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目的:观察皮肤磨削术联合光动力疗法(PDT)治疗鲍恩病的临床疗效。方法:将门诊经组织病理诊断为鲍恩病的19例患者随机分为两组。联合治疗组:先进行肿瘤皮损的皮肤磨削术,术后外用5-氨基酮戊酸(ALA)溶液封包,5 h后给予红光照射,波长635 nm,能量密度为100 J/cm~2,照射20 min。14 d后待创面愈合进行第2次,1周后进行第3次,3次为一个疗程,于1、2、3、6周及半年观察患者病灶局部反应。对照组:单用PDT,方法同联合治疗组,每周1次,3次为一个疗程。结果:联合治疗组治疗后,8例患者病灶完全缓解,2例患者病灶明显缩小>50%。对照组中5例完全缓解,3例部分缓解,1例无效。两组完全缓解率差异有统计学意义。结论:皮肤磨削术结合PDT可以作为鲍恩病治疗的一种新选择。
Objective: To observe the clinical efficacy of skin grafting combined with photodynamic therapy (PDT) in the treatment of Bowen’s disease. Methods: Nineteen patients diagnosed as Bowen’s disease by clinicopathology were randomly divided into two groups. Combined treatment group: The first skin lesions of tumor skin surgery, postoperative topical 5-aminolevulinic acid (ALA) solution package, 5 h after the red light irradiation, wavelength 635 nm, the energy density of 100 J / cm ~ 2, irradiation 20 min. After 14 days, the wounds were healed for the second time. After 1 week, the wounds were treated for the third time and three times for one course of treatment. The local reactions of the patients were observed at 1, 2, 3, 6 and 6 months. Control group: PDT alone, with the treatment group, once a week, 3 times for a course of treatment. Results: In the combined treatment group, the lesions were completely relieved in 8 patients and the lesions were significantly reduced by> 50% in 2 patients. In the control group, 5 patients were completely relieved, 3 patients partially relieved, and 1 patient was ineffective. There was significant difference between the two groups in complete remission rate. Conclusion: Skin grafting combined with PDT can be used as a new treatment for Bowen’s disease.