平阳霉素瘤内注射治疗儿童腮腺血管瘤51例临床分析  

Intralesional Pingyangmycin therapy for 51 infantile patients with parotid gland hemangiomas

作　　者：王莉莉[1] 高庆红[1] 刘坤[2] 王晓毅[1] 王昌美[1] 温玉明[1] 

机构地区：[1]四川大学华西口腔医院头颈肿瘤外科,四川成都610041 [2]四川省肿瘤医院口腔科,四川成都610041

出　　处：《上海口腔医学》2009年第2期142-146,共5页Shanghai Journal of Stomatology

基　　金：四川省卫生厅科学研究基金项目(960041)~~

摘　　要：目的:探讨平阳霉素(Pingyangmycin,PYM)瘤内注射治疗儿童腮腺血管瘤的临床疗效。方法:回顾性分析四川大学华西口腔医院1990年5月—2005年5月治疗的儿童腮腺血管瘤51例。其中,男21例,女30例,男女比例为1∶1.43;患儿年龄为6个月～4岁,平均年龄10个月。深部血管瘤38例,混合型血管瘤13例;26例(50.98%)瘤体大小在4cm×4cm以上;右侧27例,左侧24例,无双侧受累者。经全身体检和血常规检查,确定无其他严重疾病,6个月后接受PYM瘤内注射治疗。8mg注射用盐酸PYM溶解于8mL生理盐水,并加入5mg地塞米松磷酸钠注射液。每次用量0.5～1mg,每4周注射1次,连续注射5次后,间隔2～3个月。用药总量一般不超过20mg,最大剂量35mg。采用SPSS10.0软件包对瘤体直径≥4cm者与<4cm者的疗效进行χ2检验。结果:42例(82.35%)瘤体基本消失,皮肤色泽正常,面部对称;8例(15.69%)瘤体部分退化;1例(1.96%)无明显变化。无腮腺分泌障碍和面神经损伤症状;未发现肺纤维化或生长抑制现象。统计学分析表明,疗效与瘤体大小无显著相关性。结论:PYM瘤内注射疗法可作为儿童腮腺血管瘤的首选治疗方法之一,超声波检查对其诊断和治疗有辅助作用。PURPOSE： To investigate the indication and outcome of intralesional Pingyangmycin （PYM） therapy for parotid gland hemangiomas in early childhood. METHODS： 51 infantile patients with hemangiomas in the parotid gland were studied retrospectively, which had been treated in the clinic of West China Hospital of Stomatology, Sichuan University during the 15-year period from May 1990 to May 2005. In this study, 21 were male, 30 were female, and the ratio of male to female was 1：1.43. The age of the children ranged from 6 months to 4 years, with an average age of 10 months. 38 were deep-seated hemangiomas, and 13 were mixed hemangiomas. 27 were in the right parotid gland and 24 in the left, no bilateral case. All the patients underwent intralesional injection of a solution of 8mg PYM in 8mL normal saline mixed with 5mg dexamethasone. The total dose of PYM ranged from 20mg to 35mg, which was administered 0.5 or 1 mg per injection. SPSS10.0 software package was used to compare the treatment efficacy between the patients with hemangioma≥4cm in diameter and 〈4cm in diameter. RESULTS： Hemangiomas of 42 cases （82.35%） showed complete resolution with good appearance, 8 cases （15.69%） were partly regressed, and 1 case （1.96%） had no obvious size change. No serious side effects were seen, such as pulmonary fibrosis and growth inhibition. No significant correlation was found between treatment efficacy and tumor size. CONCLUSION： Intralesional PYM therapy maybe is a selective primary therapy option for parotid gland hemangioma, and ultrasonography should be useful for diagnosis and treatment of this lesion. Supported by Scientific Research Grant from Science and Technology Bureau of Sichuan Province （Grant No. 960041）.

关 键 词：血管瘤:腮腺:平阳霉素 

分 类 号：R739.8[医药卫生—肿瘤]