平阳霉素联合地塞米松瘤体内注射治疗小儿特殊部位血管瘤的疗效  

Clinical Observation on Injection of Pingyangmycin Combined with Dexamethasone in Treatment of Hemangioma at Peculiar Site in Children

作　　者：魏华[1] 丁勇[1] 孔燕[1] 王银春[1] 孙玉华[2] 

机构地区：[1]徐州医学院附属医院小儿外科,江苏徐州221002 [2]徐州医学院附属医院口腔科,江苏徐州221002

出　　处：《实用儿科临床杂志》2012年第12期953-955,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的总结和评价平阳霉素联合地塞米松瘤体内注射治疗小儿特殊部位血管瘤的疗效。方法回顾性分析本院2005年1月-2010年12月应用平阳霉素联合地塞米松瘤体内注射治疗小儿特殊部位血管瘤27例临床资料。将平阳霉素8 mg+地塞米松5 mg+20 g.L-1利多卡因1～2 mL+9 g.L-1盐水稀释至8 mL,配制成1 g.L-1平阳霉素注射液。按体表瘤体面积每1.0 cm×1.0 cm注射1 mL平阳霉素注射液计算注射量。根据瘤体大小的不同,治疗时可在同一刺入点向不同方向注射药物,注射后以血管瘤体表面皮肤或黏膜肿胀变白为限,局部施压延长药物在瘤体内的作用时间。对面积稍大的血管瘤,可采用多处进针注射的方法,一般以2、3个点为宜。1次平阳霉素用量不超过8 mg。观察2周,根据瘤体颜色及硬度决定是否继续用药,直至瘤体开始变硬萎缩为止,平阳霉素注射总量不超过40 mg。结果 27例小儿特殊部位血管瘤行瘤体内注射治疗,2例出现发热,1例出现轻微胃肠道反应,均未予任何处理,1～2 d恢复正常,另1例患儿在注射2次后出现唇部黏膜溃疡,经换药愈合。治愈22例(81.5%),显效5例(18.5%),有效率达100%。随访1～2 a未见复发。结论平阳霉素联合地塞米松瘤体内注射治疗小儿特殊部位血管瘤能减少对组织结构的破坏,最大程度保持形态功能的完整,是安全、简便易行、有效的治疗方法。Objective To evaluate the effect of pingyangmycin combined with dexamethasone infusing therapy on hemangioma at pecu-liar site in children. Methods From Jan.2005 to Dec.2010,27 cases with hemangioma at peculiar site were treated in Affiliated Hospital of Xuzhou Medical College by injecting pingyangmycin combined with dexamethasone.Eight mg of pingyangmycin,5 mg of dexamethasone and 1-2 mL of 9 g·L-1 20 g·L-1 lidocaine were dissolved in 6-8 mL of 9 g·L-1 saline.The concentration of pingyangmycin was 1 g·L-1 and the treatment dosage was based on the size of the hemangioma.The therapeutic dosage was 1 mL per cm2.Pingyangmycin was applied to inject into hemangioma from different directions through the same puncture points and local pressure was induced to prolong the action time in tumor.And then the larger hemangioma was performed in several points and 2 to 3 points were appropriate.Pingyangmycin solution was injected into children hemangioma at peculiar site until it began to swell and got pale with a dose less than 8 mg.Hardness and color of tumor lesion indicated whether it needed to be injected once again till it began to shrink or get flatter in 2 weeks with a total dose less than 40 mg. Results Twenty-seven cases of children hemangioma at peculiar site were treated with pingyangmycin combined with dexamethasone infusing therapy.Among them,2 cases occurred low-grade fever,1 case occurred mild gastrointestinal reactions and recovered after 1-2 days without any treatment.Only 1 case occurred mucosa ulceration by injection 2 times and was cured by dressing change.Twenty-two cases were cured（81.5%）,5 cases were relieved（18.5%）,and the total efficiency rate was 100%.All patients were followed up for 1-2 years without recurrence. Conclusions Pingyangmycin combined with dexamethasone infusing therapy on children hemangioma at peculiar site may decrease the damage to tissue and keep the integrity of appearance and function as far as possible.The kind of treatment is a safe,convenient and efficient method.

关 键 词：特殊部位 血管瘤 平阳霉素 地塞米松 儿童 

分 类 号：R758.6[医药卫生—皮肤病学与性病学]