利多卡因局麻对光动力治疗尖锐湿疣疗效的影响

Influence of Lidocaine Local Anesthesia on Curative Effect of Photodynamic Therapy on Condyloma Acuminatum

目的观察利多卡因局部麻醉后,5-氨基酮戊酸光动力疗法(5-aminolevulinic acid photodynamic therapy,ALA-PDT)治疗尖锐湿疣(condyloma acuminatum,CA)疗效和对治疗中疼痛的影响。方法 CA患者72例,分成3组进行ALA-PDT治疗。分别为:利多卡因局麻组,26例患者在照射激光前,采用2%的利多卡因局麻。口服双氯芬酸钠组,24例患者,照光前3 h口服双氯芬酸钠缓释片75 mg。安慰剂组,22例患者采用语言安慰和音乐止痛措施。三组光动力治疗方法相同,治疗后定期随访,术后6个月判定临床疗效。结果总有效率分别为:利多卡因局麻组65.4%;口服双氯芬酸钠组75.0%;安慰剂组72.7%,三组总有效率差异无显著意义(P>0.05)。剧痛率分别为:利多卡因局麻组7.7%,口服双氯芬酸钠组37.5%,安慰剂组剧痛率68.2%,三组比较差异有显著意义(P<0.01)。结论 ALA-PDT治疗中使用利多卡因局麻具有良好的止痛效果,对治愈率无显著影响。利多卡因局麻可作为CA光动力治疗中备选的镇痛措施。

Objective To explore the influence of lidoeaine on the therapeutic efficacy of 5-aminolevulinic acid photodynamic therapy （ALA-PDT） on condyloma aeuminatum （CA）, and on the pain suffered by the patients during the treatment. Methods Altogether 72 patients of CA were randomly divided into three groups to accept ALA-PDT. The lidocaine local anesthesia group： 2% lidocaine local anesthesia was given to 26 patients of condyloma acumlnatum before laser radiation. The oral diclofenac sodi- um group： 75 mg dielofenae sodium was given to 24 patients 3 hours before laser radiation. The placebo group ： consolation and musico- therapy was given to 22 patients before laser radiation. The same photodynamic therapy was adopted for all the three groups. Regular follow-up continued for 6 months. Results For the lidocaine local anesthesia group, oral diclofenac sodium group and placebo group, the total effective rates were 65.4%, 75% and 72. 7% respectively. The difference was not significant （P 〉0. 05）. The baryodynia rate of the lidocaine local an- esthesia group was 7.7% , the oral diclofenac sodium group 37.5% and the placebo group 68.2%, indicating a statistically significant difference （P 〈 0. 01 ）. Conclusions Lidocaine local anesthesia may be an important alternative assistant action to photodynamic therapy for condyloma acumi- natum.