杨 柳，许成蓉，陈映玲，邹 耘
（华中科技大学 同济医学院附属同济医院皮肤科，湖北 武汉430030）
摘 要: 目的：观察Nd:YAG激光治疗位于尿道口、阴道口、肛门及肛周的难治性尖锐湿疣的疗效。方法：将61例特殊部位的尖锐湿疣的患者随机分为实验组（31例）和对照组（30例），实验组采用Nd:YAG激光治疗，对照组采用普通CO2激光治疗，随访半年观察两组的创面愈合情况、治愈率及复发率。结果：采用Nd:YAG激光治疗的实验组一次治愈率为80.64%，高于对照组的一次治愈率56.67% (x2=4.087, P <0.05)，但两组的总治愈率无显著性差异（x2=1.198, P >0.05）。实验组复发率为22.58％，低于对照组的复发率46.67％。两者有显著性差异（x2=3.918, P <0.05）。激光术后第5天实验组的愈合率45.16％高于对照组的愈合率20.00％，两者有显著性差异(x2=4.490, P <0.05);第7天实验组的愈合率为87.09％高于对照组的愈合率60.00％，两者有显著性差别（x2=4.469, P <0.05）;第10天实验组的患者全部愈合，愈合率为100％，高于对照组的愈合率83.33％（P ＝0.024<0.05）。结论：Nd:YAG激光治疗特殊部位尖锐湿疣效果好，创面愈合快，复发率低。
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Analysis of Therapeutic Effect of Condyloma Acuminatum in Privileged Sites Treated with Nd:YAG Laser
YANG Liu ,XU Cheng-rong ,CHEN Ying-ling ,ZHOU Yun
(Department of Dermatology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030, China)
Abstract: Objective :To observe the therapeutic effect of recalcitrant condyloma acuminatum in urethral orifice ,ostium vaginae，anus and crissum treated with Nd:YAG laser.Methods:61 patients with condyloma acuminatum in privileged sites were divided into experimental group and control group in random.Experimental group was 31 patients treated with Nd:YAG laser，while control group was 30 patients treated with CO2 laser. Follow up a case by regular visits to half a year and observe two groups of the healing state of raw surface,cure rate and recurrence rate.Results:The cure rate was 80.64% after experimental group was treated with Nd:YAG laser once.It was higher than that of control group,56.67%( x2=4.087 , P <0.05).But no difference could be found in the con-cure rate of two groups (x2=1.198, P >0.05).The recurrence rate in experimental group was 22.58%,which was lower than that in control group，46.67%. There was remarkable difference between two groups (x2=3.918，P <0.05).Five days after the laser treatment ,the healing rate of raw surface in experimental group was 45.16%,which was higher than that in control group,20.00%( x2=4.490, P <0.05).Seven days after the treatment , the healing rate in experimental group,87.09% was higher than that in control group,60.00%( x2=4.469, P <0.05).The healing rate in experimental group was 100% in ten days after the laser treatment,while the healing rate in control group was 83.33%.There was marked qualitative difference between the two groups(P =0.024<0.05).Conclusion:Nd:YAG laser had proven to be safe and effective in treating condyloma acuminatum located in raw surface.The raw surface heal fast after laser treatment and the recurrence rate was low.
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