经尿道输尿管镜光动力疗法治疗男性尿道内尖锐湿疣临床观察

Application of treatment with photodynamic therapy through ureteroscope for urethral condyloma acuminatum

目的比较经尿道输尿管镜光动力疗法和钬激光治疗男性尿道内尖锐湿疣的疗效和安全性。方法 126例男性尿道内尖锐湿疣患者随机分为试验组和对照组,每组63例。试验组采用光动力治疗,对照组采用钬激光治疗。治疗后观察疗效、复发率及不良反应。结果试验组患者痊愈率和有效率分别为80.95%(51/63)和95.24%(60/63);对照组患者痊愈率和有效率分别为58.73%(37/63)和82.54%(52/63),两组痊愈率和有效率比较,差异有统计学意义(P<0.01&P<0.05)。所有患者均随访6个月,试验组复发率为12.70%(8/63),明显低于对照组的复发率26.98%(17/63),两组比较差异有统计学意义(P<0.05)。试验组患者治疗后无尿道出血、尿道狭窄和瘢痕,而对照组分别有3例(4.8%)和5例(7.9%)患者出现尿道狭窄和瘢痕。结论经尿道输尿管镜光动力治疗尿道内尖锐湿疣临床有效、不良反应小、复发率低。

Objective To compare the therapeutical efifcacy and safety of photodynamie therapy with aminolevulinie acid （ALA-PDT） and holmium laser in urethral condyloma acuminatum. Methods The 126 cases of male urethra genital warts were randomly divided into the test group and the control group. Test group were treated by ALA-PDT, and control group were treaed by holmium laser. Local adverse reactions, extent of resolution of the lesions, time for resolution of the lesions and relapse rate were evaluated after treatment. Results Healing rate and effective rate in test group was 80.95%（51/63） and 95.24%（60/63） showing statistical difference （P＆lt;0.01＆amp;P＆lt;0.05） compared with those in control group. The relapse rate in test group was 12.70%（8/63）, which was signiifcantly lower than that control group 26.98%（17/63）. The incidence of urethrorrhagia, urethral stricture or scar was zero in test group, while it was 3（4.8%） and 5（7.9%） patients respectively in control group. Conclusion ALA-PDT therapy has the advantages of a higher therapeutic efifcacy, a lower relapse rate and fewer side effects in the treatment of urethral condyloma acuminatum.