氨基酮戊酸(ALA)光动力治疗皮肤癌前病变及原位癌的临床疗效及安全性分析  

Efficacy and safety of ALA photodynamic therapy for skin precancerous lesions and carcinoma in situ

作　　者：伊力努尔·哈力甫[1,2] 梁俊琴 陈文静[1,2] 邹晓辉 康晓静[1,2] Yilinuer-Halifu;LIANG Junqin;CHEN Wenjing;ZHOU Xiaohui;KANG Xiaojing(Department of Dernatology,People's Hospital ol Xinjiang Uygur Autononous Region,Urumqi,830001 China;Depurtment of Xinjiang Key Laboratory of Dermatology Research,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi.830001,China)

机构地区：[1]新疆维吾尔自治区人民医院皮肤性病科,乌鲁木齐市830001 [2]新疆皮肤病研究重点实验室(XJYS1707),乌鲁木齐市830001

出　　处：《新疆医学》2020年第12期1241-1244,共4页Xinjiang Medical Journal

基　　金：国家自然科学基金地区项目(项目编号:81760494)。

摘　　要：目的观察研究氨基酮戊酸(ALA)光动力治疗皮肤癌前病变的临床疗效及安全性,为临床治疗提供参考依据。方法选取本院收治的84例非黑素瘤性皮肤癌和癌前病变患者进行研究,对所选患者采用ALA光动力疗法进行治疗,回顾性分析所选患者的临床资料,对治疗后6个月的治疗疗效进行评价,同时观察记录治疗后不良反应的发生情况。结果所选患者经治疗6个月后,显效有50例,有效有31例,无效3例,总有效率为96.43%,其中日光性角化病有效率均为100%,鲍温病的有效率为90.62%,两组病变类型的有效率比较无明显差异,差异无统计学意义(P>0.05)。所选患者经治疗后,有11例患者出现复发,复发率为13.10%。其中日光性角化复发率为12.50%,鲍温病复发率为15.63%,各组病变类型的复发率比较无明显差异,差异无统计学意义(P>0.05)。所选患者经治疗后,大部分患者均出现红肿、疼痛、瘙痒等不良反应,但均在可忍受范围之内,在短时间内均自行康复,有部分患者出现轻度糜烂和灼伤症状,进行针对性治疗后均痊愈。结论采用ALA光动力疗法治疗皮肤癌和癌前病变患者的临床疗效满意,且术后不良反应较轻微,复发率较低,有利于患者预后恢复,为非黑素瘤性皮肤癌和癌前病变患者的手术治疗提供了新思路。Objective To observe the clinical efficacy and safety of aminolevulinic acid(ALA)photodynamic therapy in non-melanoma skin cancer and provide a reference for clinical treatment.Methods A total of 84 patients with non-melanoma skin cancer and precancerous lesions in our hospital were enrolled in this study.Selected patients were treated with ALA photodynamic therapy.The clinical data of selected patients were retrospectively analyzed.The curative effect of 6 months after treatment was evaluated,and the incidence of adverse reactions after treatment was recorded.Results In the 6 months after treatment,the selected patients had 50 cases with obvious effect,31 cases had effect and 2 cases had no effect.The total effective rate was 96.43%.The clinical efficacy of ALA photodynamic therapy in patients with skin cancer and precancerous lesions is satisfactory,and the postoperative adverse reactions are mild with low recurrence rate,rates of solar keratosis was 100%.The effective rate of Bowen’s disease was 90.62%.There were no significant difference in the effective rate of each type of lesions,the difference was not statistically significant(P>0.05).The selected patients after treatment,11 patients relapsed,the recurrence rate was 13.01%.The recurrence rate of solar keratosis was 12.50%,Bowen’s disease recurrence rate was 15.63%.No significant difference was found in the recurrence rate between the two groups(P>0.05).The selected patients after treatment,most patients have redness,pain,itching and other adverse reactions,but these are within tolerance.In a short time,these symptoms can be self-healing.Some patients showed mild erosion and burns symptoms,the symptoms were cured after targeted treatment.Conclusions The clinical efficacy of ALA photodynamic therapy in patients with skin cancer and precancerous lesions is satisfactory.The adverse reaction after surgery is mild and the recurrence rate is low,which is good for prognosis recovery.It also offers new insights into the surgical management of non-melanoma skin

关 键 词：非黑素瘤性皮肤癌 光动力疗法 氨基酮戊酸 临床疗效 安全性 

分 类 号：R454.2[医药卫生—治疗学]