手术切除联合ALA-PDT治疗Fisher大鼠9L胶质瘤的实验研究

目的 观察手术切除联合ALA-PDT治疗Fisher344大鼠9L脑胶质瘤的效果并探讨其作用机制.方法 32只Fisher 344大鼠颅内种植9L脑胶质瘤细胞7 d后,随机分为对照组(未治疗)、手术组(近全切除颅内肿瘤)、PDT组(5-ALA 300 mg/kg,激光能量密度80 J/cm2)和联合治疗组(手术切除+PDT),每组8只鼠.治疗后7 d处死所有动物并取出脑组织,常规石蜡包埋切片,HE染色分析肿瘤体积和浸润瘤灶,以Ki67免疫组化染色和TUNEL染色方法分别分析胶质瘤细胞的增殖和凋亡.结果 与对照组比较,手术组和PDT组的肿瘤体积明显减小.与手术组和PDT组相比,联合治疗既能缩小肿瘤体积又可以减少浸润瘤灶.无论是否联合手术,PDT均能增加凋亡的肿瘤细胞数,单纯手术对凋亡的肿瘤细胞无影响.各组之间肿瘤细胞的增殖(Ki67阳性表达率)无显著性差异.结论 PDT通过增加凋亡的肿瘤细胞数,杀灭浸润的肿瘤病灶,提高手术的治疗效果.     

神经导航在颅内肿瘤手术治疗中的应用价值探讨

目的：探讨神经导航在颅内肿瘤切除中的应用价值。方法采用病例对照研究,导航组和对照组按1：1配对,每组82例颅内肿瘤术病例,比较肿瘤全切除率、神经功能损伤率和住院时间。结果导航组颅内肿瘤全切率95.1%,神经功能损伤率14.6%,平均住院日8天,对照组肿瘤全切率70.7%,神经功能损伤率30.5%,平均住院日15天。结论在颅内肿瘤切除手术中,应用神经导航系统能准确定位肿瘤及重要神经结构,显著提高肿瘤全切率,并降低手术相关的神经功能损伤,具有广泛的应用价值。     

初级皮质运动区和锥体束的可视化研究及应用

目的探讨基于血氧水平依赖功能磁共振成像(BOLD-fMRI)和弥散张量成像(DTI)的功能神经导航技术在神经外科手术中对脑功能区进行显微镜下可视化的可行性。方法连续收集2009年2月-2010年7月初级运动皮质及锥体束附近病变患者278例,男156例,女122例,年龄40.7±15.9(7~79)岁。278例中胶质瘤231例,转移瘤5例,脑膜瘤16例,海绵状血管瘤18例,动静脉畸形2例,血管内皮细胞瘤1例,生殖细胞瘤3例,淋巴细胞瘤2例,均在功能神经导航下行手术切除。术前应用BOLD-fMRI及DTI技术进行扫描,通过导航工作站重建手运动区和锥体束并将导航影像投射至手术显微镜,用于镜下导航。比较患者术前及术后的肌力、运动功能及KPS评分,并统计手术并发症发生情况。结果 278例患者中217例(78.1%)病变切除≥95%,246例(88.5%)病变切除≥90%,259例(93.2%)病变切除≥80%;术后1周内神经功能障碍加重发生率为22.3%(62/278),随访1~6个月神经功能障碍发生率为6.8%(19/278)。结论在神经外科手术中应用fMRI及DTI结合功能神经导航对脑功能区进行显微镜下可视化是可行的,可最大限度地切除病变,减轻神经功能损伤,有利于术后功能恢复。     

光动力疗法对荷瘤小鼠血清中TNF-α含量影响的实验研究

目的探讨光动力疗法（PDT）抑瘤效应的免疫机制,以及PDT联合肿瘤局部注射卡介苗（BCG）的治疗效果。方法建立小鼠Heps肝癌移植瘤模型72只,随机分为对照组、PDT组、BCG组和联合组,每组18只。观测各组移植瘤体积的变化。采用酶联免疫吸附实验（ELISA）,测定各组PDT治疗后2、24 h和7 d荷瘤小鼠血清中肿瘤坏死因子（TNF）-α的变化。结果 1.各治疗组治疗后7 d的移植瘤体积较对照组均明显缩小（P〈0.01）。治疗后7 d联合组的肿瘤体积较PDT组明显缩小（P〈0.05）。2.ELISA结果显示,治疗后2、24 h和7 dPDT组和联合组荷瘤小鼠血清中TNF-α的含量均明显高于对照组和BCG组（P〈0.01）,联合组荷瘤小鼠血清中TNF-α的含量明显高于PDT组（P〈0.05）。结论 PDT可增强荷瘤小鼠全身的免疫力,肝癌移植瘤体积明显缩小。PDT联合局部注射BCG的疗效优于单用PDT和单用BCG。     

