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目的 :探讨血卟啉注射液结合LED-IB复合窄光谱光动力治疗微静脉畸形的近期效果和安全性。方法 :选择2011年12月—2015年11月期间治疗的280例微静脉畸形患者,其中男116例,女164例;病变位于头面部162例、颈部63例、四肢30例、躯干25例;病变大小6.3~92.0 cm~2,平均30.7 cm~2。按3~5 mg/kg缓慢静脉推注血卟啉注射液,推注半量后,立即给予LED-IB复合窄光谱光动力治疗仪照射20~35 min,照射剂量为儿童80 m W/cm2,成人100 m W/cm~2。对比治疗前、后红斑消退情况和不良反应。结果:280例患者共治疗504次,平均1.8次。随访1~4 a,平均2.1 a。效果:优204例、良62例、差14例,有效率达95%,随访期内未见复发。治疗后大部分患者水肿3~5 d、结痂5~7 d;2例患者水肿达20 d;5例患者发生一过性色素沉着;1例患者出现皮肤暂时性光敏反应,避光时间长达3个月;2例患者因结痂太厚加上护理不当留有瘢痕。结论:LED-IB复合窄光谱光动力治疗微静脉畸形技术操作简单、疗效确切,光敏剂使用安全,治疗后和随访期间不良反应少。
Objective: To investigate the short-term effect and safety of hematoporphyrin injection combined with LED-IB complex narrow-spectrum photodynamic therapy for venous malformations. Methods: A total of 280 patients with venous malformations were enrolled from December 2011 to November 2015. There were 116 males and 164 females. The lesions were located in 162 cases of head and face, 63 cases of neck, 30 cases of limbs, 25 cases of trunk The lesion size ranged from 6.3 to 92.0 cm ~ 2, with an average of 30.7 cm ~ 2. The bolus injection of hematoporphyrin at a dose of 3-5 mg / kg was bolted to the LED-IB composite narrow-band photodynamic therapy apparatus for 20-35 min immediately after bolus injection of half dose. The irradiation dose was 80 mW / cm2 for children, Adult 100 m W / cm ~ 2. Comparison of treatment before and after erythema regression and adverse reactions. Results: A total of 280 patients were treated 504 times, an average of 1.8 times. Follow-up 1 ~ 4 a, average 2.1 a. Results: Excellent in 204 cases, good in 62 cases, poor in 14 cases, the effective rate of 95%, no recurrence during the follow-up period. After treatment, most of the patients had edema for 3 to 5 days and scabbed for 5 to 7 days. Edema was found in 2 patients for 20 days. One patient had transient pigmentation and 1 patient had transient skin photoperiod. Up to 3 months; 2 patients with scar too thick due to scab plus care improper. Conclusion: The technique of LED-IB narrow-spectrum photodynamic therapy for treatment of venous malformations is simple and effective, and the photosensitizer is safe to use. There are few side effects after treatment and during follow-up.