5-氨基酮戊酸光动力疗法联合电灼术治疗肛周尖锐湿疣疗效观察

Observation of the effects of 5-aminolevulinic acid photodynamic therapy combined with fulguration in treating perianal condyloma

目的 评价5-氨基酮戊酸光动力疗法（ALA-PDT）联合电灼术治疗肛周尖锐湿疣的疗效和复发率.方法 将67例肛周尖锐湿疣患者按门诊就诊顺序随机分为三组,联合治疗组22例用电灼术去除显性疣体后立即进行ALA-PDT治疗,每周1次,连续治疗3～4次;光动力组22例,用ALA-PDT治疗,每周1次,1个月为1个疗程;电灼术组23例,用传统方法电灼术对所有皮损逐个进行电灼气化治疗,每周1次的分批治疗,1个月为1个疗程.末次治疗后随访6个月判定疗效及观察复发率.结果 联合治疗组痊愈率为90.9％（20/22）,复发率为9.1％ （2/22）;光动力组痊愈率为54.5％ （12/22）,复发率为22.7％ （5/22）;电灼术组痊愈率为39.1％ （9/23）,复发率为43.5％ （10/23）.联合治疗组的痊愈率和复发率与电灼术治疗组差异有统计学意义（P =0.000;P =0.017）.结论 ALA-PDT治疗肛周尖锐湿疣治愈率高,复发率低,副作用小.

Objective To evaluate the relapse rate and the effect of 5-aminolevulinic acid photodynamic therapy（ALA-PDT） combined with fulguration in the treatment of perianal genital warts.Methods 67 patients with perianal genital warts were randomly divided into the three groups.22 cases in the fulguration and ALA-PDT treatment group performed the ALA-PDT treatment immediately after removal of dominant wart by fulguration,once a week,treatment for 3-4 times.22 cases in the ALA-PDT treatment group only underwent ALA-PDT treatment,once a week,treatment for one month.23 cases in the fulguration group were given the traditional fulguration methods one by one electrocautery fulguration gasification treatment for all skin lesions,a weekly batch treatment,treatment for a month.Follow-up six months after the last treatment to determine efficacy and recurrence rate.Results The cure rate of combined treatment group was 90.9％ （20/22）,and recurrence rate was 9.1％ （2/22） ;cure rate of photodynamic group was 54.5％ （12/22）,and its recurrence rate was 22.7％ （5/22） ; cure rate of fulguration group was 39.1％ （9/23）,and the recurrence rate was 43.5％ （10/23）.There were statistically significant differences in the cure rate and relapse rate between combination therapy group and electrocautery treatment group （P =0.000,P =0.017）.Conclusion The fulguration combined with ALA-PDT in the treatment of perianal genital warts has high cure rate,low recurrence rate,and less side effects.