LED-IB复合窄光谱光动力治疗微静脉畸形280例近期疗效分析  

Treatment of venular malformations with LED-IB compound narrow spectrum photodynamic therapy: short-term outcome in 280 consecutive patients

作　　者：周天元 赵海光[2] 汪小勇 郑家伟[3] 戈旌[3] 

机构地区：[1]上海曹安医院血管瘤科,上海201804 [2]上海交通大学医学院附属第九人民医院血管外科,上海200011 [3]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面-头颈肿瘤科,上海200011

出　　处：《中国口腔颌面外科杂志》2016年第5期445-448,共4页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的 :探讨血卟啉注射液结合LED-IB复合窄光谱光动力治疗微静脉畸形的近期效果和安全性。方法 :选择2011年12月—2015年11月期间治疗的280例微静脉畸形患者,其中男116例,女164例;病变位于头面部162例、颈部63例、四肢30例、躯干25例;病变大小6.3~92.0 cm^2,平均30.7 cm^2。按3~5 mg/kg缓慢静脉推注血卟啉注射液,推注半量后,立即给予LED-IB复合窄光谱光动力治疗仪照射20~35 min,照射剂量为儿童80 m W/cm2,成人100 m W/cm^2。对比治疗前、后红斑消退情况和不良反应。结果:280例患者共治疗504次,平均1.8次。随访1~4 a,平均2.1 a。效果:优204例、良62例、差14例,有效率达95%,随访期内未见复发。治疗后大部分患者水肿3~5 d、结痂5~7 d;2例患者水肿达20 d;5例患者发生一过性色素沉着;1例患者出现皮肤暂时性光敏反应,避光时间长达3个月;2例患者因结痂太厚加上护理不当留有瘢痕。结论:LED-IB复合窄光谱光动力治疗微静脉畸形技术操作简单、疗效确切,光敏剂使用安全,治疗后和随访期间不良反应少。PURPOSE： To investigate the short-term clinical effect and safety of hematoporphyrine injection combined with LED-IB compound narrow spectrum photodynamic therapy in the treatment of venular malformation. METHODS： A consecutive 280 patients with venular malformation were treated from December 2011 to November 2015.Among them, 116 cases were male and 164 cases were female. Lesions of 162 patients were located at head and face, 63 cases at neck, 30 cases at limbs and 25 cases at the trunk. The size of the lesion was from 6.3 cm^2 to 92.0 cm^2, with an average size of 30.7 cm^2. Slow intravenous injection of hematoporphyrin （3-5 mg/kg） was performed. Immediately after the injection, LED-IB compound narrow spectrum photodynamic therapy was given for 20-35 min. The irradiation dose for children was 80 mW/cm^2 and 100 mW/cm^2 for adults. The extinctive degree of erythema and adverse reactions after treatment were recorded and analyzed. RESULTS： Two-hundred and eighty patients were treated for 504 times totally, with an average of 1.8 times. Fallow-up time was 1-4 years with an average of 2.1 years. The efficacy was excellent in 204 cases, good in 62 cases and poor in 14 cases. The overall effective rate was 95%. No recurrence was found during the follow-up period.Most of the patients developed edema for 3-5 days and scab for 5-7 days. The edema in 2 cases continued for 20 days. Five cases had pigmentation, one case suffered from temporary skin photosensitivity reaction and the time of avoiding light rays exposure was for 3 months. Scars were left in 2 patients because of the thick scab and improper care. CONCLUSIONS： LED-IB compound narrow spectral photodynamic therapy for venular malformation is simple and effective. The use of photosensitizer is safe and the adverse reactions after treatment and during follow-up are rare.

关 键 词：LED-IB复合窄光谱光动力治疗 血卟啉注射液 微静脉畸形 

分 类 号：R543.6[医药卫生—心血管疾病]