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目的观察利多卡因局部麻醉后,5-氨基酮戊酸光动力疗法(5-aminolevulinic acid photodynamic therapy,ALA-PDT)治疗尖锐湿疣(condyloma acuminatum,CA)疗效和对治疗中疼痛的影响。方法 CA患者72例,分成3组进行ALA-PDT治疗。分别为:利多卡因局麻组,26例患者在照射激光前,采用2%的利多卡因局麻。口服双氯芬酸钠组,24例患者,照光前3 h口服双氯芬酸钠缓释片75 mg。安慰剂组,22例患者采用语言安慰和音乐止痛措施。三组光动力治疗方法相同,治疗后定期随访,术后6个月判定临床疗效。结果总有效率分别为:利多卡因局麻组65.4%;口服双氯芬酸钠组75.0%;安慰剂组72.7%,三组总有效率差异无显著意义(P>0.05)。剧痛率分别为:利多卡因局麻组7.7%,口服双氯芬酸钠组37.5%,安慰剂组剧痛率68.2%,三组比较差异有显著意义(P<0.01)。结论 ALA-PDT治疗中使用利多卡因局麻具有良好的止痛效果,对治愈率无显著影响。利多卡因局麻可作为CA光动力治疗中备选的镇痛措施。
Objective To observe the curative effect of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) on condyloma acuminatum (CA) and its effect on the pain during the treatment of local anesthesia with lidocaine. Methods 72 patients with CA were divided into 3 groups for ALA-PDT treatment. Respectively: lidocaine local anesthesia group, 26 patients before laser irradiation, the use of 2% lidocaine local anesthesia. Oral diclofenac sodium group, 24 patients, 3 hours before light oral diclofenac sodium sustained release tablets 75 mg. The placebo group, 22 patients with language comfort and music analgesic measures. The same three groups of photodynamic therapy, regular follow-up after treatment, 6 months after surgery to determine the clinical efficacy. The total effective rate was 65.4% in the lidocaine group, 75.0% in the diclofenac group and 72.7% in the placebo group, respectively. There was no significant difference in the total effective rate between the three groups (P> 0.05). The rates of severe pain were 7.7% in the lidocaine group, 37.5% in the diclofenac group and 68.2% in the placebo group, respectively. There was significant difference between the three groups (P <0.01). Conclusion ALA-PDT treatment with lidocaine local anesthesia has a good analgesic effect, no significant effect on the cure rate. Lidocaine Local anesthesia may be used as an alternative analgesic for CA photodynamic therapy.