局部5-氨基酮戊酸光动力学疗法治疗老年疣的疗效评价

Local 5-aminolaevulinic Acid-photodynamic Therapy in the Treatment of Senile Warts

目的:探讨局部5-氨基酮戊酸光动力学疗法(ALA-PDT)治疗老年疣病的疗效。方法:93例老年疣患者,分别采用局部ALA-PDT治疗63例(A组),二氧化碳(CO2)激光治疗30例(B组)。结果:A组患者经3次治疗后,痊愈16例(25.4%),显效25例(39.7%),有效13例(20.6%),无效9例(14.3%),总有效率65.1%,复发率6.3%,术后伤口疼痛3.2%,无其它明显副作用发生;B组治疗1次,痊愈率100%,复发率16.7%;伤口并发感染7例(23.3%),愈后局部遗留浅表瘢痕9例(30%),伤口疼痛100%。B组复发率、伤口感染率及局部遗留瘢痕的发生率均显著高于A组(P<0.05)。结论:ALA-PDT无明显痛苦、无瘢痕形成,且复发率低,适合于头面部多发性、较大面积的皮损。

Objective： To investigate the effects of 5-aminolaevulinic acid-photodynamic therapy （ALA-PDT） in the treatment of senile warts. Methods： Sixty-three patients with senile warts were treated by ALA-PDT and other 30 eases by CO2 laser as control group. Results： All patients were treated 1-3 times in ALA-PDT group, and the number of eases treated 1, 2 and 3 times was 45 （71.4%）, 15 （23.8%） and 3 （4. 8%） , respectively. Sixteen cases （16/63, 25. 4G） were cured, 25 cases （39.7%） obtained significant improvement, 13 eases （20.6%） moderate improvement, and 9 eases （14.3%） had no change or mild improvement. The total effective rate was 65. 1%, recurrent rate was 6. 3%, and postoperative wound pain occurred in 3.2% patients. In control group, all patients were cured, recurrent rate was 16. 7G, 7 eases （23.3%） had postoperative wound infection, 9 eases （30%） had sear and 100% patients had wound pain. The recurrent rate, incidence of wound infection and the occurrence of local sear in control group were significantly higher than in ALA-PDT group （P〈0.05）. Conclusion： Local ALA- PDT is a simple, effective and new treatment with lower recurrent rate, no sear formation and excellent cosmetic results for senile warts, espeeially for the large and multifocal lesions located on the face.