结合雌激素治疗幼女阴唇粘连的效果评价及影响因素分析

doi:10.5246/jcps.2021.12.084

中国药学(英文版) ›› 2021, Vol. 30 ›› Issue (12): 976-985.DOI: 10.5246/jcps.2021.12.084

结合雌激素治疗幼女阴唇粘连的效果评价及影响因素分析

李佳乐¹, 杨艳², 黄兆耆¹, 莫小兰¹^,^*()

1. 广州医科大学广州市妇女儿童医疗中心药学部, 广东广州 510620
2. 广州医科大学广州市妇女儿童医疗中心妇产科, 广东广州 510620

收稿日期:2021-07-15 修回日期:2021-08-20 接受日期:2021-09-14 出版日期:2021-12-24 发布日期:2021-12-20
通讯作者: 莫小兰
作者简介:
+ Tel.: +86-18820095289, E-mail: allenmor@163.com
基金资助:
National Natural Science Foundation of China (Grant No. 81603203), Health Commission of Guangdong Province (Grant No. A2016400), Guangdong Pharmaceutical Association Program (Grant No. 2015FS10 and 2015SW05), Guangzhou Institute of Pediatrics/Guangzhou Women and Children’s Medical Center (Grant No. YIP-2018-020).

Efficacy evaluation and influencing factors analysis of combined estrogen in the treatment of labial adhesion in children

Jiale Li¹, Yan Yang², Zhaoqi Huang¹, Xiaolan Mo¹^,^*()

1 Department of Pharmacy, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510620, Guangdong, China
2 Department of Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510620, Guangdong, China

Received:2021-07-15 Revised:2021-08-20 Accepted:2021-09-14 Online:2021-12-24 Published:2021-12-20
Contact: Xiaolan Mo

摘要/Abstract

摘要：

观察结合雌激素乳膏治疗幼女阴唇粘连的效果, 挖掘影响治疗效果的可能因素。回顾性纳入2018年10月至2019年10月广州市妇女儿童医疗中心收治的123例阴唇粘连患儿。采集患儿治疗结局、结合雌激素用法用量、治疗期间是否同时联合了手法或手术分离、是否联合使用红霉素、是否伴发外阴炎、不良反应等变量信息。采用χ²检验、Fisher检验和t检验分析结合雌激素治疗阴唇粘连的各个变量与治疗结局的相关性。继而采用逻辑回归分析这些变量与结局的关系, 挖掘可能的影响因素。患儿使用结合雌激素联合手法分离或手术分离(P = 0.001), 以及阴唇粘连的程度(P = 0.011)这两个变量对最终治疗结局有显著性影响。结合雌激素治疗频次(P = 0.202)、治疗期间是否联合使用红霉素(P = 0.787)、患儿是否伴发外阴炎(P = 1.000), 均对治疗结局无显著性影响。Logistic回归分析得知是否联合手法或手术分离(P = 0.000, OR = 0.078, 95% CI = 0.030–0.203)、患儿阴唇粘连程度(P = 0.003, OR = 5.324, 95% CI = 1.767–16.041)与结合雌激素治疗效果独立相关。患儿轻度粘连时单用结合雌激素治疗效果较好, 重度粘连需要考虑手法或手术分离联合结合雌激素治疗效果更佳。不建议临床常规合用红霉素治疗。结合雌激素用药频次为每日一次也能取得较好的治疗效果。本文结论可为结合雌激素临床治疗阴唇粘连提供参考或依据。

关键词: 结合雌激素, 阴唇粘连, 小儿妇科门诊, 影响因素

Abstract:

In the present study, we aimed to assess the effect of combined estrogen cream on young girls’ labial adhesions, and to identify the possible factors affecting the treatment outcome. We retrospectively included 123 children with labial adhesions. Variables were collected, including treatment outcomes, conjugated estrogen usage, and dosage, whether it was combined with manual or surgical separation, whether to use erythromycin, and whether to be accompanied with vulvitis. Chi-square test, Fisher’s exact test, and t-test were used to analyze the correlation between influencing factors and treatment outcome in univariate analysis. We used logistic regression analysis to explore the key influencing factors. The use of conjugated estrogen in combination with manual or surgical separation (P = 0.001), and the degree of labial adhesions (P = 0.011) had significant effects on the final treatment outcome. The frequency of conjugated estrogen treatment, whether erythromycin was used in combination during treatment, and whether the children were accompanied by vulvitis had no significant effect on the treatment outcome (P > 0.05). After the logistic regression, we found that whether it was combined with manual or surgical separation (P = 0.000, OR = 0.078, 95% CI = 0.030–0.203), and the degree of labial adhesions in children (P = 0.003, OR = 5.324, 95% CI = 1.767–16.041) were independently related to the effect of conjugated estrogen treatment. The therapeutic effect of conjugated estrogen alone was better for mild adhesion. However, severe adhesions need to consider with manual or surgical separation in combination with conjugated estrogen treatment. It is not recommended to combine erythromycin with routine clinical treatment. Conjugated estrogen once a day can also achieve a good therapeutic effect.

