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目的:评估并比较钬激光与冷冻治疗肛门巨大尖锐湿疣(LAW)的疗效与安全性。方法:LAW患者随机接受钬激光或冷冻治疗,观察2组患者的疣体首次治疗清除率、平均治疗次数、复发率、不良反应及并发症、大便习惯改变及患者满意度等。结果:97例患者进入本研究(钬激光组54例、冷冻组43例),最终83例完成治疗和随访,其中激光组45例、冷冻组38例。2组患者在病史、发病年龄、性别、疣体最大直径和随访时间上均无显著性差异。首次治疗清除率钬激光组显著优于冷冻组(P<0.05)。2组患者均有复发,但复发次数上无显著性差异(P>0.05),激光组平均复发次数为1.47,冷冻组为1.38。2组在并发症与不良反应方面有差异,术后大便习惯改变和患者满意度方面钬激光组优于冷冻治疗组(P<0.05)。结论:钬激光治疗LAW的疗效、安全性及患者满意度等方面均优于冷冻治疗,值得临床推广应用。
Objective: To evaluate and compare the efficacy and safety of holmium laser and cryotherapy in the treatment of anal giant condyloma acuminatum (LAW). METHODS: LAW patients were randomly treated with holmium laser or cryotherapy. The initial treatment clearance rate, average number of treatment, recurrence rate, adverse reactions and complications, changes in bowel habits and patient satisfaction were observed in two groups. Results: 97 patients entered the study (54 in the holmium laser group and 43 in the frozen group). In the final 83 patients completed the treatment and follow-up, 45 were in the laser group and 38 in the frozen group. There was no significant difference between the two groups in history, age of onset, sex, maximal diameter of wart and follow-up time. The first treatment clearance rate of holmium laser group was significantly better than the frozen group (P <0.05). There was no significant difference between the two groups (P> 0.05). The average number of recurrence in the laser group was 1.47 and in the frozen group was 1.38.2, there were differences in complications and adverse reactions. After the bowel habits The changes of holmium laser group and patient satisfaction were better than that of cryotherapy group (P <0.05). Conclusion: The efficacy, safety and patient satisfaction of holmium laser are better than cryotherapy in the treatment of LAW, which is worthy of clinical application.