点阵式CO_(2)激光联合光动力疗法治疗外阴硬化萎缩性苔藓的疗效及安全性  

Efficacy and safety of fractional CO_(2) laser combined with photodynamic therapy in the treatment of vulvar lichen sclerosus et atrophicus

作　　者：胡勇 王瑞华 郑秀芬 汤红峰 HU Yong;WANG Ruihua;ZHENG Xiufen;TANG Hongfeng(Dermatological Department,Shunde Hospital of Southern Medical University/the First People's Hospital of Shunde,Foshan 528300,China)

机构地区：[1]南方医科大学顺德医院/顺德第一人民医院皮肤科,广东佛山528300

出　　处：《临床医学研究与实践》2021年第15期4-6,16,共4页Clinical Research and Practice

基　　金：佛山市医学类科技攻关项目(No.2017AB003903)。

摘　　要：目的探讨点阵式CO_(2)激光联合光动力疗法治疗外阴硬化萎缩性苔藓的疗效和安全性。方法选取2018年5月至2019年5月南方医科大学顺德医院皮肤科门诊收治的12例外阴硬化萎缩性苔藓患者作为研究对象,均行点阵式CO_(2)激光联合光动力疗法治疗,分析其疗效和安全性。结果治疗前,12例患者表现为中、重度瘙痒,治疗后1个月,瘙痒明显缓解,且随着治疗时间的延长,瘙痒评分逐渐下降,治疗后3个月,11例患者瘙痒完全消失,1例患者瘙痒由重度转为轻度。治疗前,5例患者表现为性交痛,治疗后3个月,3例患者性交痛完全消失,2例患者性交痛由重度转为轻度。治疗后6个月,9例患者表现为轻度白斑,3例患者表现为中度白斑;3例患者表现为轻度萎缩,9例患者萎缩症状显著改善。治疗前,8例患者皮损面积>外阴表面的60%,4例患者皮损面积占外阴表面的30%~60%;治疗后,12例患者的皮损面积显著缩小。治疗后1、3、6个月,患者的瘙痒、性交痛、白斑、萎缩、皮损面积评分及总分均低于治疗前,差异具有统计学意义(P<0.05)。12例患者治疗期间及治疗后6个月均未出现严重不良反应,主要不良反应为疼痛、红肿。结论点阵式CO_(2)激光联合光动力疗法治疗外阴硬化萎缩性苔藓的效果显著,且不良反应少。Objective To investigate the efficacy and safety of fractional CO_(2) laser combined with photodynamic therapy in the treatment of vulvar lichen sclerosus et atrophicus.Methods From May 2018 to May 2019,12 patients with vulvar lichen sclerosus et atrophicus admitted in dermatological department clinic in Shunde hospital of southern medical university were selected as the research objects,and the patients were treated with fractional CO_(2) laser combined with photodynamic therapy.The efficacy and safety were analyzed.Results Before treatment,12 patients showed moderate and severe pruritus,1 month after treatment,the pruritus significantly relieved,and with the extension of treatment time,the pruritus score gradually decreased,at 3 months after treatment,11 cases of pruritus disappeared completely,and 1 case of pruritus changed from severe to mild.Before treatment,5 patients showed sexual intercourse pain,at 3 months after treatment,3 cases of sexual intercourse disappeared completely,2 cases of sexual intercourse pain changed from severe to mild.Six months after treatment,9 patients showed mild leukoplakia and 3 patients showed moderate leukoplakia;3 patients showed mild atrophy and atrophic symptom of 9 patients significant improvement.Before treatment,the lesion area of 8 patients was more than 60%of the vulva surface,and lesion area of 4 patients was 30%-60%of the vulva surface;after treatment,the lesion area of 12 patients decreased significantly.The scores of pruritus,sexual intercourse pain,leukoplakia,atrophy,lesion area and total score at 1,3 and 6 months after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).There were no serious adverse reactions in 12 patients during treatment and at 6 months after treatment,the main adverse reactions were pain and swelling.Conclusion Fractional CO_(2) laser combined with photodynamic therapy in the treatment of vulvar lichen sclerosus et atrophicus has significant effect with less adverse reactions.

关 键 词：点阵式CO_(2)激光 光动力疗法 外阴硬化萎缩性苔藓 

分 类 号：R711.72[医药卫生—妇产科学]