二氧化碳点阵激光联合5-氨基酮戊酸光动力疗法治疗顽固性扁平疣的临床效果

Efficacy of CO2 fractional laser combined with 5-aminolevulinic acid photodynamic therapy on refractory verruca plana

目的 探讨二氧化碳点阵激光联合5-氨基酮戊酸光动力疗法（ALA-PDT）治疗顽固性扁平疣的效果及安全性.方法 将80例面部扁平疣患者按治疗方法不同完全随机分为观察组和对照组,各40例.观察组采用二氧化碳点阵激光联合ALA-PDT治疗,对照组仅采用ALA-PDT治疗.若第1次治疗疣体未完全消退,需进行第2次或第3次治疗,每次治疗间隔2周,观察第2周、第4周及治疗结束后6个月时的疗效和不良反应.结果 两组患者自身前后比较,疣体均明显消退及改善,观察组总有效率为90.0％（36/40）,对照组为72.5％（29/40）,差异有统计学意义（P＜0.05）.观察组2例出现色素沉着,对照组3例出现色素沉着,两组均无感染、无瘢痕形成.结论 二氧化碳点阵激光联合ALA-PDT治疗顽固性扁平疣的疗效和安全性均优于仅用ALA-PDT治疗.

Objective To investigate the safety and efficacy of CO2 fractional laser combined with 5-aminolevulinic acid （ALA）-mediated photodynamic therapy （ALA-PDT） for the treatment of refractory flat wart.Methods The 80 patients with facial flat wart were randomly divided into observation group （40 cases） and control group （40 cases）.The observation group was treated with CO2 fractional laser combined with 5-ALA-PDT,and the control group was treated with 5-ALA-PDT only.Those with residual lesions after the first treatment were treated with the second or third times.The interval duration between treatments was 2 weeks.The efficacy and the adverse reaction were evaluated after the 2-week,4-week and 6-month after the last treatment.Results Compared with prior treatment,the facial lesions achieved complete response and improvement.The total effective rate of the observation group were 90.0% （36/40） and 72.5% （29/40） for the control group,the difference was statistically significant （P〈0.05）.There were 2 cases of pigmentation occurred in observation group and 3 cases in control group.The complications including infection and hypertrophic scar were seldom occurred in the two groups.Conclusions The safety and efficacy of CO2 fractional laser combined with ALA-PDT are better than that with ALA-PDT only in the treatment of refractory flat wart.