光动力联合点阵CO_(2)激光治疗鲍温样丘疹病的临床疗效分析

Clinical Efficacy of Photodynamic Therapy Combined with Fractional Carbon Dioxide Laser in the Treatment of Bowenoid Papulosis

目的:观察光动力联合点阵CO_(2)激光治疗鲍温样丘疹病(Bowenoid papulosis,BP)临床疗效。方法:选取2017年8月-2021年8月笔者医院收治的112例BP患者,按照随机数字表法分为56例对照组(点阵CO_(2)激光)和56例观察组(光动力+点阵CO_(2)激光)。比较两组治疗后临床疗效,红肿消退时间及伤口愈合时间,治疗前后血清生化指标、美学评价评分变化,记录两组不良反应及复发率。结果:观察组总有效率92.86%显著高于对照组78.57%(P<0.05);观察组红肿消退时间及伤口愈合时间均显著低于对照组(P<0.05);治疗后,两组GM-CSF和VEGF均较治疗前降低(P<0.05),LTN均较治疗前升高(P<0.05);治疗后,两组皮肤形态、皮肤色泽、排尿功能、性功能、视觉美感评分均较治疗前升高(P<0.05),且观察组治疗后评分显著高于对照组(P<0.05);两组不良反应发生差异无统计学意义(P>0.05);观察组复发率为3.57%,显著低于对照组的14.29%(P<0.05)。结论:光动力联合点阵CO_(2)激光治疗BP患者临床疗效较佳,可有效改善患者症状,复发率低。

Objective To observe the clinical efficacy of photodynamic therapy combined with fractional carbon dioxide laser in treating Bowenoid papulosis(BP).Methods 112 patients with BP who were treated in the hospital from August 2017 to August 2021 were selected and divided into control group(n=56,fractional carbon dioxide laser)and observation group(n=56,photodynamic therapy+fractional carbon dioxide laser)according to the random number table method.The clinical efficacy,redness and swelling subsidence time and wound healing time after treatment and changes in serum biochemical indicators and aesthetic evaluation scores before and after treatment were compared between the two groups.The adverse reactions and recurrence rate of the two groups were recorded.Results The total effective rate in observation group was 92.86%,which was significantly higher than 78.57%in control group(P<0.05).The redness and swelling subsidence time and wound healing time in observation group were significantly shorter compared with those in control group(P<0.05).After treatment,GM-CSF and VEGF in the two groups were decreased compared with those before treatment(P<0.05)while the LTN was increased compared with that before treatment(P<0.05),and the above indicators in observation group were significantly different from those in control group after treatment(P<0.05).After treatment,the scores of skin morphology,skin color,voiding function,sexual function and visual beauty in the two groups were significantly higher than those before treatment(P<0.05).There were no significant differences in the occurrence of adverse reactions between the two groups(P>0.05).The recurrence rate was 3.57%in observation group,which was significantly lower than 14.29%in control group(P<0.05).Conclusion Photodynamic therapy combined with fractional carbon dioxide laser has good clinical efficacy in the treatment of patients with BP,and it can improve the symptoms and has low recurrence rate.