Key words: Combined estrogen, Labial adhesion, Pediatrics &, gynecology clinic, Influencing factors

Supporting:

李佳乐, 杨艳, 黄兆耆, 莫小兰. 结合雌激素治疗幼女阴唇粘连的效果评价及影响因素分析[J]. 中国药学(英文版), 2021, 30(12): 976-985.

Jiale Li, Yan Yang, Zhaoqi Huang, Xiaolan Mo. Efficacy evaluation and influencing factors analysis of combined estrogen in the treatment of labial adhesion in children[J]. Journal of Chinese Pharmaceutical Sciences, 2021, 30(12): 976-985.

图/表 6

Figure 1. Age-frequency of 123 cases. It shows the age frequency of 123 cases included in the study. Most of the girls, 36.59% (n = 45), reported between the age group of < 1 year.

Table 1. The correlation between three disease groups of children with labial adhesions in different influencing factor groups.

Table 2. Univariate analysis of influencing factors on the treatment effect of labial adhesions in children.

Table 3. Multivariate logistic regression analysis of the treatment effect of labial adhesions.

Figure 2. Binary logistic regression analysis of the factors influencing the therapeutic effect of labial adhesions.

Table 4. Summary of adverse reactions of conjugated estrogen.

参考文献 20

[1]	Bacon, J.L.; Romano, M.E.; Quint, E.H. Clinical recommendation: labial adhesions. J. Pediatr. Adolesc. Gynecol. 2015, 28, 405–409.
[2]	Eyk, N.V.; Allen, L.; Giesbrecht, E.; Jamieson, M.A.; Kives, S.; Morris, M.; Ornstein, M.; Fleming, N. Pediatric vulvovaginal disorders: a diagnostic approach and review of the literature. J. Obstet. Gynaecol. Can. 2009, 31, 850–862.
[3]	Sugar, N.F.; Graham, E.A. Common gynecologic problems in prepubertal girls. Pediatr. Rev. 2006, 27, 213–223.
[4]	Barbosa Ardila, S.D.; Tristancho Baró, A.I.; Suescún Vargas, J.M. Labial adhesions: review of the literature. Arch. Argent. De Pediatr. 2017, 115, 597–601.
[5]	Soyer, T. Topical estrogen therapy in labial adhesions in children: therapeutic or prophylactic? J. Pediatr. Adolesc. Gynecol. 2007, 20, 241–244.
[6]	Myers, J.B.; Sorensen, C.M.; Wisner, B.P.; Furness, P.D. III, Passamaneck, M. III, Koyle, M.A. III. Betamethasone cream for the treatment of pre-pubertal labial adhesions. J. Pediatr. Adolesc. Gynecol. 2006, 19, 407–411.
[7]	Bacon, J.L. Prepubertal labial adhesions: evaluation of a referral population. Am. J. Obstet. Gynecol. 2002, 187, 327–331; discussion332.
[8]	Kumetz, L.M.; Quint, E.H.; Fisseha, S.; Smith, Y.R. Estrogen treatment success in recurrent and persistent labial agglutination. J. Pediatr. Adolesc. Gynecol. 2006, 19, 381–384.
[9]	Capraro, V.J.; Greenberg, H. Adhesions of the labia minora. A study of 50 patients. Obstet. Gynecol. 1972, 39, 65–69.
[10]	Leung, A.K.; Robson, W.L.; Kao, C.P.; Liu, E.K.; Fong, J.H. Treatment of labial fusion with topical estrogen therapy. Clin. Pediatr. 2005, 44, 245–247.
[11]	Schober, J.; Dulabon, L.; Martin-Alguacil, N.; Kow, L.M.; Pfaff, D. Significance of topical estrogens to labial fusion and vaginal introital integrity. J. Pediatr. Adolesc. Gynecol. 2006, 19, 337–339.
[12]	Nurzia, M.J.; Eickhorst, K.M.; Ankem, M.K.; Barone, J.G. The surgical treatment of labial adhesions in pre-pubertal girls. J. Pediatr. Adolesc. Gynecol. 2003, 16, 21–23.
[13]	Moeen, G.; Triq, S.; Naseem, N. Topical Estrogen Treatment in Paedaitric Labial Adhesions. Pak. J. Med. Health Sci. 2009, 3, 218–223.
[14]	Khanam, W.; Chogtu, L.; Mir, Z.; Shawl, F. Adhesion of the labia minora - a study of 75 cases. Aust. New Z. J. Obstet. Gynaecol. 1977, 17, 176–177.
[15]	Muram, D. Treatment of prepubertal girls with labial adhesions. J. Pediatr. Adolesc. Gynecol. 1999, 12, 67–70.
[16]	Mayoglou, L.; Dulabon, L.; Martin-Alguacil, N.; Pfaff, D.; Schober, J. Success of treatment modalities for labial fusion: a retrospective evaluation of topical and surgical treatments. J. Pediatr. Adolesc. Gynecol. 2009, 22, 247–250.
[17]	Ferreira, V.; Vaz, I.; Fernandes, E.; Oliveira, T.; Guimarães, S. Labial Fusion in childhood-literature review Fusão Labial na infância-revisão da literatura. Acta obstet. Ginecol. Portuguesa. 2012, 6, 193–198.
[18]	Tebruegge, M.; Misra, I.; Nerminathan, V. Is the topical application of oestrogen cream an effective intervention in girls suffering from labial adhesions? Arch. Dis. Child. 2007, 92, 268–271.
[19]	Velander, M.H.; Mikkelsen, D.B.; Bygum, A. Labial agglutination in a prepubertal girl: effect of topical oestrogen. Acta Derm Venereol. 2009, 89, 198–199.
[20]	Deligeoroglou, E.; Karountzos V.; Dimopoulos K.D.; Athanasopoulos N.; Tsimaris P. Vulvovaginitis As A Risk Factor For the Degree of Labial Adhesions in Prepubertal Girls With Labial Fusion. J. Womans Reprod. Health. 2017, 4, 24.

