扩大切除术联合光动力治疗面部基底细胞癌的临床疗效观察  

Observation on clinical efficacy of extensive resection combined with photodynamic therapy on facial basal cell carcinoma

作　　者：李富利 黄晓琴[2] 蔡艳桃[1] LI Fu-li;HUANG Xiao-qin;CAI Yan-tao(Department of Dermatology,Foshan Maternal and Child Health Hospital,Foshan 528000,China)

机构地区：[1]广东省佛山市妇幼保健院皮肤科,528000 [2]广东省佛山市高明区人民医院皮肤科,528500

出　　处：《中国实用医药》2020年第17期8-11,共4页China Practical Medicine

摘　　要：目的观察扩大切除术联合5-氨基酮戊酸光动力疗法(ALA-PDT)治疗面部基底细胞癌(BCC)的临床疗效。方法32例面部基底细胞癌患者,随机将患者分为实验组和对照组,各16例。对照组患者采用常规肿物切除术联合光动力治疗,实验组患者采用肿瘤扩大切除术+局部皮瓣转移术联合光动力治疗。观察两组治疗效果、复发情况及不良反应发生情况。结果所有患者全部完整切除病灶,术后病理提示标本边缘未见肿瘤细胞。所有患者在拆线后再进行6次光动力治疗,患者的皮损症状完全消失。实验组患者复发0例,对照组患者在原皮疹处复发2例(12.5%);两组复发率比较差异无统计学意义(χ^2=2.133,P=0.144>0.05)。部分患者在光动力治疗后出现轻微的疼痛,在可接受范围内,未予以特殊处理;部分患者出现显著性肿痛,予以止痛药口服及创面冷敷,后可缓解;部分患者面部出现手术伤口瘢痕,均能接受。结论对于面部基底细胞癌行肿瘤扩大切除术+局部皮瓣转移术联合光动力治疗,效果好,复发率低,值得临床推广。Objective To observe the clinical efficacy of extensive resection combined with 5-aminolevlinic acid photodynamic therapy(ALA-PDT)on facial basal cell carcinoma(BCC).Methods A total of 32 facial basal cell carcinoma patients were randomly divided into experimental group and control group,with 16 cases in each group.The control group was treated by conventional tumor resection combined with photodynamic therapy,and the experimental group was treated by extensive resection,local skin flap transposition combined with photodynamic therapy.The therapeutic effect,recurrence situation and occurrence of adverse reactions of the two groups.Results All patients were completely resected.Postoperative pathology suggested that no tumor cells were seen at the edge of the specimen.All patients were treated with photodynamic therapy 6 times after the suture was removed,and the skin lesions disappeared completely.In the experimental group,0 case recurred,and in the control group,2 cases(12.5%)recurred in the original rash.There was no statistically significant difference in recurrence rate between the two groups(χ^2=2.133,P=0.144>0.05).Some patients experienced slight pain after photodynamic therapy,which was within the acceptable range without special treatment.Some patients had significant swelling and pain,which could be relieved by taking painkillers orally and cold compress on the wound surface;some patients had scar on the face,which could be accepted.Conclusion Extensive resection,local skin flap transposition combined with photodynamic therapy shows good effect for the treatment of facial basal cell carcinoma with low recurrence rate,and it is worthy of clinical promotion.

关 键 词：面部基底细胞癌 扩大切除术 局部皮瓣转移术 5-氨基酮戊酸光动力疗法 

分 类 号：R739.5[医药卫生—肿瘤]