平阳霉素局部注射治疗婴幼儿血管瘤的系统评价
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[摘要] 目的 探索平阳霉素注射治疗婴幼儿血管瘤的效果。 方法 58例患儿随机分为实验组和对照组，实验组患者采用平阳霉素4～8 mg，2%利多卡因3～4 mL，加生理盐水2～4 mL，等量稀释，根据瘤体大小，从中央开始多点注射，注射剂量按平阳霉素0.2～0.3 mg/kg计算，每次总量不超过8 mg，注射至瘤体表面苍白肿胀为度。对照组未加用平阳霉素。观察分析两组总有效率、不良反应情况。 结果 实验组与对照组的总有效率比较，差异具有统计学意义（93.10% vs 72.41%，P < 0.05）；两组患者出现发热、胃肠反应及皮肤溃疡等不良反应比较，差异均无统计学意义（P > 0.05）。 结论 平阳霉素注射治疗血管瘤方法较为简单，疗效确切，且并发症少，对年龄较小的患儿是一种较为安全的治疗方法。
[关键词] 平阳霉素；注射；婴幼儿；血管瘤
[中图分类号] R782.22 [文献标识码] C [文章编号] 1673-7210（2012）07（b）-0153-02
Effect of injection treatment of Pingyangmycin on angeioma for nurseling
LIANG Tao1 ZHANG Jianwen2
1.Department of Pharmacy, the First Affiliated Hospital of Zhengzhou College, He′nan Province, Zhengzhou 450052,China；2.Department of Orthopedics Surgery, the First Affiliated Hospital of Zhengzhou College, He′nan Province, Zhengzhou 450052, China
[Abstract] Objective To explore the effect of the injection treatment of Pingyangmycin on angeioma for nurseling. Methods 58 children patients were randomly divided into the experiment group and the control group. The Pingyangmycin of 4-8 mg, 2% Lidocaine and normal saline of 2-4 mL were used in the experiment group with diluted comparably. According to the size of tumor, multiple injections were given from the centre with 0.2-0.3 mg/kg until the cancer become pale and swelling, but not exceed 8 mg each time. Pingyangmycin was not used in control group. Total effective rate, untoward effect of the two groups were observed and compared. Results There was a statistically difference (93.10% vs 72.41%, P < 0.05) in the total effective rate of two groups. The untoward effect of two groups, such as fever, gastrointestinal reaction and skin ulcer had no statistically difference (P > 0.05). Conclusion The injection treatment of Pingyangmycin in treating angeioma is easy, effective and has less complication, which is safe for little-aged children.
[Key words] Pingyangmycin; Injection; Nurseling; Angeioma
小儿血管瘤病是常见的先天性良性肿瘤，多发于头面部，由于该种体表肿物发展迅速，有时会侵袭面部器官，遗留有不同程度的畸形及功能障碍，应及早给予治疗[1-2]。血管瘤的治疗方法有很多，如手术切除、冷冻、同位素照射、局部注射药物等。目前多数报道认为在血管瘤注射治疗中，以平阳霉素注射治疗效果较佳，同时简便、安全，是具有中国特色的治疗方法。但由于各医院选择的病例不尽相同，而且血管瘤的类型、大小和部位不一，因而疗效有所差异。为了明确平阳霉素瘤内注射治疗婴幼儿血管瘤的确切疗效，我院采用平阳霉素治疗婴幼儿血管瘤共58例，获得良好的临床疗效，未发生严重并发症，现总结分析如下：
1 资料与方法
1.1 一般资料
本次观察对象共58例，均来自于2009年7月～2011年11月郑州大学第一附属医院整形外科治疗的患儿，其中男32例，女26例；最大年龄为17个月，最小年龄为8个月；部位：头面部35例，躯干10例，四肢13例；瘤体大小：1.5 cm×1.2 cm×1.0 cm～4.0 cm×6.0 cm×3.0 cm。血管瘤类型为毛细血管瘤或海绵状血管瘤。全部患儿随机分为实验组和对照组各29例，两组患儿在性别、病情等一般资料比较，差异均无统计学意义（均P > 0.05），具有可比性，见表1。进行研究的患儿均由家长签定了知情同意书，并获得我院伦理委员会批准。