结合雌激素治疗幼女阴唇粘连的效果评价及影响因素分析

Efficacy evaluation and influencing factors analysis of combined estrogen in the treatment of labial adhesion in children

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 6

参考文献 20

相关文章 9

编辑推荐

Metrics

本文评价

[1]	王可欣, 田胜男, 王佳, 靳瑾, 王婷婷, 张丽藏, 刘焕龙. 基于KAP理论的石家庄市区居民用药风险调查研究[J]. 中国药学(英文版), 2023, 32(9): 755-763.
[2]	刘文夏, 马俊, 杨照, 江滨. 中国仿制药替代影响因素分析——基于"4 + 7"带量采购精神科用药患者角度[J]. 中国药学(英文版), 2023, 32(4): 317-321.
[3]	彭词艳, 陈景, 李斯妮, 李健和, 彭六保. 后疫情时代中南地区脑卒中患者经济负担及影响因素研究[J]. 中国药学(英文版), 2022, 31(7): 545-555.
[4]	王壮飞, 管晓东, 周越, 韩晟, 姚鹏, 史录文. 中国中老年人自我药疗发生率及影响因素研究：基于CHARLS 2011年, 2013年和2015年的面板数据[J]. 中国药学(英文版), 2019, 28(6): 430-438.
[5]	刘疆燕, 李秀男, 张晓雪, 黄豪雁, 陈利清, 崔京浩, 曹青日. 改善双氯芬酸钾颗粒及胶囊剂稳定性的工艺优化研究[J]. 中国药学(英文版), 2018, 27(2): 82-91.
[6]	管晓东, 马莉莉, 王国英, 海沙尔江·吾守尔, 满春霞, 韩晟, 史录文. 中国2型糖尿病患者胰岛素注射笔用针头重复使用的影响因素研究[J]. 中国药学(英文版), 2018, 27(1): 51-58.
[7]	施亮, 王增, 俞婷婷, 夏亮. 慢性病及其治疗药物可能会影响肺癌患者术后5年生存率[J]. 中国药学(英文版), 2017, 26(2): 147-155.
[8]	侯甜甜, 王岩青, 田蕊, 张光鹏. 县级公立医院医生薪酬现状及其影响因素研究[J]. 中国药学(英文版), 2015, 24(7): 482-486.
[9]	潘妍^*, 李英剑, 赵会英, 郝劲松, 郑俊民. 胰岛素壳聚糖纳米粒的制备及影响包封率因素的考察[J]. , 2002, 11(3): 97-100.