CAJ | 학술논문

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.
목적 탐토피부마삭술연합안기동무산광동력요법(ALA-PDT)치료비부결절형기저세포암(BCC)적료효.방법 25례경병리학진、피손면적＞1 cm2、무골혹연골침범적비부결절형BCC환자,실시피부마삭술연합ALA-PDT치료.수선거제종류병조(대우돌출피부표면적병조선실시절삭술,연후실시마삭술),술후창면즉각피광조건하외부20％안기동무산3～4 h,연후평균100 J/cm2 LED광조사20 min.ALA-PDT매주1차,련속3주.술후관찰창면유합정황화시간;1년후수방관찰종류복발、반흔형성、외관효과등정황,병주출종합평개.결과 25례환자미견창면감염,평균창면유합시간위(11.2± 1.3)d.술후1년미견복발병례;1례환자발생반흔련축,3례환자유경도적반흔증생,4례환자유류요함성반흔.제1례환자대술후외관기본만의외,24례환자균대술후외관만의.결론 피부마삭술연합ALA-PDT치료비부결절형BCC조작간편,창면유합쾌,술후복발솔저,환자만의도고,치득림상추엄.
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 Twentyfive 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.