喜泊芬-光力疗法治疗鲜红斑痣5例.doc

中华医学会第十九次全国皮肤性病学术年会投稿 喜泊芬-光动力疗法治疗鲜红斑痣5例 何瑞明 唐建秀 胥忠校 万心章 尹忠渝 何华杰 黄静 龚永芳 蒋长超 重庆长峰医院 　　　　　　　　　　　　　　　邮政编码：400084 ? 【摘要】目的：探讨喜泊芬注射液作为光敏剂配合525nm半导体激光光动力治疗鲜红斑痣的临床效果。方法: (1) 做好治疗前的准备工作。将喜泊芬避光保存于-10℃冰柜内，先划痕试验阴性者方可注射光敏剂。照射前应沿拟照射光斑区周边按其形状贴好胶布条, 并用双层黑布遮盖非照射区域, 要注意胶布条不要覆盖住红斑, 以离开其边缘1mm 为宜。照射区要尽量选择在一个平面上, 同时要保持照射区的清洁卫生, 并剔净遮挡的毛发等。同时还要注意保持呼吸道通畅。(2) 静脉滴注光敏剂。光敏剂喜泊芬一般用量为5 mg/ kg 体重,用250ml生理盐水稀释后静脉滴注，可一边推注光敏剂, 一边照光。(3) 照光。照光前要按治疗方案调整并测定光纤末端输出功率, 定时在功率计上监测。激光照射剂量一般儿童为80mW/cm2, 成人为100mW/ cm2。照射时应保持扩束头与照射平面垂直, 注意光斑的大小, 密切观察照射区的变化情况, 并结合患者年龄、肤色等因素, 准确掌握照射时间( 照射时间一般为35~60min) 。对某些特殊部位( 如鼻唇沟, 嘴角,眼角、耳廓及颏部等) 应适当缩短照射时间(一般为10~20 min) ; 对面积较大者可分次、分区照射。照射区的选择一般遵照先侧面后正面的原则, 若照射面不平, 可适当调整照射角度以保证垂直照射。直至红斑颜色改变。治疗结束后冰敷。外涂美宝或绿药膏，避光1个月，每次治疗间隔1～3个月。结果: ??5 例鲜红斑痣患者经1～4次，喜泊芬-PDT治疗,随访观察,完全治愈2例,基本治愈2例,明显好转1例,总有效率达100%。结论: 喜泊芬注射液作为光敏剂配合525nm半导体激光光动力治疗鲜红斑痣是一种安全、有效、简便易行的方法。 【关键词】鲜红斑痣? 喜泊芬? 光动力 Abstract Objective: To explore the hi-Park-fun Injection as a photosensitizer with 520nm semiconductor laser photodynamic treatment of PWS clinical effect. Methods: (1) do the preparatory work before the treatment. Hi parked Fen stored in the freezer of -10 ℃ first scratch test negative before injection of the photosensitizer. Be irradiated spot area surrounding their shape stickers textile strip before irradiation along the non-irradiated area and covered with a double layer of black cloth tape strips to pay attention not to cover erythema, to leave its edges 1mm appropriate. Irradiation area to try to choose the same time to maintain the cleanliness of the irradiated areas, and tick net blocked hair in a plane. Also note that to keep the airway open. (2) intravenous infusion of the photosensitizer. Photosensitizer hi parked Fen general dosage of 5 mg / kg body weight, diluted with 250ml of saline intravenous infusion, you can enjoy a bolus photosensitizer side illuminated. (3) illumination. Illuminated before adjustment according to the treatment plan and the determination of the end of the