ALA-PDT联合氩离子束凝固术对女性外阴巨大尖锐湿疣的临床疗效探究

The clinical curative effect of ALA-PDT combined with argon plasma coagulation for female genital giant condyloma acuminate

目的:探讨ALA-PDT联合氩离子束凝固术治疗女性外阴巨大尖锐湿疣的临床疗效和安全性。方法:选择安康市中医院2014年5月至2017年5月间收治的130例诊断为女性外阴巨大尖锐湿疣患者作为研究对象,按照随机数字表法将其分为观察组和对照组。对照组65例患者给予合氩离子束凝固术治疗,观察组患者给予ALA-PDT联合氩离子束凝固术治疗,对两组患者的治愈率、复发率和术后不良反应进行比较分析。结果:两组患者手术均成功,创面愈合良好,会阴功能正常。疣体清除后部分患者有不同程度烧灼、疼痛、水肿、红斑、及糜烂等,5-8d后消退,均未出现出血、创面感染、穿孔、严重瘢痕、排便困难等严重不良反应,差异无统计学意义(P> 0. 05)。观察组65例患者,60例临床治愈,5例复发,复发率为7. 69%;对照组65例患者,52例临床治愈,13例复发,复发率为20. 00%;观察组复发率明显低于对照组(P <0. 05)。观察组平均治愈时间为(25. 5±5. 9) d,对照组平均治愈时间(30. 4±6. 5) d,差异具有统计学意义(P <0. 05)。结论:ALA-PDT联合氩离子束凝固术治疗女性外阴巨大尖锐湿疣治愈率高,复发率低,治愈时间段,不良反应少,值得临床推广。

Objective： To investigate the clinical efficacy and safety of ALA-PDT combined with argon plasma coagulation in the treatment of female genital giant condyloma acuminate（ CA）. Methods： 130 female patients with genital giant CA treated in the Ankang Hospital of Traditional Chinese Medicine from May 2014 to May 2017 were chosen and divided into observation group and control group according to the random number table. The 65 patients in the control group were treated with argon plasma coagulation and the 65 patients in the observation group were treated with ALA-PDT combined with argon plasma coagulation. The cure rate,recurrence rate and incidence of adverse reactions were compared between the two groups. Results： The operation succeeded in the two groups and the wound healed well and the perineum function returned normal. Some patients had different degrees of burning,pain,edema,erythema and erosion after the wart was removed,which disappeared 5 ～ 8 d later without serious adverse reaction of bleeding,wound infection,perforation,severe scar and difficulty in defecation,without statistically significant difference（ P〉 0. 05）. In the observation group,there were 60 cases were cured and 5 cases recurred,the recurrence rate of 7. 69% and there were 52 cases cured and 13 cases relapsed in the control group,the recurrence rate of 20. 00%（ P 〈0. 05）. The average cure time of the observation group and control group was（ 25. 5 ±5. 9） d and（ 30. 4 ± 6. 5） d respectively,with statistically significant difference（ P 〈0. 05）. Conclusions： ALAPDT combined with argon plasma coagulation in the treatment of female genital giant CA is of high cure rate,low recurrence rate,short healing time and fewer adverse reactions,which is worthy of clinical promotion.