观察包皮环切术联合光动力治疗尖锐湿疣的疗效。

选择2016年1月至2018年5月于首都医科大学附属北京安贞医院皮肤科门诊诊治的154例伴有包皮过长或包茎的尖锐湿疣患者，采用随机数字法分为两组，对照组77例患者给予光动力治疗，治疗组77例患者在对照组基础上联合包皮环切术治疗。

于患者治疗后第1周和第2周随访时，治疗组患者复发率（1.5%和1.3%）显著低于对照组（13.0%和13.0%），差异均有统计学意义（χ² = 5.7840、P = 0.0162；χ² = 7.8081、P = 0.0052）。治疗组患者总体有效率和复发率分别为99.0%和0.98%，对照组总体有效率和复发率分别为92.9%和7.14%，差异均具有统计学意义（P均< 0.001）。治疗组患者术后疼痛率（9.1%）较对照组（6.5%）低，但差异无统计学意义（χ² = 0.3615、P = 0.5477）；两组患者VAS评分经Kolmogorov-Smirnov Z检验，差异无统计学意义（Z =－1.0842，P = 0.2783）。两组患者术后各有1例出现创面感染。对照组和治疗组各有1例患者治疗后1周～6个月发生不良反应（均为治疗部位出现色素脱失），经Fisher精确检验差异无统计学意义（P > 0.9999）。

尖锐湿疣合并包皮过长或包茎者，在光动力术后行包皮环切联合治疗，可显著降低尖锐湿疣的复发率。

To investigate the efficacy of circumcision combined with photodynamic in the treatment of condyloma acuminatum.

From January 2016 to May 2018, a total of 154 cases with condyloma acuminatum complicated with redundant prepuce or phimosis of outpatient-room Department of Dermatology, Beijing Anzhen Hospital, Capital Medical University were collected, who were divided into two groups by random digital method. The 77 patients in control group were treated with photodynamic therapy, while in treatment group, 77 patients were treated with circumcision on the basis of the control group.

The recurrence rates of patients in the treatment group (1.5% and 1.3%) were significantly lower than those of the control group (13.0% and 13.0%), at the first and second week following up after treatment (χ² = 5.7840, P = 0.0162; χ² = 7.8081, P = 0.0052). The overall effective rate and recurrence rate of patients in the treatment group were 99.0% and 0.98%, respectively, which were 92.9% and 7.14% in control group , respectively, with significant differences (all P < 0.001). The postoperative pain rate of patients in treatment group (9.1%) was lower than that of the control group (6.5%), but with no significant difference (χ² = 0.3615, P = 0.5477). There was no significant difference in VAS score between the two groups (Z =-1.0842, P = 0.2783). One case occurred wound infection in each group. There were one case with adverse reactions in control group and one case in treatment group from 1 week to 6 months after treatment (both had pigmentation at the treatment site), with no significant difference between the two groups (P > 0.9999).

For patients with condyloma acuminatum complicated with redundant prepuce or phimosis, the recurrence rate of condyloma acuminatum was significantly reduced by circumcision after photodynamic therapy.