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目的观察光动力疗法抗食管真菌感染的疗效。方法临床及病理确诊为食管癌合并食管白色念珠菌感染的患者1例,静脉注射光敏剂PSD-007 5 mg/kg后6 h,以波长630nm的半导体激光(激光功率密度150 mW/cm2)出光段为3 cm的柱状光纤分节段及分次进行照射。食管癌或食管癌合并白色念珠菌感染灶处,每光斑照射30 min;单纯白色念珠菌感染灶,每光斑照射15 min。观察术中和术后不良反应发生情况,根据相应标准进行近期临床疗效评价。结果该患者共进行了3次PDT治疗,其中距门齿21～24 cm的食管癌2次治疗后达到完全效应,伴发的白色念珠菌感染1次治疗后治愈;距门齿25～28 cm念珠菌性食管炎2次治疗后治愈;距门齿35～33、33～30 cm的食管癌分别经2次和3次治疗后达到明显效应。除距门齿21～24 cm的食管癌第2次PDT治疗病变完全消失后遗留少量瘢痕外,余区未发生瘢痕,狭窄、穿孔等不良反应。结论光动力疗法不仅能有效控制进展期食管癌,还能有效治疗食管白色念珠菌感染,具有高选择性、安全、毒副作用小、可重复应用等优点,对食管真菌感染,尤是对食管真菌感染合并食管癌的患者是一种有希望的治疗方法。
Objective To observe the efficacy of photodynamic therapy against esophageal fungal infection. Methods One patient with esophageal cancer complicated with C. albicans infection was diagnosed clinically and pathologically. Six hours after intravenous instillation of PSD-007 5 mg / kg photosensitizer, a diode laser with a wavelength of 630 nm (laser power density 150 mW / cm2) Segments of 3 cm columnar fiber sub-segments and graded irradiation. Esophageal or esophageal cancer combined with Candida albicans infection at each spot irradiation 30 min; Candida albicans infection focus, each spot irradiation 15 min. Observe intraoperative and postoperative adverse reactions, according to the corresponding standard for clinical evaluation of clinical efficacy. Results A total of 3 PDTs were performed in this patient, of which the complete effect was achieved after 2 treatments of 21 ~ 24 cm of esophageal cancer, followed by 1 treatment of Candida albicans infection; Esophagitis was cured after 2 treatments; esophageal cancer with 35-33 and 33-30 cm away from the incisors achieved obvious effect after 2 and 3 treatments, respectively. Except for a small amount of scar left after the second PDT treatment of esophageal cancer 21 to 24 cm away from the incisors, scarring, stenosis, perforation and other adverse reactions did not occur in the remaining area. Conclusion Photodynamic therapy can not only effectively control advanced esophageal cancer, but also can effectively treat Candida albicans infection in esophagus. It has the advantages of high selectivity, safety, small toxic and side effects, reusable application and so on. Infection with esophageal cancer patients is a promising treatment.