CO_2激光联合5-氨基酮戊酸光动力疗法治疗难治性尖锐湿疣的临床研究

Clinical study on the treatment of refractory condyloma acuminataby CO_2 laser combined with 5-aminoglypenic photodynamic therapy

目的研究CO2激光联合5-氨基酮戊酸光动力疗法治疗难治性尖锐湿疣的价值,为临床治疗提供参考依据。方法选取2016年10月至2017年10月南通市第三人民医院诊治的80例尖锐湿疣患者作为研究对象。按照随机数表法平均分成两组。其中对照组40例采用CO2激光治疗,试验组40例在对照组的基础上联合氨基酮戊酸-光动力治疗。对比治疗后两组患者的不良反应+复发率、临床疗效及伤口愈合、伤口结痂、HPV清除时间。结果治疗后,对照组患者的复发率为22.5%,高于试验组的5.0%,差异具有统计学意义(P<0.05),且对照组的不良反应发生率为12.5%,观察组为15%,差异无统计学意义(P>0.05)。治疗后,试验组患者的总有效率为95.0%,高于对照组的77.5%,差异具有统计学意义(P<0.05);且试验组患者的HPV清除、伤口愈合、伤口结痂的时间分别为(32.4±12.4)d、(7.2±1.2)d、(3.1±1.1)d,均小于对照组,差异具有统计学意义(P<0.05)。结论 CO2激光联合5-氨基酮戊酸光动力疗法治疗难治性尖锐湿疣,可有效降低复发及不良反应发生率,临床疗效显著,有利于患者的伤口愈合、结痂及HPV清除,值得在临床上推广。

Objective To study the value of CO2 laser combined with 5-aminoglypenic photodynamic therapy for the treatment of refractory condylomaacuminata(CA), in order to provide references for its clinical treatment. Methods 80 CA patients admitted into our hospital from December 2016 to December 2017 were selected and, using the random numerical table method, divided into two groups. The 40 patients in the control group were treated with CO2 laser, while the 40 ones in the experimental group were additionally treated with 5-aminoacetopenic acid photodynamic therapy. The incidence of adverse reactions, recurrence rate, clinical efficacy and time of wound healing andHPV clearanceand scabby timewas compared between the two groups after treatment. Results After treatment, the recurrence rate in the control group was 22.5%, higher than the 5.0% of the experimental group, with statistically significant difference(P<0.05). The incidence of adverse reactions was 12.5% and 15% in the control group and experimental group respectively, with no statistically significant difference(P>0.05). After treatment, the total effective rate in the experimental group was 95.0%, higher than the 77.5% in the control group, with statistically significant difference(P<0.05). The time of HPVclearance and wound healing and scabby time in the experimental group was(32.4±12.4)d,(7.2±1.2) d,(3.1±1.1) d respectively, shorter than that in the control group, with statistically significant differences(P<0.05). Conclusions CO2 laser combined 5-aminoglypenic photodynamic therapy is effective in the treatment of refractory CA, which can effectively reduce the recurrence and the incidence of adverse reactions and shorten the time of HPVclearance and wound healing and scabby time, worthy of clinical promotion.