棒状光源5-氨基酮戊酸光动力疗法治疗肛管内尖锐湿疣的疗效观察

发布时间：2018-05-12 08:36

本文选题：棒状光源 + 肛管　；参考：《医学研究生学报》2017年12期

【摘要】：目的肛管内尖锐湿疣的治疗难度大,复发率高,一直是临床研究的重点。文中旨在观察棒状光源5-氨基酮戊酸光动力疗法(ALA-PDT)治疗肛管内尖锐湿疣的疗效及安全性。方法收集2016年6月至2017年6月中国医学科学院北京协和医学院皮肤病医院理疗科门诊就诊的肛管内尖锐湿疣患者30例。每周一次棒状光源ALA-PDT治疗,每次治疗前详细记录皮损情况,计算皮损清除率;同时记录里急后重等相关不良反应。平均随访时间(150±20)d,观察复发情况。结果治疗1次全部清除者6例(20.0%),部分清除者12例(40.0%),未清除者12例(40.0%);2次治疗全部清除者11例(36.7%),部分清除者9例(30.0%),未清除者10例(33.3%);3次治疗全部清除15例(50.0%),部分清除7例(23.3%),未清除8例(26.7%),3次治疗总有效率为73.3%(22/30)。ALA-PDT治疗期间27例均出现疼痛反应,治疗后10 min达疼痛高峰,15 min后逐渐缓解,疼痛自觉模拟尺评分为(6.57±1.24)分,仅有1例患者疼痛难忍,疼痛评分10分。至随访结束时4例(18.2%)患者复发,其中有2例仅在肛管复发,2例肛周、肛管均有复发。结论棒状光源ALA-PDT治疗肛管内尖锐湿疣疗效好,安全性高,复发率低。
[Abstract]:Objective the treatment of condyloma acuminatum in anal canal is difficult and the recurrence rate is high. The purpose of this study was to observe the efficacy and safety of 5-aminolevulinic acid photodynamic therapy in the treatment of condyloma acuminatum in anal canal. Methods from June 2016 to June 2017, 30 patients with condyloma acuminatum in anal canal were collected from Department of Physiotherapy, Department of Physiotherapy, Peking Union Medical College, Chinese Academy of Medical Sciences. Once a week ALA-PDT was treated with rod light source. The lesions were recorded in detail before each treatment and the clearance rate was calculated. Meanwhile, the adverse reactions such as acute and severe injury were recorded at the same time. The mean follow-up time was 150 卤20 days, and the recurrence was observed. Results six cases were completely cleared once, 12 cases were partially cleared, 12 cases were removed, 12 cases were not cleared, 11 cases were completely cleared, 9 cases were partially cleared, 15 cases were completely cleared, and 7 cases were partially cleared. The total effective rate was 23. 3% and 8 cases were not cleared. The total effective rate of 3 times treatment was that 27 cases had pain reaction during 73.3%(22/30).ALA-PDT treatment. After 10 min treatment, the pain peak reached 15 min and gradually relieved. The score of pain self-conscious simulation scale was 6.57 卤1.24, and only one patient could not bear pain, and the pain score was 10 points. By the end of follow-up, 4 patients had recurred, 2 of them had recrudescence only in anal canal and 2 patients had recrudescence in anal canal. Conclusion ALA-PDT has good efficacy, high safety and low recurrence rate in the treatment of condyloma acuminatum in anal canal.
【作者单位】：中国医学科学院北京协和医学院皮肤病医院理疗科;
【基金】：江苏省自然科学基金(BK20160152)
【分类号】：R752.53

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