光动力治疗过程中的疼痛和缓解对策

目的：调查光动力治疗（photodynamic therapy，PDT）过程中疼痛的相关影响因素，以及缓解疼痛的有效方法。方法：在PubMed数据库中检索PDT过程中疼痛的临床研究文献，并对数据进行总结。结果：治疗过程中的疼痛是PDT最常见的不良反应。与疼痛相关的因素包括光敏剂类型、病损部位和大小、辐照剂量、光源类型和波长等。多种疼痛缓解对策已经被研究，大多数研究显示，外用局麻药物对缓解PDT疼痛无效。对治疗部位冷却能部分缓解PDT疼痛，但效果是不充分的。神经阻滞可以有效地缓解PDT疼痛。结论：治疗部位冷却是缓解PDT疼痛，提高患者耐受度最简单、最经济的方法，作为临床优先方案被推荐使用。对于简单冷却效果不佳的患者，可以选择神经阻滞来有效控制PDT过程中的疼痛。

Pain during photodynamic therapy and its relief strategies

Objective:To investigate the factors of pain associated with photodynamic therapy (PDT) and find the effective methods for relieving the pain during treatment. Methods:The literature on the clinical research of pain resulting from PDT was thoroughly searched for by PubMed and the published data were summarized. Results:The pain during PDT is the most commonly reported adverse effect. Various factors inlfuencing pain include the type of photosensitizer, the site and size of lesion, irradiation dose, light source and wavelength. Numerous strategies for relieving pain during PDT have been studied. The most studies showed that topical anesthetics had no beneift to relieving the pain from PDT. Cooling the site of PDT treatment could partially relief the pain but the efifcacy was insufifcient. Nerve blocks could efifciently relief the pain during PDT. Conclusion:Cooling the site during illumination is an easy and inexpensive way to make PDT treatment more tolerable for the patient and has been recommended as a priority scheme to be used in clinic. For rare cases in which cooling simply fails to control the pain, nerve block can be adopted.