5-氨基酮戊酸-光动力疗法联合微波治疗尖锐湿疣的临床疗效

目的比较5-氨基酮戊酸-光动力疗法（5-aminolevulinic acid-mediated photodynamic therapy,ALA-PDT）和微波治疗尖锐湿疣的临床疗效。方法尖锐湿疣患者90例,分为3组,A组为特殊部位（尿道口、系带或宫颈部位）的疣体患者20例,采用5-ALA-PDT治疗,每周治疗一次,3次为一疗程。其余70例患者随机分为两组,每组35例,B组为采用ALA-PDT联合微波治疗组,根据疣体大小一次或分次清除疣体;C组为单纯微波治疗组。ALA-PDT微波治疗。末次治疗后7 d进行疗效评价,术后3个月随访评价复发率。结果 A组患者治疗后7 d的清除率为95.2%,总复发率为10.0%。B组和C组末次治疗后7 d的清除率均为100%,术后总的复发率分别为8.6%,28.6%,三组比较差异有显著意义（P〈0.05）。结论 ALA-PDT联合微波治疗尖锐湿疣疗效确切,复发率低。ALA-PDT可有效治疗特殊部位疣体,临床使用范围广。

Combined Treatment of Condyloma Acuminatum with 5-Aminolevulinic Acid- Mediated Photodynamic Therapy and Microwave Therapy

Objective Comparison of clinical effects of 5-aminolevulinic acid photodynamic therapy and microwave therapy on condyloma acuminatum. Methods Altogether 90 patients of condyloma acuminatum were divided randomly into 3 groups. A group consists of 20 patients with condyloma acuminatum on special sites（urethral mouth,tie-back or cervical area）,who were only given ALA-PDT therapy. The rest 70 patients were further divided into two groups,each having 35 patients,and were given ALA-PDT and microwave therapy jointly（B Group） and sole microwave treatment（C Group） respectively. ALA-PDT therapy was conducted once a week,3 times for a course. As to microwave therapy,depending on wart size,warts were removed through one or more treatments. The curative effect was evaluated at the end of the first week after the treatment,and the recurrence rate was obtained via 3 months＇ follow-up. Results For patients having condyloma acuminatum on special sites,the clearance rate stood at 95. 2% at the end of the first week after being given ALA-PDT alone with a total relapse rate of 10. 0%. Despite of a clearance rate of 100. 0% being observed in both the joint treatment group and the single microwave treatment group at the end of the first week after the treatment,the total relapse rates of the groups were 8. 6% and 28. 6% respectively,indicating a difference that is statistically significant（P 0. 05）. Conclusions ALA-PDT in combination with microwave is effective in treating condyloma acuminatum with a low relapse rate. ALAPDT works well with warts on special sites,and is widely used in clinically.