复方丹参注射液治疗脑出血的临床观察

目的观察丹参对急性脑出血的治疗效果。方法将86例脑出血患者随机分为两组,分别进行常规治疗(对照组)和早期加用丹参注射液(治疗组)治疗;观察治疗前后两组病人的颅内血肿、血肿周围水肿带面积及神经功能缺失评分的改变以及疗效。结果治疗组较对照组血肿及周围水肿带面积明显缩小(P<0.05),神经功能缺失评分明显改善(P<0.01),治疗组疗效明显高于对照组(P<0.05)。结论早期应用丹参治疗脑出血可明显改善其病情及预后。     

碘125治疗裸鼠胶质瘤的实验研究

目的:通过建立裸鼠右肩皮下C6胶质瘤动物模型,研究碘125间质内照射对恶性胶质瘤的治疗作用。方法:Balb/c裸鼠30只。体外培养大鼠C6胶质瘤细胞,接种于裸鼠右肩皮下建立肿瘤模型。肿瘤形成后对照组(15只),注入无碘125材料,治疗组(15只)肿瘤中心注入碘125聚胺酯放射材料,4周时对比两组肿瘤体积、瘤重并处死取病理行组织学检查分析。结果:C6细胞接种后1周,裸鼠皮下均可见肿瘤形成。4周时对照组与治疗组肿瘤体积、瘤重差异明显(P<0.05),病理组织学检查见对照组肿瘤细胞呈典型的恶性星形细胞瘤特征,治疗组肿瘤细胞体积缩小及大量坏死。结论:碘125聚胺酯放射材料可通过间质内照射对C6胶质瘤细胞产生杀伤作用,明显抑制肿瘤生长。     

光动力疗法及其联合注射卡介苗对小鼠肝癌移植瘤的抑瘤作用与免疫反应

目的探讨光动力疗法(PDT)联合肿瘤局部注射卡介苗(BCG)的局部免疫反应及抑瘤效应。方法建立小鼠Heps肝癌移植瘤模型96只,随机分为对照组、PDT组、BCG组和PDT+BCG联合组。观测各组移植瘤体积的变化。以F4/80抗体为标记,采用免疫组化法计数肿瘤局部巨噬细胞(MΦ)数量。结果 1.各治疗组治疗后7 d的移植瘤体积较对照组均明显缩小(P<0.01)。联合组治疗后7 d的肿瘤体积较单纯PDT组明显缩小(P<0.05)。2.免疫组化染色结果显示,PDT组和联合组治疗后2、24 h和7 d肿瘤局部MΦ数量均明显高于对照组和BCG组(P<0.01)。上述时间点联合组肿瘤局部MΦ数量明显高于PDT组(P<0.05)。结论 PDT使小鼠肝癌移植瘤体积缩小,增强荷瘤宿主治疗局部的免疫力。PDT联合局部注射BCG的治疗方法的疗效优于单纯PDT和单纯BCG。     

脑干海绵状血管瘤的显微手术治疗(附41例报告)

目的总结脑干海绵状血管瘤(BSC)的临床特点、手术入路选择、显微外科切除技术要点,评价手术治疗BSCH的疗效。方法对海军总医院神经外科2003年1月-2011年4月行显微手术切除的41例BSC患者的临床资料以及手术治疗情况进行回顾性分析。男23例,女18例,年龄8～62岁。主要临床表现包括头痛、头晕,脑神经功能障碍、肢体麻木、肌力减退等长束征以及共济失调等。根据病灶所在部位,遵循"最短距离"的原则选择手术入路,术中行短潜伏期体感诱发电位(SSEP)和听觉诱发电位(AEP)监测。结果 41例患者中35例获BSC全切除,6例巨大病变有少部分残留。无手术死亡病例。术后27例神经功能障碍得到改善,14例出现新的神经功能缺失或原有神经障碍加重,其中2例呼吸功能受影响,人工辅助呼吸1周后恢复自主呼吸。平均随访38个月,有神经功能缺失的患者多数得到恢复,1例残余肿瘤再次出血,其余患者未见复发。结论根据病变部位和病灶突向的方式,选择个体化的手术入路,遵循"最短距离"原则,手术切除BSC能获得良好的预后,术中导航和脑干电生理学监测有助于减少手术损伤及降低并发症。     

