Wetmore S J
Department of Family Medicine, University of Western Ontario, London.
Can Fam Physician. 1999 Apr;45:964-74.
To review the principles of use, common techniques, and effectiveness of cryosurgery for common skin lesions that can be treated by family physicians in their offices.
MEDLINE and the Cochrane Database controlled trials register (1998 version) were searched. Much of the evidence for the effectiveness of cryosurgery or cryotherapy is based on of cryosurgery for treating common warts, external genital warts, lentigines, and basal cell carcinomas. Many of the trials reviewed were conducted in specialty clinics and, therefore, the results might not apply accurately to family practice.
Evidence from case report and series suggests that cryosurgery is effective for actinic keratoses, seborrheic keratoses, dermatofibroma, keloids, molluscum contagiosum, and benign nevi. Randomized comparative trials show that, for external genital warts, cryosurgery is more effective than podophyllin treatment, better than or equal to trichloroacetic acid, but less effective than electrodesiccation or surgical removal. Prospective randomized trials of cryosurgery for common warts showed that weekly cryotherapy produced more rapid cures, but the overall cure rate depended on number of treatments. Two freeze-thaw cycles and paring before freezing improved the cure rate for plantar warts.
回顾冷冻手术治疗家庭医生在诊所可处理的常见皮肤损害的使用原则、常用技术及有效性。
检索了MEDLINE和Cochrane数据库对照试验注册库（1998年版）。冷冻手术或冷冻疗法有效性的许多证据基于治疗寻常疣、外生殖器疣、雀斑样痣和基底细胞癌的冷冻手术。所回顾的许多试验是在专科诊所进行的，因此结果可能不适用于家庭医疗。
病例报告和系列研究的证据表明，冷冻手术对光化性角化病、脂溢性角化病、皮肤纤维瘤、瘢痕疙瘩、传染性软疣和良性痣有效。随机对照试验表明，对于外生殖器疣，冷冻手术比鬼臼树脂治疗更有效，优于或等同于三氯乙酸，但比电干燥法或手术切除效果差。寻常疣冷冻手术的前瞻性随机试验表明，每周冷冻疗法治愈更快，但总体治愈率取决于治疗次数。两个冻融周期以及冷冻前削除可提高跖疣的治愈率。
