治疗男性复发性尿道尖锐湿疣76例报告

Treatment of male recurrent urethral condyloma: report of 76 cases report

目的探讨减少尿道尖锐湿疣复发的有效治疗方法。方法选取76例确诊为初次复发尿道尖锐湿疣的男性患者,随机分成2组:对照组物理方法(激光或电灼)除疣体后,局部外用咪奎莫特乳膏;治疗组物理方法除疣体,局部外用咪奎莫特乳膏,同时全身应用白介素-2(IL-2)和干扰素(IFN-γ),并配合生活指导。疗程为6周,均随访9月以上。结果 76例患者均完成临床研究,对照组复发率24.32%(9/37),治疗组7.69%(3/39)。2组复发率比较,差异有统计学意义(P=0.047)。不良反应发生率:局部反应(对照组12/37,治疗组15/39)两组差异无统计学意义(P=0.583),但轻微的全身不良反应及实验室检查异常者所占比例治疗组明显高于对照组(对照组1/37,治疗组13/39),两组差异有统计学意义(P=0.001)。结论物理方法除疣体,联合局部+全身免疫治疗,并配合生活指导,治疗男性复发性尿道尖锐湿疣效果满意,但是轻微的全身副反应也有所增加。

Objective To discuss the effective treatment of the recurrence of urethral condyloma acuminatum(CA).Methods 76 cases of first time CA recurrence were randomly assigned into 2 groups.Control Group: After CA was removed with physical method(laser or electrocautery),imiquimod was used locally.Therapy Group: Besides physical methods and local use of imiquimod,systemic application of interleukin-2(IL-2)and interferon(IFN-γ)were used and living style was instructed.Patients were treated for 6 weeks and followed up for over 9 months.Results All 76 patients completed the clinical research.The recurrence rates in Control Group and Therapy Group were 24.32% and 7.69%(P=0.047)respectively.No significant difference between the two groups was found in local adverse reactions(P=0.583).Howerer,systemic adverse reactions and laboratory abnormalities in Therapy Group were significantly higher than those in Control Group.Conclusion Physical excision,local and systemic immunotherapy combined with life-style instruction resulted in satisfactory effects,but minor systemic side effects also increased.