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目的观察单纯光动力疗法及联合手术治疗皮肤恶性肿瘤的疗效。方法 138例确诊皮肤恶性肿瘤患者,根据患者病变部位、大小、皮损侵入程度、年龄、身体状况及手术意愿,68例患者选择单纯光动力治疗,70例患者光动力联合手术治疗。结果 70例手术联合光动力治疗者,69例皮损基本消退,治愈率98.6%,其中46例先做手术,24例先做光动力治疗再行手术治疗,术后ALA-PDT治疗1~4次,平均2.2次;68例单纯行ALA-PDT治疗患者,63例皮损基本消退,治愈率92.6%,治疗次数2~7次,平均3.2次,另有5例患者未愈,但皮损较前改善;基底细胞癌(BCC)治疗2~7次,平均3.2次,鳞状细胞癌(SCC)治疗3~6次,平均3.8次,鲍温病治疗2~5次,平均3.15次,乳房外Paget治疗2~6次,平均3.6次。术后不良反应为一过性红肿或色素沉着。对BCC和SCC的手术患者、非手术患者分别行样本均数u检验(α=0.05),结果示,无论BCC还是SCC,手术患者ALA-PDT治疗次数均少于非手术患者(P<0.05);手术患者中SCC和BCC治疗次数差异无统计学意义(P>0.05),但在非手术患者中BCC治疗次数少于SCC(P<0.05)。结论单纯光动力疗法及联合手术治疗均是安全、有效的方法,联合手术治疗可以缩短治疗周期,且BCC患者治疗次数少于SCC患者。
Objective To observe the efficacy of simple photodynamic therapy combined with surgical treatment of skin malignancies. Methods A total of 138 patients with malignant skin were diagnosed. According to the lesion location, size, degree of invasion, age, physical condition and surgical intention, 68 patients underwent photodynamic therapy and 70 underwent photodynamic therapy. Results Seventy patients underwent combined surgery and photodynamic therapy, and the lesions of 69 patients basically regressed. The cure rate was 98.6%. 46 of them underwent surgery first and 24 of them underwent photodynamic therapy before surgery. The postoperative ALA-PDT treatment of 1 to 4 Times, an average of 2.2 times; 68 cases of simple treatment of patients with ALA-PDT, 63 cases of skin lesions subsided, the cure rate was 92.6%, the number of treatment of 2 to 7 times, an average of 3.2 times, and another 5 patients healed, (BCC) were treated 2 to 7 times on average 3.2 times, squamous cell carcinoma (SCC) 3 to 6 times, an average of 3.8 times, Bowen’s disease 2 to 5 times, an average of 3.15 times, Breast Paget treatment 2 to 6 times, an average of 3.6 times. Postoperative adverse reactions were transient redness or pigmentation. For patients with BCC and SCC, non-surgical patients were tested with the sample mean u (α = 0.05). The results showed that the number of ALA-PDT treatment in patients with surgery was less than that in non-surgery patients (both BCC and SCC) (P <0.05) There was no significant difference in the number of SCC and BCC between the two groups (P> 0.05). However, the number of BCC in nonoperative group was less than that of SCC group (P <0.05). Conclusions Simple photodynamic therapy combined with surgical treatment are both safe and effective. Combined with surgical treatment can shorten the treatment cycle, and the number of BCC patients treated less than SCC patients.