外用氨基酮戊酸光动力疗法联合CO_2激光治疗肛管尖锐湿疣的疗效观察

Investigation of aminolevulinic acid photodynamic therapy combined with carbon dioxide laser in the treatment of anal tube condyloma acuminatum

目的:观察外用氨基酮戊酸光动力疗法(ALA-PDT)联合CO2激光治疗肛管尖锐湿疣的临床疗效。方法:84例肛管尖锐湿疣患者随机分为治疗组及对照组各42例,治疗组接受ALA-PDT联合CO2激光治疗,每周1次,连续3次,对照组接受CO2激光治疗,每周1次,连续3次。末次治疗后第1周进行疗效评价,第4、8和12周观察复发率。治疗前及末次治疗后1周进行实验室检查,并观察不良反应。结果:在末次治疗后1周,治疗组和对照组疣体清除率分别为100%和97.62%(P>0.05)。治疗组治疗后总复发率(11.9%)明显低于对照组(35.71%)(P=0.010 4<0.05)。治疗组及对照组均未发生严重的不良反应,主要的不良反应包括红斑、疼痛、溃疡和疤痕等。结论:外用ALA-PDT联合CO2激光治疗肛管尖锐湿疣的治愈率高,复发率低,安全性好。

Objective To investigate the safety and efficacy of topical aminolevulinic acid photodynamic therapy （ALA-PDT） combined with carbon dioxide laser in the treatment of anal tube condyloma acuminatum.Method Eighty-four patients with anal tube condyloma acuminatum were randomly assigned to the treatment group and control group in an allocation ratio of 1：1.The treatment group was treated with ALA-PDT combined with carbon dioxide laser weekly for 3 times.The control group was treated with carbon dioxide laser weekly for 3 times.The recurrence rate was evaluated at weeks 4,8,and l2 after the treatment ended.Results At l week after the last treatment 100% and 97.62% of the base line warts were eliminated in the treatment group and the control group respectively （P〈0.05） .The overall recurrence rate of the treatment group was significantly lower than that in the control group （11.9% Vs 35.7%,P = 0.010 4） .There was no severe adverse event in either group.The main adverse event were mild symptoms including erythema,pain,ulcer and scarring.Conclusion Our results confirmed that ALA-PDT combined with carbon dioxide laser is an effective,safe and well-tolerated treatment for anal tube condylomata acuminata.