目的研究点阵式CO_2激光治疗绝经后外阴阴道萎缩的疗效及可行性。方法招募北京大学人民医院门诊具有外阴阴道萎缩(vulvovaginal atrophy,VVA)症状的患者,使用CO_2激光治疗仪进行阴道内治疗3次,每次间隔1个月,治疗前后采用阴道健康指数评...目的研究点阵式CO_2激光治疗绝经后外阴阴道萎缩的疗效及可行性。方法招募北京大学人民医院门诊具有外阴阴道萎缩(vulvovaginal atrophy,VVA)症状的患者,使用CO_2激光治疗仪进行阴道内治疗3次,每次间隔1个月,治疗前后采用阴道健康指数评分(vaginal health index score,VHIS)及视觉模拟评分法(visual analogue scale,VAS)评估患者的VVA症状和疼痛程度,并进行满意度调查。结果 30例患者激光治疗后VHIS评分较治疗前显著改善[(9.79±2.76)分和(16.33±2.06)分,P<0.001],VVA症状评分显著改善[阴道瘙痒:(6.00±2.60)分和(1.38±0.97)分,P<0.001;阴道干涩:(7.04±2.26)分和(1.88±1.03)分,P<0.001;阴道灼痛:(6.25±2.13)分和(1.50±0.88)分,P<0.001;性交痛:(7.54±2.54)分和(2.04±1.15)分,P<0.001]。30例患者在激光探头插入、移动和激光治疗时疼痛轻微,治疗总体满意率93.33%(28/30),无不良事件发生。结论点阵式CO_2激光治疗外阴阴道萎缩操作简单,可门诊实施,无需麻醉和镇痛,能够显著改善绝经后女性VVA症状。展开更多
绝经期泌尿生殖综合征（genitourinary syndrome of menopause, GSM）指由于雌激素降低导致的一组外阴阴道症状（干涩、烧灼感、性交痛）和下尿路症状（排尿困难、尿频和尿急），该病名是北美绝经学会（The North American Menopause So...绝经期泌尿生殖综合征（genitourinary syndrome of menopause, GSM）指由于雌激素降低导致的一组外阴阴道症状（干涩、烧灼感、性交痛）和下尿路症状（排尿困难、尿频和尿急），该病名是北美绝经学会（The North American Menopause Society,NAMS）和国际妇女性健康研究学会（International Society for the Study of Women＇ s Sexual Health,ISSWSH）于2014年提出。展开更多
围绝经期泌尿生殖综合征(genitourinary syndrome of menopause,GSM),在绝经后妇女中的发病率约50%以上,而在乳腺癌患者中的发病率可高达79%~95%,且症状常较正常绝经女性更严重,显著降低了患者的生活质量。此现象并未受到充分的重视,其...围绝经期泌尿生殖综合征(genitourinary syndrome of menopause,GSM),在绝经后妇女中的发病率约50%以上,而在乳腺癌患者中的发病率可高达79%~95%,且症状常较正常绝经女性更严重,显著降低了患者的生活质量。此现象并未受到充分的重视,其中多数患者并未被诊断和进一步治疗。研究发现,乳腺癌化疗、内分泌治疗均可能增加GSM的发生率及其严重程度。因此,正确认识乳腺癌患者中的GSM,并探索其有效防治措施,对改善患者生活质量及预后具有重要意义。展开更多
The breast cancer care continuum entails detection, diagnosis, treatment, and survivorship. During this time, focus on the whole woman and medical concerns beyond the breast cancer diagnosis itself is essential. In th...The breast cancer care continuum entails detection, diagnosis, treatment, and survivorship. During this time, focus on the whole woman and medical concerns beyond the breast cancer diagnosis itself is essential. In this comprehensive review, we critically review and evaluate recent evidence regarding several topics pertinent to and specific for the woman living with a prior history of breast cancer. More specifically, we discuss the most recent recommendations for contraceptive options including long-acting reversible contraception and emergency contraception, fertility and pregnancy considerations during and after breast cancer treatment, management of menopausal vasomotors symptomsand vulvovaginal atrophy which often occurs even in young women during treatment for breast cancer. The need to directly query the patient about these concerns is emphasized. Our focus is on non-systemic hormones and non-hormonal options. Our holistic approach to the care of the breast cancer survivor includes such preventive health issues as sexual and bone health,which are important in optimizing quality of life. We also discuss strategies for breast cancer recurrence surveillance in the setting of a prior breast cancer diagnosis. This review is intended for primary care practitioners as well as specialists caring for female breast cancer survivors and includes key points for evidence-based best practice recommendations.展开更多
