光动力疗法联合CO_(2)激光治疗尖锐湿疣的疗效观察及美学评价

Clinical Observation and Medical Aesthetic Evaluation of Photodynamic Therapy Combined with CO_(2) Laser in the Treatment of Condyloma Acuminatum

目的:研究光动力疗法联合CO_(2)激光治疗尖锐湿疣的美学评价及对血清增殖细胞核抗原(PCNA)和血管内皮生长因子(VEGF)表达的影响。方法:选取2016年6月-2019年6月于笔者医院接受治疗的156例尖锐湿疣患者,采用随机数字表法将患者分为联合组和激光组,每组78例。激光组给予CO_(2)激光治疗,联合组给予光动力联合CO_(2)激光治疗,持续治疗3周后,比较两组临床疗效、血清PCNA水平、VEGF表达水平,美学评价指标评分及不良反应。结果:联合组总有效率(97.44%)明显高于激光组(78.21%),差异有统计学意义(P<0.05);治疗前,两组患者PCNA、VEGF表达水平、医学美学指标评分比较差异无统计学意义(P>0.05);治疗后,两组PCNA、VEGF水平与治疗前比较显著下降,且联合组PCNA、VEGF水平明显低于激光组,差异有统计学意义(P<0.05);两组皮肤解剖形态、排尿功能、性功能、皮肤色泽及视觉美感评分与治疗前比较显著上升,且联合组明显高于激光组,差异有统计学意义(P<0.05);联合组总不良反应发生率(6.41%)、半年复发率(5.13%)显著低于激光组(26.92%、42.31%),差异有统计学意义(P<0.05)。结论:光动力疗法联合CO_(2)激光治疗尖锐湿疣疗效确切,能有效改善美学效果,调节机体VEGF、PCNA表达水平,降低副反应,值得临床推广应用。

Objective To investigate the effects of photodynamic therapy combined with CO_(2) laser ablation on aesthetic evaluation and the expression of serum proliferating cell nuclear antigen(PCNA)and vascular endothelial growth factor(VEGF)of patients with condyloma acuminatum.Methods 156 patients with condyloma acuminatum in our hospital from June 2016 to June 2019 were enrolled,and divided into two groups by random number table methods,each with 78 cases.Laser group received CO_(2) laser ablation,while combined group received photodynamic therapy combined with CO_(2) laser ablation.Treatment in both groups lasted for 3 weeks.Then the clinical efficacy,serum PCNA and VEGF levels,medical aesthetic evaluation indicators,adverse reaction rate and side effects were compared between groups.Results The clinical efficacy of combined group was higher than that of laser group(97.44%vs 78.21%,P<0.05).Serum PCNA,VEGF expression levels and medical aesthetics scores had no significant difference between groups before treatment(P>0.05).After treatment,serum PCNA and VEGF expression levels were decreased in both groups,and were lower in combined group than in control group(P<0.05).Skin anatomical morphology,urination function,sexual function,skin color and visual beauty scores were increased in both groups after treatment,and were higher in combined group than in control group(P<0.05).The total adverse reactions and half-year recurrence rates of combined group were significantly lower than those of laser group(6.41%vs 26.92%,5.13%vs 42.31%,P<0.05).Conclusion Photodynamic therapy combined with CO_(2) laser ablation can effectively ameliorate the aesthetic evaluation and the expression of serum VEGF and PCNA of patients with condyloma acuminatum,with fewer side effects,so it is worthy of clinical promotion.