光动力疗法治疗头面部皮肤肿瘤的疗效观察与护理干预  

Nursing intervention and effective summary of topical 5-aminolaevulinic acid photodynamic therapy in the cosmetic treatment of cephalic and facial skin tumor

作　　者：胡雪慧[1] 李强[1] 赵荣[2] 廖文俊[1] 罗莉[1] 孙林潮[1] 高天文[1] 

机构地区：[1]第四军医大学西京医院全军皮肤病研究所,陕西西安710032 [2]第四军医大学西京医院心血管外科

出　　处：《中国美容医学》2009年第11期1643-1645,共3页Chinese Journal of Aesthetic Medicine

基　　金：2007年第四军医大学西京医院临床高新技术项目(XJGX0746H08)

摘　　要：目的:总结分析5-氨基酮戊酸光动力疗法(ALA-PDT)治疗头面部皮肤肿瘤的护理策略及效果。方法:选择28例头面部皮肤肿瘤及癌前病变患者进行ALA-PDT治疗,包括基底细胞癌(BCC)、鳞状细胞癌(SCC)、脂溢性角化病(SK)及日光性角化病(AK)等,所有病例均经病理诊断确诊且不愿意接受手术治疗,在治疗前、中、后采取护理干预措施,治疗后随访3个月,对患者进行临床表现、副作用(自觉症状、光毒反应、光敏反应)及患者满意度调查三个方面的评价。结果:治疗28例头面部皮肤肿瘤患者,有2例未坚持治疗,痊愈22例,显效2例,好转1例,无效1例,总有效率92.3%。26例患者平均疼痛指数为4.4,疼痛部位排序:眼睑>唇部>鼻>颧部>面颊>头皮。患者满意度调查中非常满意者18例,占69%;满意者3例,占11%;一般者2例,占7.7%;差者3例,占11.5%。结论:适当的护理措施对于ALA-PDT疗法治疗不愿手术的头面部皮肤肿瘤患者可以降低患者平均疼痛指数,减少副作用,提高患者美容效果满意度。Objective To investigate and summarize the nursing strategy and effects in the treatment of cephalic and facial skin tumors with 5-aminolaevulinic acid photodynamic therapy （ALA-PDT）. Methods 28 patients with cephalic and facial skin tumor and precancerous changes were given topcial ALA followed by PDT. And all patients were diagnosed by dermatopathology,unwilling accept operative treatment simultaneously. Skin tumors contained basal cell carcinoma （BCC）,squamous cell carcinoma （SCC）,keratosis seborrheica （KS）, solar keratosis （SK） and so on. Nursing intervention were employed before, in the course and after treatment. After three months follow-up,all patients underwent the appreciation of clinical manifestation, pathology, side effects and patients satisfaction questionnaire. Results There were 28 patients with cephalic and facial skin tumors accepting ALA-PDT,2 of 28 patients can＇t accomplish the treatment,22 patients recoveried,2 patient shew excellence, 1 patients effective and 1 patients ineffective. Total effective rate was 92.3%, 26 of 28 patients presented different degree pain, mean pain exponent was 4.4.On the basis of pain susceptivity, the sorting of the pain position was eyelid, lips, nose, zygomatic arch,cheeks and scalp.In the aesthetic content investigation, extreme satisfaction 18 patients （69%）,satisfaction 3 patients （11%）, little satisfaction 2 patients （7.7%）, unsatisfaction 3 patients （11.5%）. Conclusion Proper nursing intervention in the treatment of cephalic and facial skin tumors with topical ALA-PDT can low mean pain exponent, decrease side effect and improve aesthetic effective.

关 键 词：光动力疗法 5-氨基酮戊酸 皮肤肿瘤 

分 类 号：R473.73[医药卫生—护理学]