湿润烧伤膏研究论文

提要：报告采用湖南奥世电气公司提供的DNR-300数控热凝治疗系统，作为皮肤性病科、妇科的临床使用研究验证。到目前为止门诊共治疗215例尖锐湿疣、59例寻常疣、65例外痔、80例良性肿瘤、51例宫颈糜烂、83例宫颈息肉取得良好的效果。采用本术式治疗，术中不出血、痛苦小、术后反应轻，安全可靠。结果表明该疗法有很好的临床应用价值。 关键词： DNR技术 皮肤性病科、妇科临床应用 1998年12月—1999年6月，我们采用湖南奥世电气公司提供的 DNR300数控热凝治疗系统，共治疗尖锐湿疣215例、寻常疣59例、外痔65例、良性肿瘤80例、宫颈糜烂51例、宫颈息肉83例取得良好的效果。同时我们分别将150例尖锐湿疣、87例外痔、56例寻常疣、62例良性肿瘤、57例宫颈糜烂、93例宫颈息肉用高频电灼及微波治疗方法作对照，并进行临床对比研究，现将结果报告如下：1 资料与方法： 将确诊为上述疾病的患者按随机原则分为治疗组、对照组；性别分类见表二中的性别栏，年龄15-55岁，其中自然分布情况符合统计学标准。几组病例均符合专业学科中的诊断标准。 2 适应症及禁忌症 适应症：凡炎症已呈不可逆性病变时，或局部组织反应性增生肥大、切片检查确诊为良性肿瘤等符合妇科、皮肤性病科专科疾病诊断学的疾病均为适用对象。 禁忌症：炎症急性发作期间一般不施行，宜在炎症消退2—3周后才可治疗。全身性疾病，如活动性肺结核、风心病、肾炎等，病情尚未稳定时应暂缓治疗。 3 治疗方法 仪器准备：使用湖南奥世电气公司提供的数控热凝治疗系统，软件数字能量工作代码：MRC码，数字模块峰值电压≤AC10V，数字能量合成功率为180W。发射头选用普通规格型号3mm × 3mm × 3mm，铂金材料。 操作方法：调整计算机自动温控程序在30℃~300℃；患者取卧位，皮肤周围常规消毒，（妇科粘膜组织区用1%地卡因粘膜表面麻醉3次，每次间隔5min），其它疾病，取10ml注射器抽取盐酸利多卡因溶液5ml，作常规局部浸润麻醉。5min后，将发射头紧贴病变组织表面，共治疗1-3个点，每点治疗2-6s。待病变组织凝固成白色或黄色后，治疗完毕。观察10min，无不良反应即可离开治疗室。治疗时间视患者合作情况而定。 术后处理：（1）局部涂搽湿润烧伤膏或红霉素眼药膏（多用于粘膜组织）以防治疗后局部热量导致组织水肿。（2）常规给予抗生素肌注或口服用药，以防感染。（3）7天—3个月后复查。一般只需1次即可治愈，术后随访观察1年。 4 疗效评定标准：以炎症不再复发及瘤体或痔核萎缩正常作为痊愈标准。显效：病变区明显好转；无效：症状及体征均无变化5 治疗结果 六组治疗一年后远期疗效见表表一：六组治疗远期疗效观察结果（%） 评定标准 评定标准 评定标准 痊愈 显效 无效 总有效率 分组 N 痊愈 显效 无效 N % N % N % N % 尖锐 疣体全部 疣体大部分 疣体无变化或 203 7 5 210 湿疣 215 消失 消退 术后一个月复发 寻常 疣体全部 疣体大部分 疣体无变化或 55 3 1 58 疣 59 消失 消退 术后一个月复发 痔核全部 大部分消失 痔核 59 5 1 64 外痔 65 消失 无变化 良性 瘤体全部 大部分消失 瘤体 75 3 2 78 肿瘤 80 消失 无变化 宫颈 病区粘膜 糜烂范围明显 无变化 35 14 2 49 糜烂 51 恢复正常 缩小 宫颈 息肉全部 大部分消失 息肉无变化或 71 6 6 77 息肉 83 消失 术后一个月复发 表二 ：六组治疗后临床指标观察对比 出血情况（例） 性 别 术后疼痛平均 术后感染 术后继发 术后一年瘢痕 组别 N 10ml >165ml 男（例）女 时间（h） （例） 并发症（例） 粘连（例） 尖锐 215 0 0 110 105 10 15 0 0 湿疣 微波 150 5 0 80 70 24 26 5 8 寻常 59 0 0 26 23 5 1 0 0 疣 高频 56 15 0 30 26 10 5 2 1 外 65 0 0 28 37 10 5 1 1 痔 高频 87 15 1 39 48 24 10 6 9 良性 80 5 0 45 35 12 2 1 3 肿瘤 高频 62 25 3 32 30 24 15 5 6 宫颈 51 0 0 26 25 5 1 1 1 糜烂 微波 57 0 0 28 29 10 5 5 6 宫颈 83 0 0 43 40 5 0 0 0 息肉 高频 93 3 0 59 34 10 3 5 5 注：表二每栏中上排数据为治疗组，下排为对照组。微波：指用微波治疗作对照组；高频：指用高频电灼治疗作对照组。由表一可以说明电脑数控热凝对于皮肤性病科、妇科的上述疾病疗效好、复发率低、 且具有不易出血等优点[3]；由表二可见，治疗后治疗组各项指标明显低于对照组（P< ），由此说明电脑数控热凝治疗上述疾病在术后反应方面明显优于高频电灼、微波治疗。6 讨论 皮肤性病科、妇科的物理治疗方法根据检索资料表明：方法有很多如：激光、冷冻、红外线、普通电凝、高频电灼、微波等，目前以微波、高频电灼治疗法较为普及，但这些常规治疗均采用开环控制电路（只简单的调节治疗时间、治疗电压及治疗电流的大小），局部组织内无热电信号反馈电路，因此，容易受局部组织大小、水分、痰液及血液的影响，热量不易控制，对周围正常组织及神经损伤均匀性差，不是损伤大，就是凝固能量不够，达不到最佳治疗效果，并且容易带来继发性疾病及瘢痕粘连等并发症。根据动物明胶试验以及治疗区组织内温度的测量，病理检查证实电脑数控热凝治疗在计算机自动控制作用下，实时反馈温度电信号并由电脑作出正确的指令，保证热凝温度控制在30℃~300℃。组织中温度过低时，计算机自动加热，并记录所加的能量；反之，计算机停止热量供给。这样既保证周围正常组织损伤较小，又达到快速治疗目的。 运用现代电脑数控热凝技术其原理在于：数字热能代码通过特制的发射器时会产生相应的能量，该能量可使被接触的组织产生生物热效应。该仪器的热能控制和常规仪器不同，它由局部组织中热传感器反馈来的电信号所控制，当局部温度升高到30℃~300℃时，治疗仪的电脑接受数控信号并执行命令，保持能量。同时肿大或病变组织的蛋白质则产生凝固变性，变性组织因失活而自然脱落，最终使肿大或病变的组织缩小到正常[4]。 对于部分患者，我们使用该系统随机配置的摄像系统，对病灶区进行彩色图片储存，为后期对比治疗效果及临床学术讨论提供较大帮助。在治疗妇科宫颈糜烂及息肉等视野较狭窄的手术部位，使用能量自动控制程序，有效的提高了治疗安全性能。通过国际互连INTERTEN 网，我们与奥世电气公司科技部在治疗时取得图片传输，视频对话，这样给我们在操作该仪器时，对该系统不清楚的地方作出了远程指挥。比如：有一次在治疗时，系统程序出现错误的提示，我们无法自行解决，通过他们技术部远程指挥，我们很快找到了排除故障的办法，手术得以正常进行。该仪器一机多用，真正体现了现代多媒体技术的属性。将学习光盘放进计算机光驱中，能自行播放、演示手术过程；达到电脑教学的目的，是一款具有新颖性、实用性、科学性的新型产品。该机配置了医学专业手提工控电脑，对 windows98 micosoft word 等国外极具盛名的软件都给予了预装，因此，在工作之余，对提高医务人员的计算机水平有很大的帮助。 建议尽快广泛地培养新一代医疗技术与电脑技术相结合的专业人才，以满足临床操作及进一步科研的需要；进一步提高网上的图象传输速率。 7 结论 本研究资料表明：采用电脑数控热凝技术对皮肤性病科、妇科上述疾病的治疗，方法简单、治疗速度快、安全可靠、能治愈上述疾病，且无明显副作用。