治疗男性尿道口尖锐湿疣的麻醉方法

尖锐湿疣(CA)在选用物理治疗时,麻醉效果的好坏,直接影响CA的疗效.在工作中,我们对男性单纯发生在尿道口CA的麻醉方法进行了反复的临床实践,摸索出一种系带阻滞加尿道口浸润麻醉法,现将此法总结如下.     

尖锐湿疣清除术前应用恩纳乳膏局部麻醉的效果

自2002年以来,笔者用恩纳乳膏外涂局部麻醉治疗皮肤黏膜尖锐湿疣,取得满意麻醉效果,现报告如下。     

恩纳乳膏表面麻醉在CO2激光治疗尖锐湿疣和汗管瘤中的应用

目的:探讨恩纳乳膏表面麻醉在CO2激光治疗尖锐湿疣、汗管瘤的麻醉效果及不良反应.方法:在307例尖锐湿疣患者中,188例恩纳乳膏涂抹表面麻醉,119例1%利多卡因注射局部麻醉.在47例汗管瘤患者中,36例恩纳乳膏涂抹表面麻醉,11例1%利多卡因注射局部麻醉.比较各组麻醉效果及副反应,并将结果进行统计学分析.结果:恩纳组和利多卡因组患者治疗效果均无显著差异(P=0.867,P=0.583),恩纳组伤口渗液明显少于利多卡因组(P=0.024,P=0.03).伤口愈合明显好于利多卡因组(P＜0.01,P＜0.05).结论:恩纳乳膏应用于CO2激光治疗尖锐湿疣、汗管瘤患者有效而且安全.     

丁卡因表面麻醉在治疗男性尿道口尖锐湿疣中的应用

目的探索治疗男性尿道口尖锐湿疣适宜的麻醉方法。方法治疗组50例应用1%丁卡因注射液进行尿道口表面麻醉,对照组40例应用2%盐酸利多卡因注射液对尿道口内疣体进行基底部注射麻醉,两组均再以微波烧灼凝固疣体,并观察麻醉效果。治疗后1月,3月评价两组近期复发率。结果两组疼痛消失时间平均为5.4min,2.5min,未见不良反应发生。两组疼痛消失时间比较差异有显著性(t=12.40,P<0.05),而麻醉效果良好率比较差异无显著性(χ2=2.54,P>0.05)。对照组麻醉时患者均有不同程度的注射部位疼痛、表情痛苦、尿道口局部渗血和操作部位视野欠清晰。治疗后1月,3月随访,两组CA复发率比较差异有显著性(χ2分别为4.50,4.48,P<0.05)。结论丁卡因作为表面麻醉在治疗男性尿道口CA中显示麻醉效果好,手术视野清晰,病灶清除彻底。     

恩纳表面麻醉在CO2激光治疗女阴多发性尖锐湿疣中的应用

我们在CO2激光治疗女阴多发性尖锐湿疣(CA)时,采用恩纳乳膏进行表面麻醉并对该方法的麻醉效果、不良反应进行探讨,现将结果报告如下。     

恩纳和利多卡因局麻在激光治疗尖锐湿疣的对照观察

我中心在应用激光治疗外生殖器尖锐湿疣时,术前采用5％恩纳乳膏涂抹达到局麻效果,并设对照组,现报告如下。     

高频电针治疗男性尿道口尖锐湿疣

男性尿道口尖锐湿疣(ＣＡ)比较少见,治疗操作不便,有一定困难。作者用高频电针治疗取得满意疗效,现报告如下。临床资料　20例均为典型男性尿道口ＣＡ。年龄21～45岁,平均30岁。职业以打工和经商者多见(占80%)。病程3天～11月,以1～2月为多。伴有尿道外ＣＡ者5例,既往有ＣＡ史者4例。5例曾自涂疣必治,其中1例由于涂药次数太多使粘膜损伤,瘢痕形成,轻度狭窄。皮损多位于尿道外口以内0.5～1ｃｍ,皮损1处者6例,2处8例,3处以上6例。米粒状损害8例,草莓状5例,疣状斑块4例,丝状3例。其中损害占整个尿道口1/2周长者2例,1/3周长者1例。各例均以5%醋酸…     

复方利多卡因乳膏表面麻醉在治疗尿道口尖锐湿疣中的应用

目的：探讨复方利多卡因乳膏表面麻醉在二氧化碳激光治疗尿道口尖锐湿疣的麻醉效果及安全性。方法：选择尿道口尖锐湿疣患者40例,随机分为两组;治疗组20例,应用复方利多卡因乳膏表面麻醉;对照组20例,应用2%盐酸利多卡因注射液局部浸润麻醉。观察两组患者使用二氧化碳激光治疗尖锐湿疣时的麻醉效果及不良反应。结果：治疗组麻醉起效时间平均为（17.86±6.42）分钟,有效率90%,未见不良反应发生;对照组麻醉起效时间平均为（2.25±0.97）分钟,有效率100%,麻醉时所有患者在注射部位均出现不同程度疼痛、渗血和肿胀等副作用。两组麻醉起效时间差异具有统计学意义（t=10.762,P〈0.001）,而麻醉有效率差异无统计学意义（2=0.533,P〉0.05）。结论：复方利多卡因乳膏表面麻醉在二氧化碳激光治疗尿道口尖锐湿疣中麻醉效果满意,手术视野清晰,不良反应少,值得临床推广。     

