中华皮肤科杂志 ›› 2015, Vol. 48 ›› Issue (4): 252-255.

• 论著 • 上一篇    下一篇

皮肤磨削术联合氨基酮戊酸光动力疗法治疗鼻部结节型基底细胞癌25例

吴晓琰1,陈晓栋2,丁鹏3,顾黎雄1,姚晓东4,丁瑜洁5,沈聪聪6   

  1. 1. 南通大学附属医院
    2. 南通大学附属医院皮肤科
    3. 南通市妇幼保健院
    4. 南通大学附属医院皮肤性病科
    5. 江苏省南通市南通大学附属医院医学美容科
    6. 南通大学医学院;南通大学附属医院皮肤科
  • 收稿日期:2014-07-31 修回日期:2014-12-27 出版日期:2015-04-15 发布日期:2015-03-27
  • 通讯作者: 陈晓栋 E-mail:dermatochen@163.com
  • 基金资助:

    2012 HS社会事业科技创新与示范计划

Dermabrasion combined with aminolevulinic acid-based photodynamic therapy for the treatment of nasal nodular basal cell carcinoma: 25 case reports

  • Received:2014-07-31 Revised:2014-12-27 Online:2015-04-15 Published:2015-03-27
  • Contact: Chen Xiao-Dong E-mail:dermatochen@163.com

摘要:

目的 探讨皮肤磨削术联合氨基酮戊酸光动力疗法(ALA-PDT)治疗鼻部结节型基底细胞癌(BCC)的疗效。 方法 25例经病理确诊、皮损面积 > 1 cm2、无骨或软骨侵犯的鼻部结节型BCC患者,实施皮肤磨削术联合ALA-PDT治疗。首先去除肿瘤病灶(对于突出皮肤表面的病灶先实施切削术,然后实施磨削术),术后创面即刻避光条件下外敷20%氨基酮戊酸3 ~ 4 h,然后平均100 J/cm2 LED光照射20 min。ALA-PDT每周1次,连续3周。术后观察创面愈合情况和时间;1年后随访观察肿瘤复发、瘢痕形成、外观效果等情况,并做出综合评价。 结果 25例患者未见创面感染,平均创面愈合时间为(11.2 ± 1.3) d。术后1年未见复发病例;1例患者发生瘢痕挛缩,3例患者有轻度的瘢痕增生,4例患者遗留凹陷性瘢痕。除1例患者对术后外观基本满意外,24例患者均对术后外观满意。 结论 皮肤磨削术联合ALA-PDT治疗鼻部结节型BCC操作简便,创面愈合快,术后复发率低,患者满意度高,值得临床推广。

Abstract:

Wu Xiaoyan*, Chen Xiaodong, Ding Peng, Gu Lixiong, Yao Xiaodong, Ding Yujie, Shen Congcong. *Department of Dermatovenereology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China Corresponding author: Chen Xiaodong, Email: dermatochen@163.com 【Abstract】 Objective To investigate the efficacy of dermabrasion combined with aminolevulinic acid-based photodynamic therapy (ALA-PDT) for the treatment of nasal nodular basal cell carcinoma (nBCC). Methods Twenty-five patients who were pathologically diagnosed as nasal nBCC with lesion area > 1 cm2 but no bone or cartilage involvement, were included in this study and treated with dermabrasion combined with ALA-PDT. At first, the part of tumor protruding outside the skin was removed by artherectomy, then dermabrasion was carried out. The wound surface was topically treated with 20% aminolevulinic acid solution for 3 - 4 hours away from light immediately after surgery, then irradiated with LED light at a mean dose of 100 J/cm2 for 20 minutes. ALA-PDT was performed once a week for 3 consecutive weeks. The degree of and time required for wound healing were assessed, and tumor recurrence, cicatrization and appearance outcomes were observed during 1 year after surgery. Efficacy was assessed comprehensively. Results No postoperative wound infection occurred in these patients, and the average time for wound healing was (11.2 ± 1.3) days. During 1 year after the treatment, no recurrence was found, while cicatricial contracture developed in 1 case, mild proliferative scar in 3 cases, and depressed scar in 4 cases. All the patients were satisfied with the treatment outcomes, except 1 patient who was basically satisfied. Conclusions Dermabrasion combined with ALA-PDT is easy to operate with rapid wound healing, low postoperative recurrence rate and high degree of patient satisfaction, and is worthy of clinical promotion.