CAJ | 학술논문

目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗宫颈尖锐湿疣患者的疗效和安全性.方法治疗组采用ALA-PDT对45例宫颈尖锐湿疣患者进行治疗,每2周治疗1次,治疗1～4次后判断临床疗效.对照组采用CO2激光对35例宫颈尖锐湿疣患者进行治疗,两组随访时间均为3个月.结果治疗组45例患者中,3例经1次ALA-PDT治疗、6例2次治疗、20例3次治疗、15例4次治疗获得完全缓解,完全缓解率为97.8%(44/45);复发3例,复发率6.8%(3/44).对照组30例患者一次性去除疣体,5例分批治疗,完全缓解率为100%(35/35),复发率为31.4%(11/35).经统计学处理,两组间完全缓解率,差异无统计学意义(P＞0.05),复发率对照组明显高于治疗组(x2=6.497,P＜0.05).治疗组几乎所有患者在红光照射期间出现轻度下腹部坠胀感,但未发现明显不良反应和瘢痕形成.对照组不良反应主要表现为出血、糜烂、浅溃疡和瘢痕.结论 ALA-PDT具有疗效好、副作用小、复发率低等优势,可作为治疗宫颈尖锐湿疣的治疗选择之一.
목적 탐토5-안기동무산광동력요법(ALA-PDT)치료궁경첨예습우환자적료효화안전성.방법 치료조채용ALA-PDT대45례궁경첨예습우환자진행치료,매2주치료1차,치료1～4차후판단림상료효.대조조채용CO2격광대35례궁경첨예습우환자진행치료,량조수방시간균위3개월.결과 치료조45례환자중,3례경1차ALA-PDT치료、6례2차치료、20례3차치료、15례4차치료획득완전완해,완전완해솔위97.8%(44/45);복발3례,복발솔6.8%(3/44).대조조30례환자일차성거제우체,5례분비치료,완전완해솔위100%(35/35),복발솔위31.4%(11/35).경통계학처리,량조간완전완해솔,차이무통계학의의(P＞0.05),복발솔대조조명현고우치료조(x2=6.497,P＜0.05).치료조궤호소유환자재홍광조사기간출현경도하복부추창감,단미발현명현불량반응화반흔형성.대조조불량반응주요표현위출혈、미란、천궤양화반흔.결론 ALA-PDT구유료효호、부작용소、복발솔저등우세,가작위치료궁경첨예습우적치료선택지일.
Objective To investigate the efficacy and safety of 5-aminolaevulinic acid-photodynamic therapy (ALA-PDT) in cervical condyloma acuminatum. Methods Forty-five patients with cervical condyloma acuminatum topically applied 10% ALA thermal gel followed by PDT. The treatment was repeated 14 days later if the lesion was not completely removed. Totally, 1 - 4 treatment sessions were given. Thirty-five patients with cervical condyloma acuminatum who received CO2 laser treatment served as the control. All patients were followed up for 12 weeks. Results Complete remission was achieved in 97.8% (44/45) of patients with cervical condyloma acuminatum treated by ALA-PDT, and among the 44 cured patients, 3 were treated by 1 cycle of ALA-PDT, 6 by 2 cycles, 20 by 3 cycles, and 15 by 4 cycles. The lesions of condyloma acuminatum were removed after 1 session of CO2 laser treatment in 30 patients, and after repeated treatments in 5 patients, with the complete remission rate being 100% (35/35). The overall recurrence rate calculated for the whole followup period in patients treated with ALA-PDT was significantly lower than that in patients treated with CO2 laser [6.8% (3/44) vs 31.4% (11/35), x2 = 6.497, P ＜ 0.05]. However, no significant difference in complete remission rate was found between the two groups (P ＞ 0.05). Almost all the patients in ALA-PDT group presented with pain of bythus during illumination, but no severe side effects or scar formation was observed. In patients treated with CO2 laser, adverse reactions mainly included bleeding, erosion, shallow ulcer and even scar formation. Conclusions Topical ALA-PDT is effective and safe for the treatment and reduction in recurrence of condyloma acuminatum, and may serve as a therapeutic option for cervical condyloma acuminatum.