该疗法具有痛苦小、术中不出血，术后反应轻等优点，有很好的临床应用价值，便于各级医院推广.Abstract : World Report, Hunan Electric Company, the Olympic DNR-300 NC coagulation therapy system As of Dermatology, the use of clinical gynecology verified. Condyloma acuminata clinic treated 215 cases so far, 59 cases warts, hemorrhoid 65 exceptions, 80 benign cases, 51 cases of cervical erosion, and 83 cases of cervical polyp achieved good results. Treatment with this procedure, the surgery is not bleeding, pain and mild postoperative reaction, safe and reliable. The results show the therapy is a good clinical value. Keywords : DNR technical Dermatology, gynecological clinical application in December 1998, June -1999, Hunan Electric Company, we have adopted the World Olympic DNR300 NC coagulation therapy system 215 cases were treated condyloma acuminata, warts 59 cases, external hemorrhoids 65 cases, 80 cases of benign tumors. 51 cases of cervical erosion, and 83 cases of cervical polyp achieved good results. We were 150 cases will be studied and 87 exceptions hemorrhoids, warts 56 cases, 62 patients with benign tumors, 57 cases of cervical erosion, and 93 cases of cervical polyp with high-frequency electrocautery methods for the control of microwave therapy, and clinical research, the results of the report are as follows : 1 The following information : The disease will be diagnosed in patients randomly divided into two groups, the control group; gender-disaggregated gender column of Table 2. aged 15-55 years, with statistical distribution of natural standards. Several groups of patients were diagnosed with professional standards. 2 : All indications and contraindications indications inflammatory lesions shown not reversible, or tissue hypertrophy response. biopsy diagnosed with benign gynecologic and other skin diseases specialist STD diagnosis of the disease are objects. contraindications : During acute inflammation generally not implemented, it would be desirable for 2-3 weeks after treatable inflammation dissipated. Systemic diseases such as active tuberculosis, rheumatic heart disease, nephritis, yet stable condition treatment should be suspended. Three treatments : 310 machines ready to use the Olympic world Hunan Electric Company to provide therapy for the NC system MRC figures energy work : the software code code, the number of modules peak voltage ≤ AC10V. Digital Synthesis of 98,000 watts of energy. Launch of the first models to use the ordinary standard 3mm × 3mm × 3mm, platinum material. The method of operation : automatic adjustment of 30 ° C to 30 ° C temperature control procedures; The patient was supine. Conventional skin around disinfection (gynecological tissue mucosal surface anesthesia with 1% tetracaine zone three times, 5 min intervals), other diseases take 5ml and 10ml syringes from lidocaine hydrochloride solution for conventional local anesthesia. After 5 minutes, the first to be launched close to the surface lesions were treated by 1-3 months, and every point 2-6s treatment. To be solidified into a white or yellow lesions after the treatment finished. Observation 10min be no adverse reaction from treatment rooms. Cooperation in the treatment of patients, as the case may be. after treatment : (1) Local Infriction MEBO nursery, or (used for tissue) to prevent partial treatment Heat caused edema. (2) conventional intramuscular injection or oral administration of antibiotics to prevent infection. (3) 7 days to 3 months after the inspection. It takes only one can cure, the patients were followed up for 1 year. 4 