单纯光动力疗法及联合手术治疗皮肤恶性肿瘤的临床观察

发布时间：2019-04-21 18:15

【摘要】：目的观察单纯光动力疗法及联合手术治疗皮肤恶性肿瘤的疗效。方法 138例确诊皮肤恶性肿瘤患者,根据患者病变部位、大小、皮损侵入程度、年龄、身体状况及手术意愿,68例患者选择单纯光动力治疗,70例患者光动力联合手术治疗。结果 70例手术联合光动力治疗者,69例皮损基本消退,治愈率98.6%,其中46例先做手术,24例先做光动力治疗再行手术治疗,术后ALA-PDT治疗1~4次,平均2.2次;68例单纯行ALA-PDT治疗患者,63例皮损基本消退,治愈率92.6%,治疗次数2~7次,平均3.2次,另有5例患者未愈,但皮损较前改善;基底细胞癌(BCC)治疗2~7次,平均3.2次,鳞状细胞癌(SCC)治疗3~6次,平均3.8次,鲍温病治疗2~5次,平均3.15次,乳房外Paget治疗2~6次,平均3.6次。术后不良反应为一过性红肿或色素沉着。对BCC和SCC的手术患者、非手术患者分别行样本均数u检验(α=0.05),结果示,无论BCC还是SCC,手术患者ALA-PDT治疗次数均少于非手术患者(P0.05);手术患者中SCC和BCC治疗次数差异无统计学意义(P0.05),但在非手术患者中BCC治疗次数少于SCC(P0.05)。结论单纯光动力疗法及联合手术治疗均是安全、有效的方法,联合手术治疗可以缩短治疗周期,且BCC患者治疗次数少于SCC患者。
[Abstract]:Objective to observe the efficacy of photodynamic therapy (PDT) and combined operation in the treatment of skin malignant tumors. Methods 138 patients with skin malignant tumor were enrolled in this study. According to the lesion location, size, degree of invasion, age, physical condition and surgical intention, 68 patients were treated with photodynamic therapy (PDT) and 70 patients with photodynamic therapy (PDT). Results in 70 cases of operation combined with photodynamic therapy, 69 cases of skin lesions disappeared, the cure rate was 98.6%. Among them, 46 cases were operated first, 24 cases were treated with photodynamic therapy first and then the operation was performed. After ALA-PDT treatment, the average time was 2.2 times. Of the 68 cases treated with ALA-PDT alone, 63 cases regressed basically, the cure rate was 92.6%, the times of treatment were 2 times, 7 times (mean 3.2 times), the other 5 cases were not cured, but the skin lesions were improved. (BCC) therapy for basal cell carcinoma was 2 times (mean 3.2 times), (SCC) therapy for squamous cell carcinoma was 3 times (3. 8 times), Bowen's disease was 2 times (3.15 times), extramammary Paget therapy was 2 times (average 3. 6 times). Postoperative adverse reactions were transient redness or pigmentation. For BCC and SCC patients, non-surgical patients underwent u-test (伪 = 0.05). The results showed that the times of ALA-PDT treatment in both BCC and SCC, patients were less than those in non-operative patients (P0.05). There was no significant difference between SCC and BCC in surgical patients (P0.05), but the number of BCC treatment in non-operative patients was less than that in SCC (P0.05). Conclusion photodynamic therapy alone and combined surgery are safe and effective methods. Combined surgery can shorten the treatment cycle, and the times of treatment in BCC patients are less than those in SCC patients.
【作者单位】：西安交通大学第二附属医院皮肤科;
【分类号】：R739.5

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