| Object:To explore whether short-term vaginal administration of estrogen ointment before colposcopy in postmenopausal women can improve the adequacy of colposcopy,the visibility of squamous columnar junction and transformation zone,the ability to detect cervical and vaginal lesions under colposcopy,and the accuracy of colposcopy diagnosis,etc.It is expected to reduce the rate of missed diagnosis and biopsy of colposcopy caused by decreased estrogen level in postmenopausal women,improve the quality of colposcopy and enhance the clinical efficacy of colposcopy in postmenopausal women.Methods:Menopausal female patients who needed to be referred for colposcopy due to abnormal vaginal bleeding or abnormal cervical cancer screening results in the outpatient department of Obstetrics and gynecology of our hospital from July 2021 to May 2022 were selected as research objects.After randomization,there were 161 patients in the cervical intraepithelial lesions study group and 58 patients in the vaginal intraepithelial lesions study group and 58 patients in the control group.Colposcopy was performed 3-4 weeks after the vaginal administration of estrogen ointment(Lang Yi Geng Bao Fen)in the study group,while colposcopy was performed directly in the control group.General evaluation contents of colposcopy in the cervical study group and the control group were compared,including sufficient colposcopy,SCJ and TZ changes.The coincidence rate of colposcopy diagnosis and biopsy pathology and the detection rate of all levels of lesions were compared between the cervical study group and the control group.The coincidence rate of colposcopy diagnosis and biopsy pathology and the detection rate of all levels of lesions were compared between the vaginal study group and the control group.Results:1.In the control group,67 patients(41.6%)underwent adequate colposcopy,94 patients(58.4%)underwent inadequate colposcopy,and in the study group,138 patients(85.7%)underwent adequate colposcopy,23 patients(14.3%)underwent inadequate colposcopy.Compared with the control group,the proportion of adequate colposcopy in the study group was increased,x~2=67.68,P<0.05,the difference was statistically significant.There were 5 patients with type I,6 patients with type II,and150 patients with type III in the control group,and 11 patients with type I,24 patients with type II,and 126 patients with type III in the research group.Compared with the two groups,the changes of type II and III in the two groups were significant(Z=3.75,P<0.05).In the control group,11 patients were completely visible at squamous-column junction,19patients were partially visible,and 131 patients were invisible;in the study group,35 patients were completely visible at squamous-column junction,38 patients were partially visible,and 88 patients were invisible.Compared with the two groups,the changes were more obvious in those who were not visible at squamous-column junction,Z=5.22,P<0.05.2.Comparing the cervical intraepithelial lesion study group and the control group,the diagnostic accuracy rate under colposcopy increased from 58.86%(93/158)to 77.22%(122/158),x~2=12.24,P=0.000<0.05,the difference was significant.The coincidence rate between colposcopy diagnosis of chronic cervicitis and corresponding pathological results wasx~2=0.339.P=0.561>0.05,there was no statistical significance;the difference in the coincidence rate of diagnosis LSIL was 4.884,P=0.027<0.05,there was statistical significance;the difference in the coincidence rate of diagnosis HSIL was 10.122,P=0.001<0.05,and the difference was significant.3.The diagnostic accuracy of colposcopy was increased from58.62%(34/58)to 82.76%(48/58),x~2=8.155,P=0.004<0.05,and the difference was statistically significant.The coincidence rate of colposcopy in the diagnosis of inflammation was the same as that of corresponding pathological results,without statistical significance;the difference of coincidence rate in the diagnosis of LSIL was statistically significant byx~2=4.074,P=0.044<0.05;the difference of coincidence rate in the diagnosis of HSIL was statistically significant byx~2=4.244,P=0.039<0.05.Conclusions:1.The local application of estrogen in the vagina can effectively improve the symptoms of cervical vaginal atrophy and bleeding in postmenopausal women.2.Short-term vaginal application of estrogen can enable postmenopausal women to obtain more adequate colposcopy,improve the visibility of the cervical squamous column junction and transformation area,improve the accuracy of colposcopy results,improve the efficiency of colposcopy biopsy,and thus improve the quality of colposcopy. |
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