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目的 :探索血卟啉光动力学疗法治疗肝癌时对正常肝脏的损伤。方法 :以光纤输出功率 30 0 m W及350 m W的波长 6 32 .8nm的 He- Ne激光插入法照射狗肝脏 0 .5cm深度 ,观察照射 12、15分钟后各点当时及照射后 15天局部肉眼及病理的变化。结果 :1.肉眼变化 :(1)照光当时 :局部见暗褐色斑 ,直径 1.2～ 1.5cm,中央直径8mm白凝 ,并有深 2～ 3mm的凹陷 ,随照射剂量及时间的加大而增加 ;(2 )照光后 15天 :局部略有淡白色变化外无其它异常。 2 .病理变化 :(1)照光后 1天 :局部见肝窦扩张、内有红细胞 ,点状坏死不多 ,灶性坏死少 ,有片状炎性细胞浸润 ;(2 )照光后 15天 :肝实质区点状炎性细胞浸润 ,几片灶性细胞坏死 (轻度损伤 ) ,肝包膜活动性炎性细胞浸润及增厚 ,以上变化程度随照射剂量及时间的加大而增加。结论 :血卟啉光动力学疗法治疗肝癌时对正常肝脏的损伤较少 ,当时及术后均不不致引起致死性损伤 ,故该法治疗肝癌还是比较安全的
Objective : To explore the damage to normal liver in the treatment of liver cancer with hematoporphyrin photodynamic therapy. METHODS: Dog livers were irradiated with He-Ne laser at a wavelength of 30 0 mW and 350 mW at a fiber output power of 0.5 cm in depth. Observed at each point after 12 and 15 minutes of irradiation and 15 days after irradiation. Local changes in the naked eye and pathology. Results: 1. Changes in the naked eye: (1) At the time of light: partial dark brown spots, diameter 1.2 ~ 1.5cm, central diameter 8mm white condensate, and deep 2 ~ 3mm depression, with the increase of irradiation dose and time increase (2) Fifteen days after lighting: There is no other abnormality except for a slight pale white change. 2. Pathological changes: (1) 1 day after illumination: localized hepatic sinusoidal dilatation, red blood cells inside, few spotty necrosis, focal necrosis, and flaky inflammatory cell infiltration; (2) 15 days after illumination: The punctate inflammatory cell infiltration in the hepatic parenchyma, several focal necrosis (mild lesions), and active inflammatory cell infiltration and thickening of the liver capsule increased the degree of these changes with increasing dose and time. Conclusion: Photodynamic therapy with hematoporphyrin has less damage to normal liver during liver cancer treatment. At that time and postoperatively, it does not cause fatal injury. Therefore, this method is safer for liver cancer treatment.