二氧化碳激光联合5%咪喹莫特乳膏治疗尖锐湿疣120例临床观察

Clinical Observation on 120 Cases in Treatment of Condyloma Acuminatum with Imiquimod and Carbon Dioxide Laser

目的:探讨二氧化碳激光联合局部外用5%咪喹莫特乳膏治疗尖锐湿疣的临床疗效、安全性以及对治疗后复发的预防作用。方法:收集我院自2011年1月至2011年10月的门诊共120例患尖锐湿疣患者,随机分为两组,每组各60例患者,两组患者年龄、性别、病程等差异无统计学意义。治疗组给予二氧化碳激光治疗,二氧化碳激光术后给予局部外用5%咪喹莫特乳膏治疗8周,每周一、三、五或二、四、六晚用药一次,对照组仅给予二氧化碳激光治疗,两组患者治疗后均每两周复查一次,共随访3个月,比较两组患者的治愈率、复发率及不良反应发生情况。结果:治疗后的3个月随访期间治疗组60例患者中治愈53例,复发7例,治愈率88.33%,复发率11.67%;对照组60例患者中治愈41例,复发19例,治愈率68.33%,复发率31.67%,两组间差异有统计学意义(X2=7.07,P<0.01),治疗组60例患者中32例出现不良反应,不良反应发生率为53.33%,对照组60例患者中17例出现不良反应,不良反应发生率为28.33%,两组间差异有统计学意义(X2=7.76,P<0.01),不良反应均表现为局部红斑、水肿及烧灼感,但未影响继续用药治疗,两组患者均无明显的全身不良反应发生。结论:二氧化碳激光联合5%咪喹莫特乳膏对于尖锐湿疣能够取得良好的治疗效果,并能有效预防治疗后复发。

Objective： To observe the effect,safety and prevention on relapse of topical application of 5% imiquimod with carbon dioxide laser on patients with condyloma acuminatum.Methods： 120 patients came from the clinic of our hospital from January 2011 to october 2011,with the diagnosis of condyloma acuminate,were randomly divided into two groups： study group and control group,60 for each.There were no differences in age,gender and course of disease.The patients in control group received carbon dioxide laser resection only,while the patients in study group received carbon dioxide laser combined with imiquimod cream for 8 weeks,which were applied three times a week at night,the follow-up time was 3 months for both groups with assessment visits every 2 weeks.The rates of cure,recurrence and adverse reactions were compared.Results： During the follow-up time after treatment,in the control group,complete clearance occurred in 53 patients and recurrence occurred in 7 patients,the cure rate and the recurrence rate was 88.33% and 11.67% respectively.In the control group,complete clearance occurred in 41 patients and recurrence occurred in 19 patients,the cure rate and the recurrence rate was 68.33% and 31.67% respectively（X2 =7.07,P 0.01）.32 patients observed adverse reactions in study group and 17 patients in control group,the incidence of adverse reactions of study group and control group was 53.33% and 28.33% respectively（X2 =7.76,P0.01）,side effect include erythema,edema,burning,there was no systemic side effect in two groups.Conclusion： Topical application of 5% imiquimod cream combined with carbon dioxide laser in treatment of condyloma acuminatum is effective and can significantly reduce the recurrence rate.