evaluation standards : no recurrence of inflammation and tumor shrinkage or piles, post-operative foley insertion as a normal recovery standards. Produce a marked improvement : the lesion; Void : There was no change in the treatment of the symptoms and signs of the results of 510 5 Long-term effect one year after the treatment table Table 1 : 6 Long-term effect of the treatment results (%) recovered biological assessment criteria, assessment criteria, assessment criteria, the total efficiency of a void N %% N N N recovered biological invalid% N% of all warts most intense warts or warts unchanged wet 203 7 5 210 215 dissipated warts disappeared after a month recurrence unusual warts Most of all warts or warts body did not change 59 55 3 1 58 warts disappeared after a month dissipated recurrence Most of all piles, post-operative foley insertion disappeared piles, post-operative foley insertion 59 5 1 64 65 disappeared unchanged external hemorrhoids Most of all benign tumor 75 3 2 7 tumors disappear Tumors disappeared 80 8 No change scope of cervical mucosa erosion Ward 35 14 2 49 51 No change significantly resume normal erosion narrow 9 Most of all cervical polyps No change or disappear polyps 83 71 6 6 77 polyps disappeared one month after rehabilitation Table 2 : fat Six clinical observation of hemorrhage after treatment (cases) Sex postoperative pain after a year on average postoperative infection after secondary N 10ml scar group "165ml men (cases) female time (h) (cases), complications (cases) adhesive (patients) Tsim Rui 215 0 0 110 105 10 15 0 0 warts Microwave 150 5 0 80 70 24 26 5 8 5 unusual 9 0 0 26 23 5 1 0 0 warts HF 56 15 0 30 26 10 5 2 1 65 0 0 28 37 10 5 outside HF hemorrhoid 1 1 87 15 1 39 48 24 10 6 9 benign 80 5 0 45 35 12 2 1 3 6 HF tumor 2 25 3 32 30 24 15 5 6 cervical 51 0 0 26 25 5 1 1 1 57 0 0 28 29 microwave Erosion Cervical 10 5 5 6 83 0 0 43 40 5 0 0 0 polyps HF 93 3 0 59 34 10 3 5 5 Note : Table 2 ranks data for each treatment group column, row under the control group. Microwave : a microwave treatment for the control group. HF : refers to high-frequency electric cautery for the control group. Table 1 shows computer numerically controlled by the heat condensate for Dermatology, gynecological disease, the above effects, a low recurrence rate, [3] having the advantages of easy bleeding can be seen from Table 2. after all significantly lower than the control group (P <). It showed computer numerically controlled postoperative therapy for the disease in response to high-frequency electrocautery than microwave therapy. 6 discussion Dermatology, gynecological physical therapy method based on the show : there are many ways of retrieving information such as : laser, Frozen, infrared, general coagulation, high-frequency electrocautery, Microwave, a microwave, high-frequency electrocautery treatment more popular. But these conventional treatment of the open-loop control circuit (for the treatment of simple conditioning, Current treatment voltage and the size of the treatment), local organizations without thermoelectric signal feedback circuit, therefore, Local organizations vulnerable size, moisture, sputum and blood, heat is harder to control. Nerve damage to the surrounding normal tissues and poor uniformity, not injury, solidified energy is not enough, less-than-optimal treatment, and secondary diseases