鬼臼毒素脂质体软膏治疗外耳道尖锐湿疣1例

尖锐湿疣是一种常见的性传播疾病,好发于外生殖器及肛周等,也可发生于口腔、乳房等部位,但发生在外耳道的比较少见。现将我们遇到的1例外耳道尖锐湿疣的诊治情况报道如下。临床资料　患者,女,2 3岁。因左外耳道有持续性少量分泌物流出伴耳内闷胀感和听力减退8天就医。检查:左外耳道粉红色乳头样新生物,多蒂,质软,触之易出血。醋酸白试验阳性。病理检查示鳞状上皮疣状增生,伴较多空泡细胞,符合尖锐湿疣的诊断。追问病史,患者为某夜总会服务员,有不洁性交史和精液射入外耳道史。予鬼臼毒素脂质体软膏(由我院药学部提供)治疗,用药方法:1 80 0 0…     

男性尿道口尖锐湿疣综合治疗探讨

尿道口CA因其部位特殊,检查或治疗时暴露不彻底造成漏诊或漏治,治疗不适当易损伤正常粘膜及组织,造成粘连,重者可致尿道狭窄。     

5%咪喹莫特乳膏治疗尖锐湿疣的临床研究

目的探讨5%咪喹莫特乳膏治疗尖锐湿疣的有效性和安全性。方法采用多中心、随机、双盲、安慰剂平行对照法对236例尖锐湿疣患者进行了8周的临床研究。结果有116例治疗组患者和120例对照组患者完成临床观察并纳入统计分析。两组治疗后2周、6周及治疗后8周在疗效评价方面有显著差异(P<0.05),不良反应主要是轻至中度的红斑、水肿、糜烂、刺痛及瘙痒。结论5%咪喹莫特乳膏是一种治疗外生殖器疣有效而安全的新药。     

A Double-Blind,Randomized, Placebo-Controlled Trial of Eutectic Lidocaine/Prilocaine Cream 5% (EMLA)® for Analgesia Prior to Cryotherapy of Warts in Children and Adults

Abstract: Liquid nitrogen cryotherapy is an effective treatment modality for verrucae in children. However, sometimes the pain of the procedure is too much for the young child. In such instances the availability of an effective topical anesthetic would be of tremendous benefit. Warts are usually present on hardened skin, that is, the palms, periungual areas, and soles. In a double-blind, randomized, placebo-controlled, single-center, parallel-group trial with one visit, children (6–18 years old) and adults (> 18 years old) had 2.5 g of lidocaine/prilocaine cream 5% applied under an occlusive dressing to the wart and a 1 to 2 mm area surrounding it 1 hour prior to liquid nitrogen cryotherapy. In both age groups the warts were subdivided by location—hardened skin areas versus nonhardened skin sites. The topical anesthetic was then removed and cryotherapy applied for 5 to 10 seconds. The pain of cryotherapy was assessed by the patient on a visual analogue scale (VAS) immediately after the cryotherapy and 4 and 8 hours later. There was no statistically significant difference in the pain of cryotherapy experienced following the application of active cream (n= 64) and placebo (n = 64). Exploratory subgroup analysis by wart location showed promising results for lidocaine/ prilocaine cream 5% over placebo in children with warts on hardened skin sites (palms and soles). The topical anesthetic was safe and generally well-tolerated. Lidocaine/prilocaine cream 5% may provide some anesthesia in children receiving cryotherapy when the wart is on the palms or soles. Further studies are needed to better understand the site and age specificity of the anesthetic properties of lidocaine/prilocaine cream 5% when used to reduce the pain experienced during cryotherapy of warts.     

二氧化碳激光联合α-干扰素栓阴道用药治疗女性生殖道尖锐湿疣疗效观察

目的评估免疫疗法联合二氧化碳（ＣＯ２）激光治疗生殖道尖锐湿疣的疗效和作用机理。方法用ＣＯ２激光联合α－干扰素阴道用药治疗女性生殖道尖锐湿疣６０例（治疗组）,并与６０例单用ＣＯ２激光（对照组）相比较。结果两组治愈复发率分别为６．６７％、３１．６７％,前者明显降低,两组比较差异有统计学意义（Ｐ＜０．００１）。结论ＣＯ２激光联合干扰素栓阴道用药治疗生殖道尖锐湿疣能提高治愈率,有效降低复发率。     

Local anaesthesia with a lidocaine/prilocaine cream (EMLA) for cautery of condylomata acuminata on the vulval mucosa. The effect of timing of application of the cream

