CO_2激光单次治疗女性尖锐湿疣效果的影响因素分析

The factors analysis and clinical efficacy of CO_2 laser in the treatment of female genital warts FENG

目的:探讨CO2激光单次治疗女性尖锐湿疣的临床疗效及其预后影响因素分析。方法:回顾性分析2009年1月至2011年12月在云浮市慢性病防治中心接受CO2激光治疗的128例尖锐湿疣患者的临床资料,术后对患者随访2年,观察其临床疗效,并对影响预后的相关因素采用Logistic回归分析。结果:128例患者CO2激光单次治愈88例(68.80%),2次治愈27例(21.10%),2次以上治愈5例(3.90%),未治愈8例(6.30%),总治愈率为120例(93.80%)。治疗过程中共有48例患者发生不良反应,不良反应率为37.50%,均属轻度不良反应。经单因素分析可知,性伴侣个数、临床症状、病变面积、阴道受累、尿道受累、病程、学历、收入状况、社保情况均是影响患者CO2激光单次治愈效果的相关因素,经Lgositic多因素排除相关的影响因素后,病变面积、阴道受累、尿道受累、收入情况、性伴侣个数是影响CO2激光单次治愈效果独立危险因素。结论:CO2激光单次治疗女性尖锐湿疣是安全有效的,影响其单次治疗效果的危险因素包括病变面积、阴道受累、尿道受累、收入情况,因此术后应加强对收入低、病变面积范围大、阴道受累及尿道受累患者的随访及辅佐治疗,从而提高该部分患者CO2激光单次治愈率,减少患者治疗费用。

To investigate the clinical efficacy and prognostic factors of the CO2 laser in the treatment of female genital warts.Methods：The clinical data of 128 patients with genital warts in the Center from January 2009 to December 2013 were retrospectively analyzed.All patients were followed up for 2 years.The influ-encing factors were analysised with Logistic regression analyses.Results：Of the 128 patients,88 ones （68.80%） were cured with single CO2 laser;27 ones （21.10%）were cured with twice CO2 laser;five cases （3.90%）were cured with two or more times;8 cases （6.30%）were not cured,with total cure rate of 93.80%（120 cases）.48 patients incurred mild adverse reactions during treatment with adverse reaction rate of 37.50%.Univariate analysis showed that the number of sexual partners,clinical symptoms,lesion area,vaginal involvement,urethral involve-ment,course,education,income,social security conditions were all influencing factors of patients’healing effects with single CO2 laser;after irrelevant factors being excluded with Lgositic analysis,the lesion area,vaginal involve-ment,urethral involvement,income,number of sexual partners were indentified as independent risk factors affecting healing effects of single CO2 laser.Conclusion：Single CO2 laser is safe and effective in treating female genital warts,and affecting factors include treatment lesion area,vaginal involvement,urethral involvement,income. Therefore,follow-up and adjuvant treatment should be strengthened for patients with low income,large lesion area range,vaginal and urethral infection,thereby improving the single cure rate of CO2 laser in some patients and re-ducing the treatment cost of patients.