δALAPDT治疗面部基底细胞癌、Bowen病及日光性角化病临床.docVIP

δALAPDT治疗面部基底细胞癌、Bowen病及日光性角化病临床 　 作者：李洁思 李森真 李春香 【摘要】 目的 探讨δ氨基酮戊酸光动力学疗法(δALA PDT)治疗面部浅表基底细胞癌(BCC)、Bowen病(BD)及日光性角化病(AK)的近期效果。方法 24例患者中，16例皮肤BCC，3例BD病，5例AK，均经病理组织学确诊。局部外用新鲜配制的20%ALA乳膏，封包4 h后用中心波长630 nm的德国Waldmann PDT 1200不连续红光照射，病变部位照射强度为105～168 mW/cm2，剂量为150～200 J/cm2，照射时间20～30 min。结果 经过1次(12例)、2次(3例)和3次(1例)治疗后，BCC患者10例完全缓解，5例部分缓解，1例无反应；BD患者2例完全缓解，1例部分缓解；AK患者3例完全缓解，2例部分缓解。结论 δALAPDT治疗面部浅表BCC、BD病及AK有效，方法简单，患者耐受性好，无瘢痕形成，在保持患者面部美容方面有优势。 【关键词】 δ氨基酮戊酸； 光动力学疗法； 基底细胞癌； Bowen病； 日光性角化病 【Abstract】 Objective To investigate the effects of δAminolaevulinic acidphotodynamic therapy(δALAPDT)on facial basal cell carcinoma(BCC),Bowen’s disease(BD),actinic keratosis(AK). Methods Among 24 patients,16 patients suffering from BCC,3 patients from BD and 5 patients from AK were confirmed by histopathological examination of biopsy.All of the patients were given topical 20% ALA cream which was prepared freshly and under occlusive dressing for 4h.Light at 630 nm was obtained from the Waldmann PDT 1200 and its output was set at 105～168 mW/cm2.Incident light doses of 150～200 J/cm2 were applied.The exposure time was 20～30 min. Results Treated by once(12 patients),twice(3 patients) and 3 times(1 patient) of δALA PDT,of all the patients with BCC,10 patients were cured,5 patients had partial remission and 1 patient was invalid to the treatment;of all the patients with BD,2 patients was cured,1 patient had partial remission and 1 patient completely relieve from the disease;of all the patients with AK,3 patients were cured and 2 patients had partial remission. Conclusion δALAPDT is an effective,simple and welltolerated treatment for BCC,BD and AK.It hasn’t cicatrisation and has its advantage in keeping the prosopocosmetology of the patients. 【Key words】 δAminolaevulinic acid；Photodynamic therapy；Basal cell carcinoma；Bowens disease；Actinic keratosis δ氨基酮戊酸光动力学疗法(δALAPDT)对肿瘤细胞具有较好的组织特异性，对周围正常皮肤组织无损伤，无瘢痕形成，可重复治疗，是治疗面部浅表皮肤的基底细胞癌(BCC)、Bowen病(BD)、日光性角化病(AK)的新途径［1］。我们应用δALAPDT治