DWI在胶质瘤与单发转移瘤及其瘤周水肿中的诊断价值

目的:探讨DWI在颅内肿瘤及其瘤周水肿中的诊断价值和病理生理机制。材料和方法:分析ADC值在高级别胶质瘤和颅内单发转移瘤的病灶实质及水肿带中的改变(36例)。感兴趣区取病灶实质部分(病灶强化部分)及病灶周围水肿带(将水肿带三等份,分别作为近瘤周区、居中及远瘤周区水肿带),分别测定前述感兴趣区ADC值,测定对侧正常颞叶脑皮质ADC值作为参照值,测定相对ADC值(rADC值)作为分析指标。结果:转移瘤病灶实质及水肿带的ADC值均高于胶质瘤,即在DWI图上前者与后者相比为稍低信号,两者水肿带间ADC值有显著差异。胶质瘤居中水肿带ADC值最低,低于近瘤周区及远瘤周区水肿带,有统计学差异。转移瘤居中水肿带ADC值稍低于近瘤周区及远瘤周区水肿带,但无统计学差异。结论:转移瘤病灶实质及水肿带ADC值均高于胶质瘤。胶质瘤水肿带成因除血管源性水肿之外,尚有部分原因为瘤细胞的浸润所致,肿瘤细胞阻碍了水分子的运动,此点有助于术前在DWI上鉴别两种肿瘤。     

CpG ODN联合光动力疗法对肝癌移植瘤生长及局部CD8+细胞毒性T细胞的影响

目的 探讨以CpG寡脱氧核苷酸(ODN)为免疫佐剂联合光动力疗法(PDT)的光免疫疗法(PIT)对小鼠Heps肝癌移植瘤的抗肿瘤及免疫效应.方法 92只ICR小鼠皮下接种肝癌Heps细胞建立荷瘤鼠模型,随机分为对照组、PDT组、CpG ODN组和PIT组,治疗后定期测量各组肿瘤体积,计算抑瘤率.免疫组化法计数肿瘤局部CD8+细胞毒性T细胞(CD8+CTLs).结果 (1)与埘照组相比,PDT组、CpG ODN组和PlT组治疗后16d肿瘤体积均明显缩小(P<0.01),抑瘤率分别为73.88%、20.09%、84.47%.PIT组肿痛体积较单纯PDT组明显缩小(P<0.05).(2)免疫组化染色结果显示,PDT组、CpG ODN组和PIT组治疗后2、24h肿瘤局部CD8+CTLs数量较对照组无明显变化(P>0.05),治疗后72h肿瘤局部CD8+CTLs数量,均明显高于对照组(P<0.05);PIT组肿瘤局部CD8+CTLs数量明显高于单纯PDT组(P<0.01).结论 CpG ODN能激活宿主免疫应答而有效增强PDT对小鼠Heps肝癌移植瘤的抗肿瘤及免疫效应.     

鼠移植胶质瘤手术加光敏治疗的实验研究

为探讨提高肿瘤手术疗效的方法，通过对昆明小鼠移植的传代Ｇ－４２２胶质瘤，进行手术切除加瘤床光动力学治疗的生存观察。实验研究证实：手术切除加瘤床光动力学治疗组的小鼠生存时间明显长于单纯手术切除组和带瘤自然生存组。说明Ｈｅ－Ｎｅ激光作实验光源的光动力学治疗能杀伤切除后残留术野的瘤细胞，导致术后复发率降低和生存期延长，为光动力学疗法用于脑胶质瘤手术的辅助治疗提供依据     

光动力疗法治疗胶质瘤围手术期的护理

目的总结光动力疗Ok（Photodynamic therapy,PDT）治疗胶质瘤的临床护理经验。方法胶质瘤患者30例,其中颅内胶质瘤28例,恶性畸胎瘤2例。通过PDT治疗和术前准备、术中术后护理、出院指导使患者接受治疗,积极配合治疗和护理,促进病情恢复。结果30例患者中9例出现皮肤光敏反应,3例SGPT升高,肝肾功能轻微损害,其余均恢复良好。结论PDT治疗胶质瘤中认真、细致的观察与护理对治疗有重要作用。     

