超脉冲CO2激光联合改良的ALA光动力疗法治疗复发性尖锐湿疣的疗效观察

目的 探索一种可以有效减少尖锐湿疣复发的治疗方法.方法 先采用超脉冲CO2激光去除较大或角化明显的疣体,再采用ALA光动力疗法治疗复发性尖锐湿疣,在ALA光动力治疗时,先使用伍德灯作光动力学诊断,明确病变范围和潜在病变,同时对用ALA光敏剂封包方法 做了改良.结果 22例复发性尖锐湿疣患者治疗一个疗程,16例痊愈.复发率降至27.2%;其余6例复发,其平均复发周期由原来的21.3天延长到41.2天.6例复发病例重复治疗有效,经第2～3个疗程治疗全部痊愈.结论 超脉冲CO2激光联合ALA光动力疗法是治疗复发性尖锐湿疣的一种快速、安全的方法.

Super pulse carbon dioxide laser in combination with innovated 5-aminolevulinic acid-photodynamic therapy in the management of recurrent condyloma acuminatum

Objective To develop a strategy to effectively reduce the recurrence of condyloma acuminatum. Methods Twenty-two patients with recurrent condyloma acuminatum were included in this study. Super pulse carbon dioxide (CO2) laser was used to remove large or hyperkeratotic warts. Then, ALA 20% cream or solution was applied to lesions and perilesional skin and mucosa. The application method of ALA cream was modified with dressings. Three hours after the application, Wood's lamp was utilized to determine the extent of lesions and potential lesions followed by irradiation with laser therapeutic instrument. Results After one session of treatment, 16 out of the 22 patients were cured. The recurrence rate was reduced to 27.2% (6/22) with the intermission of recurrence being prolonged from 21.3 days to 41.2 days. And, these 6 patients with recurrent condyloma acuminatum were cured after 2 to 3 additional sessions of treatment. Conclusion Super pulse CO2 laser in combination with ALA-PDT is a quick and safe option for the treatment of recurrent condyloma acuminatum.