CO2激光手术治疗尖锐湿疣术后抗复发治疗的临床研究

目的 对比观察CO2激光手术治疗尖锐湿疣(CA)术后应用不同免疫调节剂抗复发治疗效果.方法 1050例CA患者常规CO2激光切割或气化病灶(功率密度637 W/cm2),术后根据应用不同的免疫调节剂随机分为α2b-干扰素(IFN-α2b)组300例、γ-干扰素(IFN-γ)组300例、卡介苗多糖核酸(BCG-PSN)组100例、甘露聚糖肽(MNT)组100例和对照组250例,术后即刻各试验组分别于创面基底部局部注射IFN-α2b 100万单位、IFN-γ 100万单位、BCG-PSN 0.5 mg或MNT 5 mg,病灶直径＞4 cm或数目＞30个剂量加倍,术后次日分别于股内侧皮下注射免疫调节剂(药物及剂量同局部注射),每日1次共5d.对照组CO2激光术后不用任何免疫调节剂.结果 各组患者均治愈,IFN-γ组、MNT组、BCG-PSN组、IFN-α2b组和对照组一次治愈率分别为76.7%、72.0%、66.0%、64.0%和51.6%,各试验组的一次治愈率与对照组比较差异有非常显著意义(P＜0.01);MNT组和IFN-γ组治愈平均次数均明显少于对照组(P＜0.01).结论 CO2激光手术治疗CA效果满意,术后局部和股内侧皮下注射IFN-γ或MNT可明显降低术后复发率,其抗复发效果亦好于IFN-α2b和BCG-PSN.

Anti-relapse Treatment in Patients with Condyloma Acuminatum after CO2 Laser Operation: a Clinical Study

Objective To observe and compare the effect of anti-relapse treatment in patients with condyloma acuminatum(CA) after CO2 laser operation.Methods According to different immunomodulators used after CO_2 laser operation 1 050 patients with CA were randomly divided into five groups; interferon-γ(IFN-γ) group (300 cases) , interferon-α2b(IFN-α2b) group (300 cases) , bacilli Calmette Guerin-polysaccharide nucleic acid(BCG-PSN) group (100 cases) , mannantide( MNT) group (100 cases) and laser only control group (250 cases). The warts of all patients were excised or gasified by C0_2 laser ( density of power 637 W/cm~2 ) , just after that one million unit IFN-γ, one million unit IFN-α2b, 0.5 mg BCG-PSN and 5 mg MNT, respectively, were locally injected into the base of wounds in the four test groups, when diameter of wart was > 4 cm or number injection of > 30 the dosage would be doubled. At the second day after laser operation the same doses were subcutaneously injected into the medial femoral side in the four test groups respectively, one time per day for 5 days. In control group didnt inject any immunomodulator after laser operation.Results All patients with CA in the five groups wered cured. The first time cure rate in order was 76. 7% in the IFN-γ group, 72. 0% in the MNT group, 66. 0% in the BCG-PSN group, 64. 0% in the IFN-α2b group and 51.6% in the control group, the differences were significant (P<0.01). The average time of cure in the MNT and the IFN-γ groups were less than in the control group(P<0.01).Conclusions The effect of treatment by CO_2 laser operation is satisfactory. The wounds of local and medial femoral side by subcutaneous injection of IFN-γ and MNT can fully recurrent after CO_2 laser operation. Their effect on prevention of relapse is better than that of IFN-α2b and BCG-PSN.