盐酸氨基酮戊酸光动力疗法治疗尿道尖锐湿疣临床观察

Photodynamic therapy with aminolevulinic acid(ALA-PDT) for urethral condyloma acuminatum:a clinical observation

目的:观察盐酸氨基酮戊酸光动力疗法(ALA-PDT)治疗尿道尖锐湿疣的临床疗效及安全性。方法:80例尿道尖锐湿疣患者中,用ALA-PDT治疗44例(试验组),采用CO_2激光治疗(对照组)36例。治疗后对局部不良反应、疣体消退程度、疣体消退时间、复发率进行评估。结果:试验组患者有效率为95.5%(42/44),疣体消退时间为(13.24±4.83)d,与对照组相比差异无统计学意义(P>0.05);试验组患者治疗后无1例出现瘢痕和尿道狭窄,而对照组患者分别有19.4%(7/36)和11.1%(4/36)出现瘢痕和尿道狭窄,两组比较差异有统计学意义(P<0.01)。试验组的总复发率为17.6%(6/34),明显低于对照组67.7%(21/31)的总复发率。结论:ALA-PDT治疗尿道尖锐湿疣具有疗效佳、复发率低及不良反应小等优点。

Objective： To observe the therapeutical efficacy and safety of photodynamic therapy with aminolevulinic acid （ALA-PDT） in urethral condyloma acuminatum. Methods： ALA-PDT was applied in the treatment of 44 patients with urethral condyloma aeuminata; as control, CO2 laser was performed in patients with urethral condyloma acuminata. Local adverse reac tions, extent of resolution of the lesions, time for resolution of the lesions and relapse rate were evaluated after treatment. Results： Total effective rate in ALA group reached 95.5%（42/44）, and the time for resolution was about （13.24±4.83） days, showing no statistical difference （P〉 0.05） compared with those in CO2 laser group. The incidence of either sear formation or urethral stricture was 0% in ALA group, while it was 19.4%（7/36） and 11.1%（4/36） respectively in CO2 laser group, showing statistical differences （P〈 0.01）. Furthermore, the overall relapse rate in ALA group was 17.6%（6/34）, which was significantly lower than that in CO2 laser group（21/31, 67.7%）. Conclusion： ALA-PDT therapy has the advantages of a higher therapeutic efficacy, a lower relapse rate and fewer side effects in the treatment of urethral condyloma acuminatum.