The analgesic efficacy of a lidocaine/prilocaine cream (EMLA) for the cautery of genital warts was evaluated in an open study. Fifty-two women aged 18 to 28 with at least two condylomata on the vulval mucosa took part. In a pilot study (n = 10) the time of onset of anaesthesia after the application of EMLA to the mucosa was established by pinching with a forceps. All ten patients were anaesthetized within 5-7 min and cautery was performed with no or only slight pain in 9/10 patients. In the main study EMLA was applied to the mucosa of 42 women for 10, 15 or 20 min. The anaesthesia was satisfactory for the cautery of condylomata in 92% of the patients after the application of EMLA for 10 minutes. The analgesic efficacy decreased gradually with application times of 15 min or longer (p less than 0.05). In the case of insufficient anaesthesia, an additional application of EMLA for 2-5 min enabled the operations to be completed in 7/8 patients.     

Comparison of Crotamiton 10% Cream (Eurax) and Permethrin 5% Cream (Elimite) for the Treatment of Scabies in Children

Permethrin 5% cream (Elimite) was approved as a treatment for scabies by the U.S. Food and Drug Administration in September 1989. In a double-blinded, randomized study, it was compared with crotamiton 10% cream (Eurax) for the treatment of scabies in children 2 months to 5 years of age. Two weeks after a single overnight treatment, 14 (30%) of 47 children were cured with permethrin 5% cream, in contrast to only 6 of 47 (13%) of subjects treated with Eurax. Four weeks after treatment the figures were 89% and 60% cured for the two agents, respectively. In 10 of the 19 patients whose treatment failed, the condition became worse after therapy. The difference in efficacy in favor of permethrin was significant (P = 0.002). That agent also demonstrated greater effectiveness in reducing pruritus and secondary bacterial infections. Elimite offers a safe, efficacious, and cosmetically elegant alternative to Eurax in the treatment of scabies in children.     

Lidocaine/prilocaine cream (EMLA(R)) versus infiltration anaesthesia: a comparison of the analgesic efficacy for punch biopsy and electrocoagulation of genital warts in men.

OBJECTIVES--To compare analgesic efficacy and pain caused by administration of lidocaine/prilocaine cream (EMLA(R)) versus xylocaine 1% local infiltration for punch biopsy and electrocoagulation of genital warts in men. DESIGN--Open randomised comparative parallel-group study. SETTING--Department of Dermatovenereology, University Hospital Rotterdam/Dijkzigt, the Netherlands. PATIENTS--63 males with warts on the genital mucosa and/or perianal area. METHODS--EMLA(R) cream (2.5-5 g) was applied during 13-45 minutes before surgery. Xylocaine 1% (0.1-4 ml) was infiltrated 0.5-4 minutes before surgery. Pain during administration and surgery was assessed by the patient on a verbal rating scale and on a visual analogue scale. RESULTS--EMLA(R) application was painless in all patients (n = 31) whereas xylocaine infiltration was slightly painful in 17/29 patients and moderately painful in 10/29 patients. EMLA(R) analgesia was satisfactory for 94% of biopsies and 62% of electrocoagulations. Xylocaine infiltration was satisfactory in all procedures. CONCLUSIONS--EMLA(R) application on the male genital mucosa is painless but it has a lower analgesic efficacy than xylocaine infiltration. However EMLA is a useful anaesthetic for taking biopsies in this area and may be used as premedication for local infiltration.     

O.25%盐酸阿莫洛芬霜治疗体股癣多中心的临床试验

目的评价0.25%盐酸阿莫罗芬霜治疗体股癣临床非劣效性及安全性.方法101例患者入选,采用随机单盲、阳性药(1%联苯苄唑霜)平行对照临床试验,根据临床症状改善及病原学检查、不良反应发生情况评价治愈率及安全性.结果试验组和对照组治愈率分别为80.0%、73.3%(P＞0.05,RR 1.09,C10.87-1.37);直接显微镜检查真菌阴转率分别为82.2%和73.3%(P＞0.05);真菌培养清除率分别为80.0%和73.3%(P＞0.05).个别患者发生与研究药物有关的不良反应,主要表现为红斑、瘙痒、灼热感、脱屑,不影响治疗,均自行缓解.ITT分析结果相似.结论0.25%盐酸阿莫罗芬霜治疗体股癣高效安全,且临床疗效、真菌学疗效和安全性均与1%联苯苄唑霜相似.     

2%夫西地酸乳膏治疗细菌感染性皮肤病临床观察

目的评价2%夫西地酸乳膏治疗细菌感染性皮肤病的疗效和安全性。方法60例细菌感染性皮肤病患者,治疗组30例外擦2%夫西地酸乳膏,2～3次/d;对照组30例外擦2%莫匹罗星软膏,3次/d,疗程7天。结果治疗组有效率86.6%;对照组有效率90.0%,两组疗效差异无显著性(P>0.05)。治疗期间未出现不良反应。结论2%夫西地酸乳膏与莫匹罗星软膏对各种感染性皮肤病均有较好疗效,安全性高,患者依从性好。