点阵激光联合氟尿嘧啶注射液局部注射治疗难治性跖疣临床对照研究

A clinical comparative study of fractional laser combined with local injection of fluorouracil in the treatment of refractory plantar warts

目的观察点阵激光联合氟尿嘧啶注射液局部注射治疗难治性跖疣的临床疗效与安全性。方法选取多发性跖疣其他方法治疗无效的患者随机分为两组,试验组(35例)CO_2点阵激光联合氟尿嘧啶局部注射(每一处皮损注射0.5 ml氟尿嘧啶),对照组(32例)仅用CO_2点阵激光(功率5～20 W、点阵模式、反复至点状出血),每周1次,连用3次,随访观察6个月。结果经过治疗3次后,试验组有效率(85.7%)高于对照组(68.6%),P <0.05,试验组皮损清除率(79.5%)显著高于对照组(59.0%), P <0.05,试验组的复发率(12%)显著低于对照组(24%),P <0.05。两组不良反应发生率低,无统计学差异。结论 CO_2点阵激光联合氟尿嘧啶注射液局部注射治疗跖疣的临床疗效显著优于单独应用一种治疗方法,有效率及清除率高,复发率及不良反应低。

Objective To observe the clinical efficacy and safety of fractional CO2 laser combined with local injection of fluorouracil in the treatment of refractory metatarsal warts. Methods All the 67 patients with plantar wart were randomly divided into treatment group(35cases) and control group(32 cases). The control group was given fractional CO2 laser only. The treatment group was treated with CO2 laser(5~20W, fractional mode, until punctate hemorrhage occurs), then given local injection of fluorouracil(0.5 ml per lesions) in the first week, subsequently treated with fire needle therapy once a week in the next two weeks. Results After three courses of treatment, the total effective rate of the treatment group was higher than the control group, and there was a significant difference between the two groups(85.7% vs. 68.6%, P<0.05). The recurrence rates of the treatment group was lower than that of the control group(79.5% vs. 59.0%, P<0.05). The incidence of adverse effect had no significant difference between the two groups(15% vs.12.%, P>0.05). Conclusion The clinical efficacy of fractional CO2 laser combined with local injection of fluorouracil in the treatment of plantar warts is significantly better than that of single treatment, with high efficiency and clearance rate, low recurrence rate and adverse reactions.