文摘目的研究点阵式CO_2激光治疗绝经后外阴阴道萎缩的疗效及可行性。方法招募北京大学人民医院门诊具有外阴阴道萎缩(vulvovaginal atrophy,VVA)症状的患者,使用CO_2激光治疗仪进行阴道内治疗3次,每次间隔1个月,治疗前后采用阴道健康指数评分(vaginal health index score,VHIS)及视觉模拟评分法(visual analogue scale,VAS)评估患者的VVA症状和疼痛程度,并进行满意度调查。结果 30例患者激光治疗后VHIS评分较治疗前显著改善[(9.79±2.76)分和(16.33±2.06)分,P<0.001],VVA症状评分显著改善[阴道瘙痒:(6.00±2.60)分和(1.38±0.97)分,P<0.001;阴道干涩:(7.04±2.26)分和(1.88±1.03)分,P<0.001;阴道灼痛:(6.25±2.13)分和(1.50±0.88)分,P<0.001;性交痛:(7.54±2.54)分和(2.04±1.15)分,P<0.001]。30例患者在激光探头插入、移动和激光治疗时疼痛轻微,治疗总体满意率93.33%(28/30),无不良事件发生。结论点阵式CO_2激光治疗外阴阴道萎缩操作简单,可门诊实施,无需麻醉和镇痛,能够显著改善绝经后女性VVA症状。
文摘绝经期泌尿生殖综合征（genitourinary syndrome of menopause, GSM）指由于雌激素降低导致的一组外阴阴道症状（干涩、烧灼感、性交痛）和下尿路症状（排尿困难、尿频和尿急），该病名是北美绝经学会（The North American Menopause Society,NAMS）和国际妇女性健康研究学会（International Society for the Study of Women＇ s Sexual Health,ISSWSH）于2014年提出。
文摘围绝经期泌尿生殖综合征(genitourinary syndrome of menopause,GSM),在绝经后妇女中的发病率约50%以上,而在乳腺癌患者中的发病率可高达79%~95%,且症状常较正常绝经女性更严重,显著降低了患者的生活质量。此现象并未受到充分的重视,其中多数患者并未被诊断和进一步治疗。研究发现,乳腺癌化疗、内分泌治疗均可能增加GSM的发生率及其严重程度。因此,正确认识乳腺癌患者中的GSM,并探索其有效防治措施,对改善患者生活质量及预后具有重要意义。
基金Supported by The research grant support from Merck and certified Nexplanon
文摘The breast cancer care continuum entails detection, diagnosis, treatment, and survivorship. During this time, focus on the whole woman and medical concerns beyond the breast cancer diagnosis itself is essential. In this comprehensive review, we critically review and evaluate recent evidence regarding several topics pertinent to and specific for the woman living with a prior history of breast cancer. More specifically, we discuss the most recent recommendations for contraceptive options including long-acting reversible contraception and emergency contraception, fertility and pregnancy considerations during and after breast cancer treatment, management of menopausal vasomotors symptomsand vulvovaginal atrophy which often occurs even in young women during treatment for breast cancer. The need to directly query the patient about these concerns is emphasized. Our focus is on non-systemic hormones and non-hormonal options. Our holistic approach to the care of the breast cancer survivor includes such preventive health issues as sexual and bone health,which are important in optimizing quality of life. We also discuss strategies for breast cancer recurrence surveillance in the setting of a prior breast cancer diagnosis. This review is intended for primary care practitioners as well as specialists caring for female breast cancer survivors and includes key points for evidence-based best practice recommendations.
