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目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗宫颈内膜外移伴人类乳头瘤病毒(HPV)亚临床感染的疗效。方法将68例宫颈内膜外移伴HPV亚临床感染患者随机分为两组,每组34例。治疗组完成1疗程的ALA-PDT治疗,共3次,每次间隔7~10d;对照组采用传统的微波治疗1次;随访3个月后判断临床疗效,1年后比较HPV转阴率。结果治疗组34例经1疗程治疗后完全缓解率为73.53%(25/34);部分缓解率为26.47%(9/34)。对照组34例完全缓解率为88.24%(30/34);部分缓解率为11.76%(4/34)。治疗组34例仅有轻度腹部坠胀及阴道分泌物稍增多,未出现阴道出血及宫颈疤痕。微波对照组34例均出现阴道排液、出血,4例宫颈疤痕。随访1年后治疗组HPV转阴率88.24%;对照组HPV转阴率32.35%。ALA-PDT与传统的微波治疗相比,完全缓解率差异无统计学意义(P=0.12);HPV转阴率差异有统计学意义(P<0.01)。结论 ALA-PDT治疗宫颈内膜外移伴HPV亚临床感染,副作用少,疗效可靠。
Objective To investigate the efficacy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of subclinical endometriosis with human papillomavirus (HPV). Methods Sixty-eight patients with endometriosis and subclinical HPV infection were randomly divided into two groups (34 in each group). The treatment group completed a course of treatment of ALA-PDT, a total of 3 times, each interval of 7 ~ 10d; control group using conventional microwave treatment 1; follow-up 3 months after the judgment of clinical efficacy, HPV negative rate after 1 year. Results In the treatment group, the complete remission rate of 34 cases after one course of treatment was 73.53% (25/34). The partial remission rate was 26.47% (9/34). The control group 34 patients complete remission rate was 88.24% (30/34); partial remission rate was 11.76% (4/34). 34 cases of treatment group only mild abdominal bulge and vaginal discharge slightly increased, no vaginal bleeding and cervical scarring. 34 cases of microwave control group were vaginal discharge, bleeding, 4 cases of cervical scar. One year after follow-up, the negative rate of HPV in treatment group was 88.24%, while the negative rate of HPV in control group was 32.35%. ALA-PDT compared with the traditional microwave treatment, complete remission rate was no significant difference (P = 0.12); HPV negative conversion rate was statistically significant (P <0.01). Conclusion ALA-PDT treatment of cervical endometriosis with subclinical HPV infection, fewer side effects, and reliable.