旷置术联合光动力治疗老年面部基底细胞癌9例临床观察  

Clinical observation of exclusion combined with photodynamic therapy for facial basal cell carcinoma in 9 elderly patients

作　　者：李姗姗 陈朝潮[2] 徐宇轩 王建芳[2] 丁高中 LI Shanshan;CHEN Zhaochao;XU Yuxuan;WANG Jianfang;DING Gaozhong(Department of Dermatology,Soochow University Affiliated Infectious Diseases Hospital,the Fifth People's Hospital of Suzhou,Suzhou,Jiangsu 215000,China;Department of Dermatology,Nanjing Medical University Af filiated Suzhou Hospital,Suzhou Municipal Hospital,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州市第五人民医院皮肤科苏州大学附属传染病医院,江苏苏州215000 [2]南京医科大学附属苏州医院苏州市立医院皮肤科,江苏苏州215000

出　　处：《中华实用诊断与治疗杂志》2024年第11期1127-1130,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：苏州市“科教兴卫”青年科技项目(KJXW2021052);苏州市科技计划项目(SKJY2021137)。

摘　　要：目的观察老年面部基底细胞癌(BCC)患者采用旷置术联合5-氨基酮戊酸光动力治疗(ALA-PDT)的效果,探讨其安全性。方法2020年11月—2022年7月苏州市立医院诊治老年面部BCC患者9例,治疗第1天手术切除瘤体,电凝止血后旷置按压包扎,不予缝合;治疗第2天行ALA-PDT,每周治疗1次,共3次。记录ALA-PDT治疗期间创面红肿、中重度疼痛(视觉模拟评分≥6分)、暂时性色素沉着等不良反应发生情况。ALA-PDT治疗3次后行皮肤镜检查评估疗效,计算治愈率。随访至2023年7月,记录创面愈合、感染、瘢痕形成、面部皮肤牵拉变形、皮损复发情况。结果9例ALA-PDT治疗3次后皮损均完全消退,治愈率为100%。ALA-PDT治疗期间发生较为明显的红肿2例,中重度疼痛2例,暂时性色素沉着1例。末次随访时9例创面愈合良好,未发生感染,无明显瘢痕形成,无明显皮肤牵拉,皮损均未复发。结论老年面部BCC患者采用旷置术联合ALA-PDT治疗治愈率高,复发率低,美容效果好,安全性高。Objective To observe the efficacy and safety of exclusion combined with 5-aminolevulinic acid photodynamic therapy(ALA-PDT)in elderly patients with facial basal cell carcinoma(BCC).Methods Nine elderly BCC patients underwent exclusion combined with ALA-PDT in Suzhou Municipal Hospital from November 2020 to July 2022,By day 1of treatment,the tumor was surgically resected,and compression bandaging was performed without suture after electrocoagulation and hemostasis;by day 2,ALA-PDT was performed once a week for 3 times.The occurrences of adverse reactions as wourd redness,swelling,moderate or severe pain(visual analogue scale≥6)and temporary pigmentation were recorded during ALA-PDT.After 3 times of ALA-PDT,dermoscopy was performed to assess the curative effect,and the cure rate was calculated.The patients were followed up till July 2023,and the occurrences of wound healing,infection,scar formation,facial skin traction deformation,and skin lesion recurrence were recorded.Results After 3 times of ALA-PDT treatment,all the skin lesions completely subsided,and the cure rate was 100%.During ALA-PDT,obvious redness and swelling occurred in 2 cases,moderate to severe pain in 2 cases,and temporary pigmentation in 1 case.All 9 cases got good wound healing,with no infection,obvious scar formation,obvious skin traction or skin lesion.Conclusion Exclusion combined with ALA-PDT for facial BCC in the elderly patients has a high cure rate,low recurrence rate,good cosmetic effect,and high safety.

关 键 词：基底细胞癌 面部 老年 旷置术 5-氨基酮戊酸光动力疗法 

分 类 号：R739.5[医药卫生—肿瘤]