光动力疗法治疗鲜红斑痣的疗效

Efficacy of photodynamic therapy on port-wine stain

目的探讨光动力疗法（photodynamic therapy，PDT）治疗鲜红斑痣的临床疗效和安全性。方法采用PDT治疗鲜红斑痣125例。根据患者体重，静脉推注相应的光敏剂PSD-007后，皮损局部行铜蒸气激光照射，至红斑肿胀渗出为治疗结点；每次治疗前采集红斑图像以评价治疗效果。2个月后复诊，采用5级分类法评价前次治疗的效果，并进行患者满意度调查，根据红斑减退变平等情况决定治疗结束或继续下一个疗程治疗。结果PDT治疗鲜红斑痣临床效果明显，治疗后即可出现明显的畸形血管肿胀封闭，经过4个疗程的治疗，治愈率达49．60％，显效率达96．00％，其中经过不到2个疗程的治疗，治愈率即达到13．60％。在整个治疗过程中，患者满意率为95．20％。结论PDT治疗鲜红斑痣疗效显著，美容效果好，不良反应小，值得临床推广应用。

Objective To observe the improvement in manifestation of port-wine stains （PWS） with photodynamic therapy （PDT）, and to further evaluate the safety and efficacy of PDT in treatment of PWS. Methods A total of 125 patients with PWS were treated with PDT. The lesion of PWS was exposured to the copper vapor laser locally after injection of photosensitizer PSD-007 based on the weight of body via vein. Before each session, lesions were photographed, and therapeutic effects were evaluated by physicians based on improvement in color, thickness, and lesion area recorded on the photos. Return visit was carried out after 2 months. The improvement rate was classified as 5 grades to value the therapeutic effect of last treatment. In addition, patients satisfaction was also investigated. The treatment was determined to terminate or continue depending on the change of red spot including color fading and flatting. Results Patients with PWS responsed remarkably to the PDT. The healing rate was 49.60 % and excellence rate 96.00 % after less than 4 session treatments. Among the total of healing patients, 13.60 % were released from PWS with no more than 2 courses of treatment. The satisfactory rate of patients was 95.20 % during observation. Conclusions PDT is a safe and highly effective treatment for PWS with good cosmetic results in the dermatologic clinic.