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目的:探讨丁卡因胶浆外用在宫颈癌三维图像引导近距离治疗中的镇痛效果及对阴道损伤的影响。方法:选择行宫颈癌三维图像引导近距离治疗患者80例,随机分为实验组40例和对照组40例,实验组在探测宫腔深度及放置施源器前均使用盐酸丁卡因胶浆行阴道黏膜及宫颈黏膜的表面麻醉,对照组仅采用常规探腔及放置施源器,观察两组患者治疗的疼痛反应及阴道损伤情况。结果:实验组和对照组疼痛总发生率分别为72.5%、92.5%,实验组的疼痛发生率明显低于对照组(P=0.037)。实验组和对照组阴道损伤总发生率分别为32.5%、67.5%,实验组的阴道损伤发生率明显低于对照组(P=0.003)。此外,实验组的轻度、中度、重度疼痛的发生率均低于对照组,实验组的Ⅱ级、Ⅲ级、Ⅳ级阴道损伤的发生率均低于对照组。结论:在宫颈癌三维图像引导近距离治疗时使用盐酸丁卡因胶浆行阴道及宫颈黏膜的表面麻醉,能明显缓解治疗中的疼痛,降低阴道损伤的发生率及损伤的程度,减轻患者痛苦,可临床推广应用。
Objective: To investigate the analgesic effect of tetracaine gum applied in the brachytherapy guided by cervical three-dimensional images and its effect on vaginal injury. Methods: Eighty patients with cervical cancer undergoing guided three-dimensional image guided brachytherapy were randomly divided into experimental group (40 cases) and control group (40 cases). In the experimental group, tetracaine hydrochloride The vaginal mucosa and cervical mucosa surface anesthesia, the control group only conventional probe and place the applicator to observe the two groups of patients treated pain and vaginal injury. Results: The total incidence of pain in experimental group and control group was 72.5% and 92.5%, respectively. The incidence of pain in experimental group was significantly lower than that in control group (P = 0.037). The total incidence of vaginal injuries in experimental group and control group was 32.5% and 67.5%, respectively. The incidence of vaginal injury in experimental group was significantly lower than that in control group (P = 0.003). In addition, the incidence of mild, moderate and severe pain in the experimental group were lower than the control group, the incidence of grade Ⅱ, Ⅲ and Ⅳ vaginal injury in the experimental group were lower than the control group. CONCLUSION: The surface anesthesia of vaginal and cervical mucosa with three-dimensional image-guided brachytherapy of cervical cancer can relieve the pain in treatment, reduce the incidence of vaginal injury and the extent of injury, and relieve the suffering of patients , Can be clinically applied.