CO_2激光联合咪喹莫特乳膏治疗尖锐湿疣的临床观察

Clinical Observation of CO_2 Laser Combined with Imiquimod Cream in Treatment of Condyloma Acuminata

目的观察CO2激光联合咪喹莫特乳膏治疗尖锐湿疣的治愈率、复发率、不良反应及血清IFN-γ浓度,为临床该疗法的应用进一步提供指导依据。方法选取重庆市第四人民医院被诊断为尖锐湿疣的94例患者,随机分为实验组和对照组。实验组予以CO2激光切除治疗,术后加用咪喹莫特乳膏治疗8周;对照组单纯予以CO2激光切除疣体。所有患者治疗开始后2、4、5、6个月均予随访,观察比较两组治愈率、总复发率、不良反应及血清IFN-γ浓度,运用统计学方法比较差异。结果治疗2个月后两组治愈率、总复发率、血清IFN-γ浓度差异均无统计学意义(P>0.05);治疗4、5、6个月后实验组的治愈率、血清IFN-γ浓度均显著高于对照组(P<0.05),对照组的总复发率显著高于实验组(P<0.05)。对照组无明显不良反应,实验组不良反应主要表现为红斑、水肿、糜烂、灼热、疼痛、瘙痒,无其他严重不良反应。结论 CO2激光切除尖锐湿疣后加用足疗程咪喹莫特乳膏安全、有效,在尖锐湿疣的治疗中值得推广应用。

Objective To observe the recovery rate,overall recurrence rate,adverse reactions and concentration of IFN-γ in sera of patients with condyloma acuminata treated by CO2 laser combined with imiquimod cream,and to further provide guide evidence for clinical application of this combined therapy.Methods A total 94 patients diagnosed with condyloma acuminata in the Fourth People＇s Hospital of Chongqing were randomly divided into experiment group and control group.The patients in control group received CO2 laser resection only,but the patients in experiment group received CO2 laser combined with imiquimod cream for 8 weeks.At the 2nd,4th,5th,and 6th months after the treatment,we followed-up therecovery rate,overall recurrence rate,adverse reactions and concentration of IFN-γ in the sera of all patients,and then these indexes were statistically analyzed and compared.Results At the 2nd month after the treatment,there were no statistically significant differences in the recovery rate,overall recurrence rate and concentration of IFN-γ between the two groups（P0.05）.At the 4th,5th,and 6th months after the treatment,the recovery rate and concentration of IFN-γ in sera in experiment group were significantly higher than those in control group（P0.05）,but the overall recurrence rate in experiment group was significantly lower than that in control group（P0.05）.No significant adverse reaction was found in control group.The adverse reactions in experiment group included erythema,edema,erosion,glow,pain,itching,but no other serious adverse reactions were found.Conclusions Using imiquimod cream after removal of condyloma acuminata with CO2 laser is safe and effective.It is worthy of being popularized and applied in the treatment of condyloma acuminata.