English reference laser therapy
Operation name: laser therapy
Laser coagulation, another name for laser therapy; Laser solidification; Laser thermal solidification; Laser thermal coagulation
Classification of Gynecology and Obstetrics/Gynecological Surgery/* * and * * Surgery/Cervical Benign Disease Surgery/Surgical Treatment of Cervical Erosion.
6 ICD code 67.390 1
Conclusion Chronic cervicitis is a common gynecological disease, characterized by cervical erosion, cervical gland cyst, cervical eversion and cervical polyp, among which cervical erosion is the most common. Long-term chronic inflammation is related to the incidence of cervical cancer. However, it is difficult to distinguish cervical erosion from early cervical cancer with naked eyes, and the diagnosis can only be made by cervical scraping or cervical biopsy. Therefore, active treatment of cervicitis is of great significance to prevent cervical cancer.
Cervical erosion is mainly treated locally and can be treated with drugs, physical therapy or surgery.
Laser treatment of cervical erosion has the characteristics of simplicity, rapidity and high curative effect. At the same time, the laser knife does not touch the tissue, so it is easy to grasp the depth of cauterized tissue, so there are few complications.
CO2 laser is commonly used in cervical erosion. Coagulation, carbonization or oxidation are often used. For cervical erosion, low-power CO2 laser is used to cauterize the carbonized surface, which is generally cured at one time. The manifestations of cervical erosion are shown in the following figure (figure11.1.3.6.1.41).
Indications: Laser therapy is suitable for moderate and severe cervical erosion.
9 contraindications 1. Patients with acute inflammation of internal and external reproductive organs, such as trichomoniasis or fungal inflammation and acute pelvic inflammatory disease, need to be cured before operation.
2. There are systemic diseases, such as severe heart disease, liver disease and hematological diseases, which are not suitable for surgical treatment.
3. Cervical invasive carcinoma.
10 preoperative preparation 1. Detailed medical history, physical examination and gynecological examination, including vaginal discharge examination. And explain the postoperative precautions to the patients.
2. Cervical curettage or cervical biopsy excludes canceration or other specific inflammation such as tuberculosis.
3. The operation time is usually 3 ~ 7 days after menstruation. No sexual history within 3 days before operation.
1 1 Anesthesia and * * generally do not need anesthesia. Take the lithotomy position of bladder.
12 operation steps 1. Take the cystolithotomy position, expose the cervix, and perform routine disinfection.
2. After adjusting the power and focal length (generally, the power is 40W, and the spot is 6mm parallel beam), the operator holds the CO2 laser cutter head, aims the light guide tube at the cervical lesion (Figure11.1.3.6.1.42), and switches the pedal from inside to outside. The cauterization range can exceed the cervical erosion surface 1 ~ 2mm.
3. Wipe the wound and apply 1% gentian violet and furacilin powder locally.
Matters needing attention in operation 13 1. Smoke generated during cauterization should be sucked out in time, otherwise it will affect the visual field and therapeutic effect and avoid eye damage.
2. Pay attention to the uniform burning surface, put the laser head at a distance of 1cm from the cervix, not too close, aim at the cervix to avoid damaging the surrounding tissues.
3. The operator should wear protective glasses, and it is forbidden to directly face the laser.
14 postoperative treatment after laser treatment, the following treatments were performed:
1. Necrosis and shedding of cervical tissue occurred 2-3 days after operation, and the secretion of * * * increased. 7- 14 days after operation, bloody secretions or a small amount of bleeding may appear, which are normal reactions and do not need treatment. If the secretion increases and smells, it should be considered as infection and treated with antibiotics.
2. Six to eight years after operation, Zhou Xinsheng squamous epithelium was completely covered and healed. No sex and bathing for 2 ~ 3 months.
15 Complications 15. 1 1. Some patients may bleed when the wound scabs 7 ~ 14 days after operation. For patients with bleeding, the voyeurism can be carefully placed to find out the bleeding point, and local application of hemostatic powder, gelatin sponge or gauze can be used for compression and rest.
15.2 2. Some infected patients have local infection or purulent secretion after operation, and antibiotics can be used locally or systemically.
15.3 3. during the operation of cervical spinal canal adhesion or stenosis, the light guide tube enters the cervical spinal canal too deeply or for too long, causing local tissue damage and forming adhesion and stenosis. Therefore, the light guide tube should enter the cervical canal 0.5 ~ 1 cm during operation, which should not be too long. At the end of the operation, a 1% gentian purple cotton swab can be inserted into the external cervix for disinfection to avoid postoperative cervical adhesion.
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