高场强术中磁共振结合语言功能神经导航技术在胶质瘤手术中的应用

目的探讨高场强术中磁共振系统与语言功能导航技术联合应用对优势大脑半球语言功能区胶质瘤手术切除效果的影响。方法收集2009年2月-2010年7月与优势大脑半球弓形束关系密切的胶质瘤患者20例,男12例,女8例,年龄20~61岁,平均43.6岁,根据术前失语评分(AQ)将患者分为语言功能正常组(n=9)和语言功能障碍组(n=11)。所有患者均接受高场强术中磁共振及弓形束导航辅助下手术,采用1.5T移动磁体、双室设计的术中磁共振系统,术前通过软件将弓形束重建的3D图像整合入神经导航系统,并在术中联合应用显微镜下功能神经导航。术前及术后2~4周、3~6个月进行随访(包括MRI检查及西方失语成套测验)。结果 20例患者均完成术前及术中弓形束重建,将3D重建图像整合入神经导航系统后成功实现了显微镜下导航。术后2~4周,语言功能正常组AQ(94.5±5.5)保持在正常水平,只有1例出现新发的传导性失语症状(AQ=81.8),而语言功能障碍组AQ(89.4±5.8)与术前比较(84.9±8.7)有明显改善(P<0.05)。术后3~6个月,语言功能正常组中除2例因肿瘤复发出现语言功能恶化外,其余患者AQ(98.3±0.5)均在正常范围,而语言功能障碍组AQ(95.2±2.6)较术后2~4周也有了明显改善(P<0.05)。两组患者术后均未出现其他新的神经功能障碍,无死亡病例。结论高场强术中磁共振结合功能神经导航是一项可靠、稳妥的技术,在肿瘤毗邻重要语言功能区及传导束时,可辅助外科手术最大限度地切除肿瘤,减轻神经功能损伤,有利于术后功能恢复。     

Intraoperative MR Imaging during Glioma Resection

One of the major issues in the surgical treatment of gliomas is the concern about maximizing the extent of resection while minimizing neurological impairment. Thus, surgical planning by carefully observing the relationship between the glioma infiltration area and eloquent area of the connecting fibers is crucial. Neurosurgeons usually detect an eloquent area by functional MRI and identify a connecting fiber by diffusion tensor imaging. However, during surgery, the accuracy of neuronavigation can be decreased due to brain shift, but the positional information may be updated by intraoperative MRI and the next steps can be planned accordingly. In addition, various intraoperative modalities may be used to guide surgery, including neurophysiological monitoring that provides real-time information (e.g., awake surgery, motor-evoked potentials, and sensory evoked potential); photodynamic diagnosis, which can identify high-grade glioma cells; and other imaging techniques that provide anatomical information during the surgery. In this review, we present the historical and current context of the intraoperative MRI and some related approaches for an audience active in the technical, clinical, and research areas of radiology, as well as mention important aspects regarding safety and types of devices.     

Effect of photodynamic therapy and endostatin on human glioma xenografts in nude mice

The aim of this study was to investigate the effect of endostar (a recombinant human endostatin) and photodynamic therapy (PDT) on gliomas. To establish glioma xenografts, human U251 glioma cells were injected into the brain of nude mice. Mice with MRI-confirmed glioma received hematoporphyrin monomethyl ether (HMME)-mediated PDT, daily injection of endostar or their combination, respectively. After treatment, tumor volume, the expression of HIF-1α, VEGF-A and apoptosis marker, and animal survival were examined. PDT and endostar treatment can prolong survival. Changes in induction of apoptosis, tumor growth and survival were more significant in PDT + endostar group. After PDT, HIF-1α and VEGF-A expressions were markedly increased. After endostar treatment, HIF-1α and VEGF-A expressions were significantly reduced. PDT in combination with endostar can significantly inhibit the growth of glioma xenografts. This approach may represent a promising strategy in the treatment of glioma.     

