液氮低温冷冻与局麻下CO_(2)激光联合外用干扰素凝胶治疗女性外阴尖锐湿疣的效果比较  

The clinical efficacy of liquid nitrogen cryopreservation and CO_(2) laser under local anesthesia combined with external interferon gel in treatment of female vulvar condyloma acuminatum

作　　者：张翠 李海燕[1] 朱超华[2] ZHANG Cui;LI Haiyan;ZHU Chaohua(Department of Dermatology,The Third Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China;不详)

机构地区：[1]河北省石家庄市第三医院,050011 [2]河北医科大学第一医院

出　　处：《河北医药》2021年第11期1710-1713,共4页Hebei Medical Journal

基　　金：石家庄市科技局计划项目(编号:181460383)。

摘　　要：目的对比液氮低温冷冻与局麻下CO_(2)激光分别联合外用干扰素凝胶治疗女性外阴尖锐湿疣的临床疗效。方法选取2018年11月至2019年3月确诊的女性尖锐湿疣患者78例,随机分为A组(液氮低温冷冻联合外用干扰素凝胶治疗组)、B组(局麻下CO_(2)激光联合外用干扰素凝胶治疗组),每组39例。A组采用液氮低温冷冻治疗,用棉签尖端蘸取液氮,直接压迫疣体,反复3~4次冻融周期,使疣体表面形成薄层白霜为止,治疗结束后应用人α-2b干扰素凝胶涂抹患处。4次/d,连续30 d。B组采用2%利多卡因局部浸润麻醉用CO_(2)激光祛除肉眼可见疣体,治疗结束后同样应用人α-2b干扰素凝胶涂抹患处,疗程如前。疗程结束后7 d,观察治疗有效率。治疗后随访6个月,比较2组并发症发生率、治愈率及复发率等。结果A组治疗后3 d内患者出现局部轻微红肿、疼痛13例,B组治疗后3 d内患者出现轻微、疼痛9例,2组差异无统计学意义(P>0.05)。治疗后7 d内,A组患者出现创面糜烂1例,B组患者出现创面糜烂6例,但程度较轻,2组差异有统计学意义(P<0.05)。总并发症发生率2组差异无统计学意义(P>0.05)。治疗结束后7 d随访,A组治愈31例,治愈率79.5%,B组治愈22例,治愈率56.4%,2组比较差异有统计学意义(P<0.05)。治疗后6个月随访,2组均未出现瘢痕及色素沉着。随访期间,A组复发2例(复发率5.1%),B组复发6例(复发率15.4%),2组差异有统计学意义(χ^(2)=4.034,P=0.045)。经再次治疗后,A组仍有1例复发,B组仍有2例复发。结论液氮低温冷冻联合外用干扰素凝胶治疗女性外阴尖锐湿疣患者疗效优于局麻下CO_(2)激光联合外用干扰素凝胶治疗,治愈率高、复发率低。2组总并发症发生率无明显差异,但在治疗后创面糜烂并发症发生率上,前者同样显著优于后者。Objective To investigate the clinical efficacy of liquid nitrogen cryopreservation and CO_(2) laser under local anesthesia combined with external interferon gel in treatment of female vulvar condyloma acuminatum.Methods A total of 78 female patients with condyloma acuminata who were diagnosed and treated in our hospital from November 2018 to March 2019 were randomly divided into group A(liquid nitrogen cryopreservation combined with external interferon gel treatment)and group B(CO_(2))laser under local anesthesia combined with external interferon gel treatment),with 39 cases in each group.The patients in group A were treated by liquid nitrogen cryopreservation,then humanα-2b interferon gel was used externally,4 times a day,for 30 days.The patients in group B were treated by local anesthesia with 2%lidocaine,and the visible corpus callosum was removed by CO_(2) laser,then humanα-2b interferon gel was used externally,4 times a day,for 30 days.At 7 days after the end of treatment,the curative effects,the incidence of complications,cure rate and recurrence rate were observed and compared between the two groups.Results There was no significant difference in the incidence of localized mild redness and pain within 3 days after treatment between the two groups(P>0.05).There was significant difference in the incidence of wound surface erosion at 7 days after treatment between the two groups(P<0.05).There was no significant difference in the incidence of complications between the two groups.The cure rate at 7 days after treatment in group A was 79.5%(31/39),which was significantly higher than that[56.4%(22/39)]in group B(P<0.05).After 6-month follow up,no scars or pigmentation were found in both groups.And the recurrence rate in group A was 5.1%(2/39),which was significantly lower than that[15.4%(6/39)]in group B(P<0.05).Conclusion The therapeutic effects of liquid nitrogen cryopreservation combined with external interferon gel in treatment of female vulvar condyloma acuminatum are superior to those by CO_(2) laser combi

关 键 词：尖锐湿疣 冷冻 CO_(2)激光 干扰素凝胶 

分 类 号：R752.53[医药卫生—皮肤病学与性病学]