnosis and Treatment of Cervical Diseases in our hospital between December, 2017, and December 2018 were enrolled in this study. The possibility of malignant lesions of the vulva was ruled out by histopathological diagnosis following colposcopic biopsy. The patients were randomly divided into two groups: a laser treatment group (group L, n=30) and a focused ultrasound treatment group (group U, n=30). The patients were monitored for changes in signs and symptoms during and after treatment, and the treatment outcomes of the two groups were compared.
The local symptoms of pruritus were alleviated by both the fractional ultrapulsed CO2 laser and high-intensity focused ultrasound. The patients in group L had no significant adverse reactions during the operation and needed no special postoperative treatment. The total effective rate in group L was 96.7%. In group U, five patients felt mild burning during the operation, painful blisters arose on the skin of the ablated area, and long-lasting local edema was observed. Seven patients had subcutaneous nodules. The total effective rate in group U was 90.0%.
Fractional ultrapulsed CO2 laser is a minimally invasive, effective, and safe treatment for white lesions of the vulva. It causes few complications and does not affect the daily and working life of patients. Therefore, it should be widely applied in clinical practice.
外阴白色病变是一种常见的外阴疾病,病因不明。虽然在临床实践中已经使用了多种治疗方法来治疗这种疾病,但目前缺乏有效的根治性治疗方法。本研究旨在比较超脉冲 CO2 激光点阵与高强度聚焦超声治疗外阴白色病变的可行性和有效性。
本研究共纳入 2017 年 12 月至 2018 年 12 月在我院宫颈疾病诊治中心就诊的外阴瘙痒患者 60 例,经阴道镜下活检排除外阴恶性病变后,采用随机数字表法将患者分为激光治疗组(L 组,n=30)和聚焦超声治疗组(U 组,n=30)。观察两组患者治疗期间及治疗后症状和体征的变化,比较两组的治疗效果。
超脉冲 CO2 激光点阵和高强度聚焦超声均能缓解外阴瘙痒等局部症状。L 组患者术中无不良反应,无需特殊术后处理。L 组总有效率为 96.7%。U 组 5 例患者术中自觉轻度烧灼感,治疗区域皮肤出现水疱,术后局部长时间水肿,7 例患者出现皮下结节。U 组总有效率为 90.0%。
超脉冲 CO2 激光点阵治疗外阴白色病变是一种微创、有效、安全的方法,并发症少,不影响患者的日常生活和工作,值得临床推广应用。