Er:YAG 2940nm激光与倍频KTP Nd:YAG激光联合免疫调节药物治疗顽固性扁平疣疗效分析

The Curative Effect of Er:YAG 2 940nm Laser and KTP Nd:YAG Laser Combined with Immunomodulating Drugs in the Treatment of Refractory Flat Warts

目的:观察Er:YAG2 940nm激光及倍频KTPNd:YAG激光联合口服免疫调节药物治疗面颈部、手部顽固性扁平疣的疗效和安全性。方法:收集2015年1月-2018年6月笔者科室门诊诊治的88例难治性多发性面颈部、手部扁平疣患者,根据皮损颜色和皮损是否高出皮面分为三组。A组:皮损呈肤色,明显高出或未高出皮面,Er:YAG2 940nm激光治疗;B组:皮损呈褐色而未高出皮面,倍频KTPNd:YAG激光治疗;C组:皮损呈褐色且高出皮面,倍频KTPNd:YAG激光治疗1个月后给予Er:YAG2 940nm激光治疗。激光治疗各组同时口服免疫调节药物(转移因子胶囊)4周。另收集30例非激光治疗的扁平疣患者为对照组,口服转移因子胶囊,外用干扰素凝胶,疗程4周。各组治疗后均随访6个月。结果:激光联合口服免疫调节药物治疗后各组有效率分别为87.88%、79.41%、85.71%,均显著高于对照组(20.00%,P<0.0001)。结论:根据扁平疣皮损的颜色和厚度选择合理的治疗方案,可以取得较好的临床疗效,治疗周期短,不良反应少,复发率低。

Objective To observe the efficacy and safety of laser therapy combined with immunomodulating drugs for refractory multiple flat warts on the face、neck or hands for a better therapeutic regimen. Methods From January 2015 to June 2018, 88 patients with refractory multiple flat warts on the face、neck or hands were divided into three groups according to the color and thickness of lesions. Group A: The lesions had no obvious pigmentation and significantly higher or not higher than the skin,treated with Er 2 940 nm laser in single spot mode;Group B: The lesions were brown but not raised above the skin treated with KTP 532 nm laser;Group C: The lesions were brown and raised above the skin,treated with KTP Nd:YAG laser and Er:YAG 2 940 nm laser in single spot mode. At the same time transfer factor capsules, one of the immunomodulatory drugs, were taken in every laser treatment group. 30 cases of flat wart patients, treated with oral transfer factor capsules and topical interferon gel, but without laser treatment were collected as control group. The course of treatment was 4 weeks. Results The effective rates in the three laser treatment groups were 87.88%,79.41% and 85.71%, respectively. Which were significantly higher than that of the control group(20.00%, P<0.0001). Conclusion It is effective and safe to treat flat warts with Er 2 940 nm laser or/and KTP Nd:YAG laser combined with immunomodulating drugs,resulting the satisfactory curative effects with short treatment period, less adverse reactions and low recurrence rate.