摘要/Abstract

摘要： 目的·探究CO2激光联合光动力疗法（photodynamic therapy，PDT）治疗口腔白斑病的临床效果。方法·选择2018年6月—2019年6月于上海交通大学医学院附属第九人民医院就诊的21例口腔白斑病患者，随机分为试验组（11例）和对照组（10例），前者采用CO2激光联合PDT治疗，后者单一采用CO2激光治疗。记录2组患者术后第1周内出现的不良反应，第1个月的治疗效果及第3、6个月的复发情况，并对上述指标的组间差异进行统计分析。结果·术后第1个月试验组和对照组的显效率分别为100%和80%，有效率分别为100%和90%，组间差异无统计学意义。术后第1周内，2组患者均出现不同程度的烧灼样疼痛、水肿和（或）糜烂，组间差异亦无统计学意义。术后第3个月随访结果显示，试验组和对照组的复发率分别为0和10%，组间差异无统计学意义；而第6个月的结果显示，试验组的复发率显著低于对照组（P=0.038）。结论·CO2激光联合PDT和单一CO2激光治疗口腔白斑病均疗效显著，无严重不良反应，且联合疗法可明显降低疾病复发率。
关键词: 光动力疗法, CO2激光, 口腔白斑病, 口腔黏膜潜在恶性疾患
Abstract:
Objective · To explore the clinical efficacy of CO2 laser combined with photodynamic therapy (PDT) in the treatment of oral leukoplakia (OL). Methods · A total of 21 OL patients in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from June 2018 to June 2019 were recruited. They were randomly divided into experimental group (11 cases, treated with CO2 laser combined with PDT) and control group (10 cases, treated with CO2 laser). The adverse effects during the 1st week, the clinical efficacy at the 1st month and the recurrence at the 3rd and 6th months after treatment were recorded. The differences of the above indexes between the two groups were statistically analyzed. Results · At the 1st month after treatment, the significant efficiency of the experimental group and the control group was 100% and 80%, respectively, while the total treatment efficiency were 100% and 90%, respectively. There was no significant difference between the two groups. During the 1st week post-treatment, the patients experienced varying degrees of pain, edema and (or) erosion, and there was no significant difference between the two groups. At the 3rd month after treatment, the recurrence rate of the experimental group and the control group was 0 and 10%, respectively, with no statistical difference; at the 6th month after the treatment, the recurrence rate of the experimental group was significantly lower than that of the control group (P=0.038). Conclusion · Both CO2 laser combined with PDT and single CO2 laser have significant curative effect and no serious adverse effect on the treatment of OL, and the combination therapy can significantly reduce the rate of recurrence.
Key words: photodynamic therapy (PDT), CO2 laser, oral leukoplakia (OL), oral mucosa potentially malignant disorder


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