Objectives:To observe the clinical efficacy and safety of patients with urethra,anus condyloma acuinatum (CA)treated with 5 -aminolevulinic acid photodynamic (ALA-P DT)therapy combined with CO2 la-ser.Methods:69 patients were randomly divided into 3 groups of 23 cases,group A for pure ALA-PDT treat-ment,group B using pure CO2 laser treatment,ALA-PDT combined CO2 laser for group C.The cure rate,recur-rence and adverse reactions were observed.Results:After group A having received treatment for 1 -4 times,1 3 ca-ses of recurrence,1 0 cases cured;after the first treatment 1 00%clear in group B,8 cases of recurrence and 1 5 ca-ses were cured;in group C,3 cases of recurrence,20 cases were cured.Difference in the cure rates among the 3 groups were significant,significant difference between group B and C,and no significant difference between group A and C.Difference in the recurrence rates among the 3 groups were not significant after 1 month of treatment.The re-currence rate of group C 2 month,3 month and 1 year after was significant lower than the other groups,with signifi-cant difference.All the three groups showed pain,swelling or ulceration of adverse reactions,but without significant difference.Group A and group C had no scarring and pigment changes;in group B,6 cases had superficial scar and 3 cases of pigmentation,which was significantly higher than that in group A and group C.Conclusion:ALA-PDT combined CO2 laser is of significant effect,low recurrence rate,and mild adverse reactions in treating patients with urethra and anus CA,thusly safer and more effective.%目的：观察5－氨基酮戊酸光动力（ALA －P DT ）疗法联合 CO2激光治疗尿道口、肛门尖锐湿疣（CA）的临床疗效及安全性。方法：将69例患者随机分为三组各23例，A组采用单纯ALA－PDT治疗，B组采用单纯CO2激光治疗，C组采用ALA－PDT联合CO2激光治疗，观察痊愈率、术后复发及不良反应。结果：A组在治疗1～4次后，13例复发，10例痊愈；B组1次治疗后100％清除，术后8例复发，15例痊愈；C组经3例复发，痊愈20例。三组患者痊愈率组间比较具有显著差异，B与C组比较差异显著，A与C组比较差异不显著。三组患者术后1个月时AC复发率组间比较无显著差异。术后2、3个月及1年时，C组复发率低于其他两组，且与其他两组比较具有显著差异。三组均有疼痛、水肿或破溃不良反应，但组间比较无显著差异，A组与C组均无瘢痕形成及色素改变，B组6例浅表瘢痕，3例色素沉着，明显高于A组与C组。结论：ALA－PDT联合CO2激光治疗尿道口、肛门CA，效果显著，复发率低，不良反应轻微，较单一治疗 更加安全有效。
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