and the scar easily bring complications. According to animal testing and treatment organize gelatin temperature measurement Pathologic examination confirmed computer numerically controlled coagulation therapy under computer control. Real-time temperature feedback signal from the computer to make the right direction to ensure that coagulation 30 ° C to 30 ° C in temperature control. Tissue temperature too low, the computer automatically heating, and energy added to the record; Instead, the computer stopped calorie supply. This ensures that the smaller surrounding normal tissue injury, and achieve rapid therapeutic purposes. The use of modern computer technology and its tenet is : NC coagulation heat through a special code number when they would have a launch capability The bio-energy organizations will be contacted thermal effect. The thermal control equipment and conventional machines, which heat sensor feedback from local organizations to control the signals. When the local temperature rises to 30 ° C to 30 ° C, NC instrument signal and the computer to accept orders, to maintain energy. Meanwhile swelling or lesions have solidified the denatured proteins, and deactivation due to natural variability organizations falling The organization eventually enlarged or reduced to normal disease [4]. For some patients, we used the random distribution of the camera system for storage areas were color photographs, Academic and clinical efficacy compared to the latter part of a larger discussion to help. In the treatment of cervical erosion and gynecologic surgery polyps narrow-minded sites, the use of energy control procedures, effective treatment to improve the safety performance. INTERTEN through international interconnection network, the Ministry of Science and Technology and the Austrian company in the world to get treatment photo transmission Video dialogue, we have to operate the equipment, the system is not clear where the remote command. For example : Once in treatment, the system suggested that errors in the process, we are unable to resolve. Remote command through their technology, we will soon find a troubleshooting approach to normal operation. The machines use a machine that truly reflects the nature of modern multimedia technology. CD into a computer CD-ROM learning, self-broadcast demonstration surgery; Achieve the objective of teaching computers, A novelty is that the practicality of the new scientific products. The aircraft configuration of the IPC medical professional mobile computers windows98 micosoft word of the apoA and other countries have given a very prestigious prepackaged software, therefore, in his spare time, medical personnel to improve the level of computer will be very helpful. widely as possible to train a new generation of medical technology combined with computer technology professionals. operation and further clinical research to meet the needs; further improve the online image transmission rate. 7 conclusions of this study show : computer numerically controlled thermal coagulation of Dermatology, the treatment of gynecologic disease. The method is simple, fast treatment, safe and reliable that can cure the disease and there is no obvious side effects. The therapy is pain, surgery is not bleeding after mild advantages, such as good clinical value. facilitate the promotion of various hospitals.