平阳霉素治疗口腔颌面部血管瘤的远期疗效及适应证探讨  

Treatment of Hemangioma in Oral and Maxillofacial Region with Intralesional Injection of Pingyangmycin

作　　者：刘学键 秦中平 李克雷 

机构地区：[1]山东省临沂市肿瘤医院省A级血管瘤,淋巴管瘤特色专科,山东临沂276001

出　　处：《上海口腔医学》2001年第4期295-298,共4页Shanghai Journal of Stomatology

摘　　要：目的　评价平阳霉素治疗口腔颌面部血管瘤的远期疗效和适应证。方法　采用平阳霉素瘤内注射治疗口腔颌面部血管瘤患者 10 40例。其中男 312例 ,女 712例 ,年龄 1月～ 5 7岁。治疗方法为分次、多点瘤内注射 ,间隔14～ 2 1d重复注射 ,2～ 3次为 1个疗程。结果　随访 1～ 13a ,获得性蜘蛛样血管瘤、毛细血管瘤、混合性血管瘤、海绵状血管瘤的疗效最好 ,治愈率分别为 10 0 %、96 .40 %、92 .2 0 %和 6 7.2 0 % ,对蔓状血管瘤和鲜红斑痣疗效不佳。平阳霉素最佳用量为 1mg/cm2 ,治疗毛细血管瘤的最佳浓度为 1mg/1ml;治疗海绵状血管瘤时 ,浓度应达 3～ 4mg/ml。发热反应发生率 6 .5 4% ,无肺纤维化发生。结论　平阳霉素局部注射可作为中、小型获得性蜘蛛样血管瘤、毛细血管瘤、混合性血管瘤、海绵状血管瘤的首选治疗方法 ,其疗效确切、安全、简便、疗程短 ,美容效果好。Objective To investigate the indication and long term treatment results of intralesional injection of Pingyangmycin for hemangiomas in oral and maxillofacial regions. Methods Between June 1986 and June 2000,1040 patients with maxillofacial hemangiomas were treated by intralesional injection of Pingyangmycin(PYM). There were 312 males and 712 females. The types of hemangiomas included capillary(436), cavernous(238), mixed(260), arterial-venous malformation(8)and port wine stain (9). The injection was performed in stages and multi-sites, repeated after 14 to 21 days for 2 to 3 times as one course. Results All the patients were followed up for 1 to 14 years. The cure rates of capillary, mixed and cavernous hemangioma were 96.40%, 92.20% and 67.20%, respectively. No effect was found for arterial-venous malformations. The best dose-effect was attained in 1mg/cm 2. The best concentration of Pingyangmycin was 1mg/ml for capillary hemangioma and the concentration may be higher for cavernous hemangiomas. Fever occurred in 6.54% of the cases. Serious complications associated with Pingyangmycin injection, such as pulmonary fibrosis were not found. Conclusions Intralesional injection of Pingyangmycin can be used as the therapy of choice for capillary, mixed and cavernous hemangiomas in oral and maxillofacial region. The advantages included a high cure rate, safety, short course, manipulation with ease and fewer side effects.

关 键 词：平阳霉素 血管瘤 口腔颌面部 局部注射 

分 类 号：R739.8[医药卫生—肿瘤]