光动力疗法联合顺铂治疗脑胶质瘤对血瘤屏障毛细血管内皮P-糖蛋白表达的影响

目的探讨光动力疗法联合顺铂治疗C6脑胶质瘤后,血瘤屏障中毛细血管内皮细胞上P-糖蛋白(P-gp)的表达及临床价值。方法建立雄性Wistar大鼠脑深部胶质瘤模型60只,2周后随机分成3组:光动力疗法联合顺铂组(20只)、非光动力疗法联合顺铂组(20只)、空白对照组(20只)。PDT联合顺铂组:腹腔注射血卟啉单甲醚(HMME,5mg/kg)3.5h后,自大鼠尾静脉注射顺铂1μg/g,30min后行PDT治疗。非光动力疗法联合顺铂组:除腹腔内未注射HMME外,余相同。空白对照组:不做任何处理。免疫组织化学方法分别检测脑胶质瘤血瘤屏障中毛细血管内皮细胞上P-糖蛋白的表达。结果PDT联合顺铂组、非PDT联合顺铂组阳性和对照组P-gp阳性表达率分别为5%、40%和45%。PDT联合顺铂组与非PDT联合顺铂组比较差异有显著意义(P0.05),PDT联合顺铂组与对照组比较差异有显著意义(P0.05),非PDT联合顺铂组与对照组比较差异无显著意义(P0.05)。结论光动力疗法联合顺铂治疗后血瘤屏障中毛细血管内皮细胞上的P-gp阳性表达率降低,促进药物通过血瘤屏障,为临床治疗脑胶质瘤提供新的途径和方法,具有重要的参考价值。     

Photodynamic therapy enhances the cytotoxicity of temozolomide against glioblastoma via reprogramming anaerobic glycolysis

The successful application of photodynamic therapy in the treatment of glioma (CNS WHO grade 4) depends in large part to the effect of killing cells in the infiltrating area after tumor had been removed, when combined with radiotherapy, chemotherapy, and targeted drug therapy. The purpose of this study was to investigate the potential mechanism of TMZ's involvement in the glioma's glycolytic metabolic pathway during photodynamic therapy. The low dose of photodynamic therapy treatment on the cell viability of gliomas was investigated by CCK8. Alterations in reactive oxygen species were detected by flow cytometer. The differentially expressed proteins related to glucose transporter 1 (GLUT-1), matrix metalloproteinase-2 (MMP-2)/actively MMP-2 and apoptosis-associated caspase-3/cleaved caspase-3 were evaluated by Western Blot experiment. Additionally, transmission electron microscopy observed apoptosis, necrosis and the changes of the ultrastructure in U251 cells. In addition, antitumor effects in vivo were tested using orthotopic BALB/c mice with the glioma U87 model. The findings showed that low dose PDT affected mitochondrial function by inducing radical oxygen, hindered cellular glucose transport and metabolism, and induced apoptosis. The results also showed that cell viability considerably decreased and increased cell apoptosis under the PDT therapy. The HIF-1/GLUT-1 axis enhanced the cytotoxicity of temozolomide in gliomas as a result of PDT treatment, which was influenced by ROS. As a result, this study presents PDT as a potential therapeutic approach for treating malignant glioma, and enhanced antitumor effect of TMZ by inhibiting glycolytic pathway.     

Gross-total surgery of supratentorial low-grade gliomas under intraoperative MR guidance

BACKGROUND AND PURPOSE: Length of survival of patients with low-grade glioma correlates with the extent of tumor resection. These tumors, however, are difficult to distinguish intraoperatively from normal brain tissue, often leading to incomplete resection. Our goal was to evaluate the effectiveness of intraoperative MR guidance in achieving gross-total resection. METHODS: We studied 12 patients with low-grade glioma who underwent surgery within a vertically open 0.5-T MR system. During surgery, localization of residual tumor tissue was guided by interactive, near real-time imaging. The amount of residual tumor tissue on MR images was evaluated at the point of the operation at which the neurosurgeon would have terminated the procedure under conventional conditions (first control) and again before closing the craniotomy. RESULTS: Significant residual tumor (more than 10% of original tumor volume) was shown in eight patients at the first control condition. The percentage of resection varied from 26% to 100% (mean, 68%) at this time. Twelve tissue samples from seven patients were obtained in areas identified as residual tumor on MR images. In 10 cases, the neuropathologic investigation confirmed the presence of residual low-grade glioma; in two cases, the borderzone of tumor was identified. In evaluating the final sets of images, we found total resection in six cases, over 90% resection in five cases, and 85% resection in one case (mean, 96%). CONCLUSION: Surgical treatment of low-grade gliomas under intraoperative MR guidance provides improved resection results with maximal patient safety.     

