之前沒用過這種方式. 所以查詢一下 uptodate.
拔指甲的治癒率 33%~75% (吃口服藥的治癒率 59%). 好像也不怎麼高.
不過這裡不能將口服與手術的直接相比
因為會手術的患者. 都是比較難治療的, 這些患者應該就是口服藥治療失敗的那一群.
我覺得比較合理的看待方式應該是這樣(不知道有沒有錯).
口服藥物治療
59%治癒.
41% 失敗
口服藥物失敗患者. 採取手術方式之後, 約 15.19%~36.75% 痊癒.
口服 + 手術都無效的患者佔 14.25% ~ 35.81%
google中文翻譯
甲真菌病：治療
手術 — 手術切除指甲（指甲撕脫術）通常適用於僅靠藥物治療無法成功治療的患者[ 78 ]。局部或全身抗真菌治療通常在手術後開始。如果沒有隨後的全身或局部治療，復發很常見。(參見“指甲撕脫術和化學基質切除術”，關於‘指甲撕脫術’一節)
指甲撕脫術隨後抗真菌治療的療效數據有限。在一項隨機試驗中，比較了四種不同的外用酮康唑或奧昔康唑的結果在40 名甲真菌病患者的指甲撕脫後的治療方案中，大約三分之一的患者未能完成治療，而在完成治療的患者中，真菌學治愈率在33% 至75% 之間[ 79 ]。患有完全營養不良型甲真菌病的患者從治療中獲益的可能性最小。
Onychomycosis: Management
Surgery — Surgical removal of the nail (nail avulsion) is typically reserved for patients who cannot be successfully treated with pharmacologic therapy alone [78]. Topical or systemic antifungal therapy is usually initiated after surgery. Recurrences are common in the absence of subsequent systemic or topical treatment. (See "Nail avulsion and chemical matricectomy", section on 'Nail avulsion'.)
Efficacy data on nail avulsion followed by antifungal therapy are limited. In a randomized trial comparing the results of four different topical ketoconazole or oxiconazole regimens after nail avulsion in 40 patients with onychomycosis, approximately one-third of patients failed to complete therapy and among patients who completed therapy, mycologic cure rates were between 33 and 75 percent [79]. Patients with total dystrophic onychomycosis were least likely to benefit from treatment.
不過這裡不能將口服與手術的直接相比
因為會手術的患者. 都是比較難治療的, 這些患者應該就是口服藥治療失敗的那一群.
我覺得比較合理的看待方式應該是這樣(不知道有沒有錯).
口服藥物治療
59%治癒.
41% 失敗
口服藥物失敗患者. 採取手術方式之後, 約 15.19%~36.75% 痊癒.
口服 + 手術都無效的患者佔 14.25% ~ 35.81%
google中文翻譯
甲真菌病：治療
手術 — 手術切除指甲（指甲撕脫術）通常適用於僅靠藥物治療無法成功治療的患者[ 78 ]。局部或全身抗真菌治療通常在手術後開始。如果沒有隨後的全身或局部治療，復發很常見。(參見“指甲撕脫術和化學基質切除術”，關於‘指甲撕脫術’一節)
指甲撕脫術隨後抗真菌治療的療效數據有限。在一項隨機試驗中，比較了四種不同的外用酮康唑或奧昔康唑的結果在40 名甲真菌病患者的指甲撕脫後的治療方案中，大約三分之一的患者未能完成治療，而在完成治療的患者中，真菌學治愈率在33% 至75% 之間[ 79 ]。患有完全營養不良型甲真菌病的患者從治療中獲益的可能性最小。
Onychomycosis: Management
Surgery — Surgical removal of the nail (nail avulsion) is typically reserved for patients who cannot be successfully treated with pharmacologic therapy alone [78]. Topical or systemic antifungal therapy is usually initiated after surgery. Recurrences are common in the absence of subsequent systemic or topical treatment. (See "Nail avulsion and chemical matricectomy", section on 'Nail avulsion'.)
Efficacy data on nail avulsion followed by antifungal therapy are limited. In a randomized trial comparing the results of four different topical ketoconazole or oxiconazole regimens after nail avulsion in 40 patients with onychomycosis, approximately one-third of patients failed to complete therapy and among patients who completed therapy, mycologic cure rates were between 33 and 75 percent [79]. Patients with total dystrophic onychomycosis were least likely to benefit from treatment.
沒有留言:
張貼留言