CAJ | 학술논문

目的：探讨5-氨基酮戊酸（5-Aminolevulinic acid，5-ALA）光动力（Photodynamic therapy， PDT）疗法对尖锐湿疣（Condyloma acuminatum，CA）疗效预后的影响因素，为改善患者的预后提出指导建议。方法：选取我院2011年3月至2013年3月收治的97例CA患者，均采取5-ALA PDT疗法治疗，按照患者预后情况分为痊愈组及未痊愈组，对比两组患者一般资料，分析其影响因素。结果：经4周治疗后，CA患者痊愈66例，显效17例，进步11例，无效3例，痊愈率68.0％；97例患者均获得有效随访，其中痊愈组复发3例，复发率4.5％，未痊愈组复发6例，复发率19.4％，痊愈组复发率显著低于未痊愈组；多因素回归分析发现，非生殖器部位皮损、疣体面积≥1.5 cm2、疣体高度≥0.5 mm、性伙伴个数≥3及存在PDT照射停顿是影响CA患者痊愈率的独立危险因素（P＜0.05）。结论：存在上述因素的CA患者多具有更差的治疗效果及更高的复发率，应采取心理干预、健康宣教等护理措施，并注重治疗的连续性，以保证治疗效果，改善患者预后。
목적：탐토5-안기동무산（5-Aminolevulinic acid，5-ALA）광동력（Photodynamic therapy， PDT）요법대첨예습우（Condyloma acuminatum，CA）료효예후적영향인소，위개선환자적예후제출지도건의。방법：선취아원2011년3월지2013년3월수치적97례CA환자，균채취5-ALA PDT요법치료，안조환자예후정황분위전유조급미전유조，대비량조환자일반자료，분석기영향인소。결과：경4주치료후，CA환자전유66례，현효17례，진보11례，무효3례，전유솔68.0％；97례환자균획득유효수방，기중전유조복발3례，복발솔4.5％，미전유조복발6례，복발솔19.4％，전유조복발솔현저저우미전유조；다인소회귀분석발현，비생식기부위피손、우체면적≥1.5 cm2、우체고도≥0.5 mm、성화반개수≥3급존재PDT조사정돈시영향CA환자전유솔적독립위험인소（P＜0.05）。결론：존재상술인소적CA환자다구유경차적치료효과급경고적복발솔，응채취심리간예、건강선교등호리조시，병주중치료적련속성，이보증치료효과，개선환자예후。
Objectives:To investigate factors influencing the effect of 5 -aminolevulinic acid (5 -ALA) photodynamic therapy (PDT)on the prognosis of patients with condyloma acuminatum (CA)and provide implica-tions for bettering patients’prognoses.Method:97 patients with CA hospitalized from March 201 1 to March 2013 were treated by 5 -ALA PDT therapy.According to the prognosis,patients were divided into the cured group and the uncured group.Then we compared the basic information of all patients and analyzed the factors influencing pa-tients’prognoses.Results:After 4-week treatment,the number of cured,markedly effective,improved and inva-lid cases were respectively 66,17,11,3,and the cure rate was 68.0%.All patients were followed up.3 cases re-curred in the cured group,with its recurrence rate being 4.5%,which was significantly lower than that of the un-cured group (19.4%).Multivariate regression analysis showed that the area of non-genital lesions,the area of verrucous body ≥ 1.5 cm2 ,the height of verrucous body ≥0.5 mm,the number of sexual partners ≥3 and the presence of PDT irradiation pause were the independent risk factors influencing the rate of cured CA patients (P<0.05 ).Conclusion:CA patients with the above-mentioned risk factors are more likely to show poorer treatment effect and higher recurrence rate.Measures like psychological intervention,health education should be taken and the continuity of treatment should be ensured to better the treatment effect and later prognosis.