棒状光源5-氨基酮戊酸光动力疗法联合微波治疗人类免疫缺陷病毒阳性肛管内尖锐湿疣的疗效观察

The effect of topical 5-aminolevulinic acid-photodynamic therapy with stick light source and microwave for the treatment of HIV-positive condyloma acuminata in the anal canal

目的探讨棒状光源5-氨基酮戊酸光动力疗法(ALA-PDT)联合微波治疗合并人类免疫缺陷病毒(HIV)感染的肛管内尖锐湿疣的临床效果。方法选取2018年1月1日至2019年12月31日长沙市第一医院收治的48例合并HIV感染的肛管内尖锐湿疣患者作为研究对象。采用随机分组法将其分为研究组和对照组,每组24例。研究组采用棒状光源ALA-PDT联合微波治疗,对照组采用单纯微波治疗。比较两组尖锐湿疣的治愈率、复发情况及不良反应发生率。结果研究组治愈率为83.33%,对照组治愈率为45.83%,差异具有统计学意义(P<0.05);治疗后24周,研究组复发率为16.67%,对照组复发率为54.17%,差异具有统计学意义(P<0.05);研究组局部黏膜疼痛程度高于对照组,差异具有统计学意义(P<0.05)。结论棒状光源ALA-PDT联合微波治疗可有效提高肛管内尖锐湿疣合并HIV感染患者的治疗效果,降低治疗后的复发率。

Objective To explore the therapeutic effect of topical 5-aminolevulinic acid-photodynamic therapy with stick light source and microwave for the treatment of HIV-positive condyloma acuminata in the anal canal. Methods A total of 48 patients with anal condyloma acuminatum complicated with HIV infection admitted to the First Hospital of Changsha from January 1, 2018 to December 31, 2019 were selected, and randomly divided into study group and control group, with 24 cases in each group. The study group received topical 5-aminolevulinic acid-photodynamic therapy with stick light source and microwave, while the control group only received microwave therapy. The cure rate, recurrence and adverse reaction rate of condyloma acuminatum were compared between the two groups. Results The cure rate was 83.33% in the study group and 45.83% in the control group, and the difference was statistically significant(P<0.05). 24 weeks after treatment, the recurrence rate was 16.67% in the study group and 54.17% in the control group, and the difference was statistically significant(P<0.05). The degree of local mucosal pain in the study group was higher than that in the control group(P<0.05). Conclusions Topical 5-aminolevulinic acid-photodynamic therapy with stick light source and microwave can effectively improve the treatment effect of HIV-infected patients with condyloma acuminatum in the anal canal, and reduce the recurrence rate after treatment.