婴幼儿腮腺咬肌区静脉畸形的平阳霉素局部硬化治疗  

Sclerotherapy of infantile venous malformations located in parotid masseteric region with pinyangmycin

作　　者：侯劲松[1] 唐海阔[1] 汪淼[1] 李唐新[1] 杨小平[1] 廖贵清[1] 黄洪章[1] 

机构地区：[1]中山大学光华口腔医学院.附属口腔医院.口腔医学研究所,广州510055

出　　处：《中华口腔医学研究杂志（电子版）》2010年第2期26-28,共3页Chinese Journal of Stomatological Research(Electronic Edition)

摘　　要：目的探讨婴幼儿腮腺咬肌区静脉畸形的无创治疗方法及其疗效。方法采用平阳霉素局部注射治疗婴幼儿腮腺咬肌区静脉畸形19例,隔周1次,连续4次为1个疗程。1个疗程不能治愈者,间隔1周开始第2疗程治疗。记录病变转归和不良反应,追踪随访,评价疗效。结果经过3～8次局部注射,16例患儿完全治愈,腮腺咬肌区病变消退,表面皮肤色泽正常。注射期间未见局部溃疡,无过敏病例。随访1～3年,未见复发,无瘢痕形成及面神经损伤症状。3例病变范围较大的患儿,注射1疗程后因疗效不显著,分别改行手术或翻瓣激光联合平阳霉素腔内注射治疗,随访可见手术瘢痕,腮腺咬肌区轻度凹陷畸形,手术治疗的1例出现面神经损伤症状,3例均无复发。结论平阳霉素局部注射治疗婴幼儿腮腺咬肌区静脉畸形治愈率高,不遗留瘢痕,不损伤面神经,是值得推荐的治疗方式。但对大范围的静脉畸形疗效较差,需配合其它治疗。Objective To investigate non-traumatic method for treatment of infantile venous malformation located in parotid masseteric regions, and to evaluate its clinical effect. Methods Nineteen patients were treated by intralesional injections of Pinyangmycin. The processes were repeated at an interval of one week, but not more than 4 injections within a treatment period. In case of necessary, the secondary period was performed 2 weeks later. The general and local adverse responses were recorded and the clinical outcomes were followed-up from 1 to 3 years. Results Complete clinical resolutions were achieved in 16 patients after 3 to 8 injections. The venous malformations disappeared and were replaced by normal skins. No ulceration or allergy was found during the treatment. No clinical recurrence or scar was observed through out follow-up. The functions of facial nerve were remained normally in all patients. 3 patients with huge venous malformations received surgical management or laser therapy combined with sclerotherapy after 4 injections for their poor clinical results. Operative scars and slight depression deformities in parotid gland regions were observed in 3 patients. Symptoms of facial nerve damage appeared in infant receiving operative treatment. No recurrence was found in all cases as well. Conclusions Treatment of infantile venous malformation in parotid gland region with intralesional injections of pinyangmycin revealed a high rate of complete clinical resolution, and did not damage facial nerve or form facial scar. It could be regarded as an effective and non-traumatic therapeutic method for infantile venous malformations in parotid masseteric regions. Comprehensive treatments might be employed in huge lesions.

关 键 词：婴幼儿 腮腺咬肌区 静脉畸形 平阳霉素 硬化治疗 

分 类 号：R782[医药卫生—口腔医学]