光动力与二氧化碳激光治疗阴道上皮内瘤变临床疗效分析  

Analysis of clinical efficacy of photodynamic and carbon dioxide laser in the treatment of vaginal intraepithelial neoplasia

作　　者：马晓团 申庆文[1] 王玲玲[1] MA Xiaotuan;SHEN Qingwen;WANG Lingling(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院妇产科,安徽蚌埠233004

出　　处：《中华全科医学》2024年第2期257-260,共4页Chinese Journal of General Practice

基　　金：安徽高校自然科学研究项目(KJ2021A0754)。

摘　　要：目的分析阴道上皮内瘤变(VaIN)的临床特征,探讨光动力(ALA-PDT)与二氧化碳(CO_(2))激光治疗VaIN的临床疗效。方法选取2019年1月—2022年4月在蚌埠医学院第一附属医院经阴道镜下活检确诊为VaIN进行ALA-PDT的136例患者的临床资料,同时选取65例行CO_(2)激光治疗的患者的临床资料,所有患者治疗后定期复查HPV、TCT,同时行阴道镜下活检,回顾性分析VaIN的临床特征,探讨ALA-PDT与CO_(2)治疗VaIN的临床疗效。结果治疗结束后进行12个月随访,末次随访时,ALA-PDT组有85例(69.1%)实现HPV完全清除,CO_(2)激光组有32例(51.6%)实现HPV完全清除,2组HPV清除率差异有统计学意义(P<0.05)。随访期间,ALA-PDT组有112例(82.4%)病变完全清除,5例(3.7%)病变持续存在,12例(8.8%)部分缓解,3例(2.2%)进展,4例(2.9%)出现复发。CO_(2)激光组有42例(64.6%)病变完全清除,3例(4.6%)病变持续存在,8例(12.3%)部分缓解,2例(3.1%)进展,10例(15.4%)出现复发。ALA-PDT组总体病变完全缓解率高于CO_(2)激光组(P<0.05),ALA-PDT组复发率低于CO_(2)激光组(P<0.05)。ALA-PDT组有6例(4.4%)出现不良反应,CO_(2)激光组有9例(13.8%)发生不良反应,ALA-PDT组不良反应发生率低于CO_(2)激光组(P<0.05)。结论ALA-PDT治疗VaIN病变完全缓解率更高,能有效清除HPV感染,不良反应少,复发率低,临床上值得进一步推广。Objective To retrospectively analyze the clinical characteristics of vaginal intraepithelial neoplasia(VaIN),and to evaluate the clinical effect of 5-aminolevulinic acid-based photodynamic therapy(ALA-PDT)in the treatment of VaIN.Methods The clinical data of 136 patients diagnosed with VaIN by colposcopic biopsy who underwent ALA-PDT at the First Affiliated Hospital of Bengbu Medical College from January 2019 to April 2022 were selected,and the clinical data of 65 patients who underwent CO_(2) laser therapy were selected.HPV and TCT were regularly checked in all patients.At the same time,colposcopic biopsy was performed to retrospectively analyze the clinical characteristics of VaIN,explore the clinical efficacy of ALA-PDT treatment of VaIN,and compare with CO_(2) laser treatment.Results A 12-month follow-up was performed after the end of treatment.At the last follow-up,85 cases(69.1%)in the ALA-PDT group and 32 cases(51.6%)in the CO_(2) laser group achieved complete HPV clearance.The HPV clearance rate was compared between the two groups,and the difference was statistically significant(P<0.05).During the follow-up,112 patients(82.4%)in the ALA-PDT group had complete clearance the lesions,5 patients(3.7%)had persistent disease,12 patients(8.8%)had partial remission,3 patients(2.2%)had progression,and 4 patients(2.9%)had recurrence.In the CO_(2) laser group,42 cases(64.6%)had complete remission,3 cases(4.6%)persisted,8 cases(12.3%)had partial remission,2 cases(3.1%)progressed,and 10 cases(15.4%)recurred.The overall complete remission rate of lesions in ALA-PDT group was higher than that in the CO_(2) laser group,the difference was statistically significant(P<0.05),and the recurrence rate in the ALA-PDT group was lower than that in the CO_(2) laser group,the difference was statistically significant(P<0.05).There were 6 cases(4.4%)of adverse reactions in the ALA-PDT group and 9 cases(13.8%)in the CO_(2) laser group.The incidence of adverse reactions was lower in the ALA-PDT group than in the CO_(2) laser group,and t

关 键 词：光动力 二氧化碳激光 阴道上皮内瘤变 临床疗效 

分 类 号：R711.7[医药卫生—妇产科学]