光动力疗法联合瘤体输注树突状细胞对小鼠肝癌移植瘤的抑制作用及免疫效应的研究

目的探讨光动力疗法（photodynamic therapy,PDT）联合瘤体内输注树突状细胞（dendritic cell,DC）的光免疫疗法（photody-namic immuno-therapy,PIT）对小鼠Heps肝癌移植瘤的抑制作用及免疫效应。方法体外培养昆明小鼠骨髓源性DC,4,＇6-二脒基-2-苯基吲哚（4,6-diamidino-2-phenylindole,DAPI）荧光染色液标记DC备用。128只昆明小鼠皮下接种Heps肝癌细胞建立肿瘤模型,随机分为对照组、PDT组、DC组和PIT组。对照组小鼠瘤体内注射生理盐水,PDT组单纯PDT治疗,DC组小鼠瘤体内注射DAPI标记的DC,PIT组PDT联合瘤体内注射DAPI标记的DC细胞。治疗后定期测量各组肿瘤体积,记录各组小鼠生存时间,荧光显微镜下计数DC组及PIT组小鼠淋巴结中荧光细胞数目,流式细胞仪测定各组小鼠外周血T细胞亚群,LDH释放法测定各组小鼠脾细胞杀伤活性。结果 （1）与对照组相比,PDT组与PIT组治疗后肿瘤生长明显受抑;（2）PDT组与PIT组小鼠生存时间延长;（3）高倍镜视野下DC组较PIT组荧光细胞数增多（P〈0.05）;（4）治疗后72 h,PDT及PIT组小鼠外周血CD8＋T细胞百分率均明显高于对照组和DC组（P〈0.01、P〈0.01）,其中PIT组较PDT组增高明显（P〈0.01）,（5）PDT组与PIT组小鼠脾脏细胞杀伤活性较对照组和DC组明显增强（P〈0.01,P〈0.01）。结论 PDT疗法能够抑制肿瘤生长并激发宿主免疫应答,联合输注DC可增强PDT对小鼠Heps肝癌移植瘤的抑制作用及免疫效应。     

光动力疗法与光动力疗法联合玻璃体腔注射贝伐珠单抗治疗中心性渗出性脉络膜视网膜病变的比较研究

目的比较光动力疗法(photodynamic therapy,PDT)与PDT联合玻璃体腔注射贝伐珠单抗(bevacizumab)治疗中心性渗出性脉络膜视网膜病变(CEC)的临床疗效及安全性分析。方法 CEC患者46例46只眼,随机分为两组,对照组22例22只眼,联合组24例24只眼。对照组单纯PDT治疗,联合组行PDT治疗1周后行玻璃体腔内注射贝伐珠单抗1.5 mg(0.06 ml)。两组患者术后1、3、6和12个月随访复查最佳矫正视力、眼底、眼底荧光造影(FFA)、吲哚青绿荧光造影(ICGA)和光学相干断层扫描(OCT)。随访时若发现脉络膜新生血管(CNV)部分闭合或仍有渗漏,联合组再行玻璃体腔注射贝伐珠单抗治疗,最短间隔1个月;对照组再行PDT治疗,最短间隔3个月。比较两组患者治疗前后最佳矫正视力、眼底改变、FFA、ICGA、OCT等,评价其疗效及安全性。结果两组患者视力较治疗前均显著提高。两组患者眼底病灶缩小、出血吸收、视网膜水肿消退。联合组19只眼(79.2%)CNV完全闭合,5只眼(20.8%)CNV大部分闭合,轻微荧光素渗漏;对照组15只眼(68.2%)CNV完全闭合,7只眼(31.8%)CNV大部分闭合,轻微荧光素渗漏。OCT显示两组患者术眼视网膜下液吸收,CNV强反射区域明显缩小;联合组和对照组患者黄斑区视网膜厚度均显著缩小。联合组患者仅接受一次PDT治疗,贝伐珠单抗玻璃体腔注射平均治疗次数1.75次;对照组患者PDT平均治疗次数为1.86次。两组患者治疗过程中及术后随访均未见明显眼部或全身不良反应。结论 PDT或PDT联合玻璃体内注射贝伐珠单抗治疗CEC均安全有效,联合治疗能更有效封闭CNV,促进视网膜渗出及出血的吸收,同时减少PDT治疗次数,减轻患者的经济负担,降低并发症发生。