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目的观察光动力联合改性几丁质治疗生殖道尖锐湿疣(CA)的疗效、安全性以及治疗后HPV基因型随访。方法将64例生殖道尖锐湿疣患者分两组,每组32例,观察组采用改性几丁质联合光动力治疗3~5次,观察两组疗效、复发率、不良反应等;每例患者首次治疗前,疗程结束时,脱落细胞送检HPV基因亚型。结果观察组和对照组治愈率分别为96.86%和84.36%,差异无统计学意义(P>0.05);复发率分别为3.23%和25.93%,不良反应率分别为0和31.25%,差异有统计学意义(P均<0.05);两组共8例复发,8例治疗前检查和随访第1次复查均为阳性,第2次、第3次复查仍然有部分病例持续阳性,其中6例为多重型别的高危型感染,随访见高危型HPV33和HPV16持续感染。结论改性几丁质联合光动力治疗对于生殖道尖锐湿疣的患者,可降低其复发率、减少其术后不良反应率;CA患者术后复查检测HPV-DNA的意义更大。
Objective To observe the efficacy and safety of photodynamic therapy combined with modified chitin in the treatment of reproductive tract condyloma acuminatum (CA) and follow-up of HPV genotypes after treatment. Methods Sixty-four patients with genital warts were divided into two groups, 32 in each. The observation group was treated with modified chitin combined with photodynamic therapy for 3 to 5 times. The curative effect, recurrence rate and adverse reactions of the two groups were observed. Each patient Before the first treatment, exfoliated cells were submitted for HPV genotyping at the end of the course of treatment. Results The cure rates of the observation group and the control group were 96.86% and 84.36% respectively, with no significant difference (P> 0.05). The recurrence rates were 3.23% and 25.93% respectively, the adverse reaction rates were 0 and 31.25% (P <0.05). A total of 8 patients relapsed in both groups, 8 patients were positive before treatment and the first follow-up examination. In the 2nd and 3rd review, some cases were still positive, of which 6 were Multiple types of high-risk infection, follow-up to see the high-risk HPV33 and HPV16 persistent infection. Conclusions Modified chitin combined with photodynamic therapy can reduce the recurrence rate and reduce the postoperative adverse reaction rate in patients with genital warts. The detection of HPV-DNA in CA patients is more meaningful after the re-examination.