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[421例生殖器尖锐湿疣连续系列病例分析。病程、管理及治疗结果]

[Analysis of a consecutive series of 421 cases of genital condylomata. Course, management and therapeutic results].

作者信息

Sadoul G, Beuret T

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1985;14(8):1049-58.

PMID:3833904
Abstract

The evolution of 421 cases of condylomata that have been followed seems to be less favourable than in other series in the literature. 45% of these cases became worse and 13% regressed, especially in the first year after diagnosis. Sometimes the case progresses in an atypical manner. It can be extremely rapid so that it becomes intra-epithelial carcinoma in less than a year in young patients who have not been pregnant or not had babies and who have cervical and vaginal infections and who use combined oral contraceptive pills. On the other hand it can "seesaw" with periods of worsening alternating with periods of regression. Treatment should be with local destruction using the CO2 laser if the lesion is on the exocervix or laser CO2 conisation if it is an endocervical lesion. It is important to distinguish when treatments have been incomplete. This involves some persistence of the lesion even after treatment, or recurrences which can be less or more serious than the initial lesion. 11% of the cases treated by local destruction showed that some of the lesion persisted after the treatment and that there were 13% of recurrences. After conisation on the other hand 8% of cases were shown to be incompletely treated and 3% showed recurrences.

摘要

421例接受随访的尖锐湿疣病例的病情发展似乎不如文献中其他系列病例乐观。这些病例中有45%病情恶化,13%病情好转,尤其是在诊断后的第一年。有时病情会以非典型方式发展。病情发展可能极其迅速,在未怀孕或未生育、患有宫颈和阴道感染且使用复方口服避孕药的年轻患者中,不到一年就会发展为上皮内癌。另一方面,病情可能会“起伏不定”,病情恶化期与好转期交替出现。如果病变位于宫颈外口,应使用二氧化碳激光进行局部破坏治疗;如果是宫颈管内病变,则应进行二氧化碳激光锥切术。区分治疗是否不彻底很重要。这包括治疗后病变仍有部分残留,或者复发,复发的病情可能比初始病变轻或重。经局部破坏治疗的病例中有11%显示治疗后仍有部分病变残留,复发率为13%。另一方面,锥切术后有8%的病例显示治疗不彻底,3%的病例出现复发。

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