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1、喜泊芬-LED-IB复合窄光谱光动力治疗鲜红斑痣50例何瑞明1戴耕武21.成都长峰医院2.四川省人民医院 邮政编码:610023 【摘要】目的:探讨喜泊芬注射液作为光敏剂配合LED-IB复合窄光谱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
2、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2.5mg/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15~30min)。对某些特殊部位(如鼻唇沟,嘴
3、角,眼角、耳廓及颏部等)应适当缩短照射时间(一般为10~20min);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: 50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42例,基本治愈6例,明显好转2例,总有效率达100%。结论:喜泊芬注射液作为光敏剂配合LED-IB复合窄光谱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
4、词】鲜红斑痣 喜泊芬 LED-IB复合窄光谱光动力AbstractObjective:Toexplorethehi-Park-funInjectionasaphotosensitizerwith520nmsemiconductorlaserphotodynamictreatmentofPWSclinicaleffect.Methods:(1)dothepreparatoryworkbeforethetreatment.HiparkedFenstoredinthefreezerof-10℃firstscratchtes
5、tnegativebeforeinjectionofthephotosensitizer.Beirradiatedspotareasurroundingtheirshapestickerstextilestripbeforeirradiationalongthenon-irradiatedareaandcoveredwithadoublelayerofblackclothtapestripstopayattentionnottocovererythema,toleaveitsedges1mmappropriate.I
6、rradiationareatotrytochoosethesametimetomaintainthecleanlinessoftheirradiatedareas,andticknetblockedhairinaplane.Alsonotethattokeeptheairwayopen.(2)intravenousinfusionofthephotosensitizer.PhotosensitizerhiparkedFengeneraldosageof5mg/kgbodyweight,dilutedwith250m
7、lofsalineintravenousinfusion,youcanenjoyabolusphotosensitizersideilluminated.(3)illumination.Illuminatedbeforeadjustmentaccordingtothetreatmentplanandthedeterminationoftheendofthefiberoutputpower,thetimeronthepowermetermonitoring.Thelaserdosegeneralforchildren8
8、0mW/cm2,andadultof100mW/cm2.Theirradiationshouldbekepttheheadandperpendiculartotheirradiatedsurfaceofthebeamexpander,andpayattentiontothesizeofthelightspot,closeobservationo