眼眶恶性嗜酸性肉芽肿15例临床特点及疗效分析  

Clinical study on treatment efficacy of malignant eosinophilic granuloma of orbit in 15 children

作　　者：张谊[1] 张伟令[1] 黄东生[1] 王一卓[1] 胡慧敏[1] 洪亮[1] 支天[1] 秦静[1] 陈丽萍[1] 

机构地区：[1]首都医科大学附属北京同仁医院儿科,100176

出　　处：《中华实用儿科临床杂志》2014年第15期1158-1160,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的 了解以眼眶包块起病的儿童眼眶恶性嗜酸性肉芽肿的临床特点及疗效分析.方法 2007年4月至2013年4月收治的经病理诊断为嗜酸性肉芽肿患儿15例.男11例,女4例;中位年龄2.25岁（1～12岁）.15例患儿应用MVP[甲氨蝶呤（M）＋长春新碱（V）＋泼尼松（P）]化疗方案治疗4例,改良化疗方案DAL-HX 83/90方案（依托泊苷＋泼尼松＋长春新碱）治疗11例.13例经手术结合化疗治疗,2例行单纯化疗治疗.统计分析15例患儿的临床发病特点、疗效及预后.结果 1.首发症状：眼眶包块、眼眶突出13例（86.7％）,病眼斜视、视力下降、眼痛3例（13.3％）;15例患儿均无发热表现.2.发病眼别：右眼眶起病7例（46.7％）,左眼眶8例（53.3％）.3.随访至2013年10月,中位随访时间17个月（8～71个月）,15例均获随访.13例患儿病灶完全吸收,2例病灶大部分吸收,所有患儿未见局部复发.5例患儿斜视、视力下降及眼痛经治疗后症状好转,无功能障碍.结论 儿童眼眶恶性嗜酸性肉芽肿起病隐匿,临床表现不典型,应注意鉴别诊断.儿童眼眶嗜酸性肉芽肿对化疗敏感,经综合治疗及随访病灶吸收率较高.Objective To study clinical character and analysis efficacy of orbit malignant eosinophilic granuloma for first symptom with orbit mass in children.Methods A total of 15 patients with orbit malignant eosinophilic granuloma in children were diagnosed using pathology hospital from Apr.2007 to Apr.2013 （11 cases of male,4 cases of female）.The median age was 2.25 years old（1-12 years）.In 15 cases,4 cases of chemotherapy using MVP project [methylamine （M） ＋ viucristine（V） ＋ prednisone（P）],and 1 1 cases of chemotherapy using DAL-HX 83/90 project [etoposide （VP-16） ＋ prednisone ＋ vinblastine].Thirteen cases were treated by using surgery and chemotherapy,and 2 cases were treated using single chemotherapy.Statistics analysis clinical characters,efficacy and prognosis of 15 cases of malignant orbit eosinophilic granuloma in children.Results 1.First symptom：13 cases of orbit mass and extruded with eyeball（86.7%）,3 cases of strabismus and diminution of vision and eyes pain（13.3%）,and no fever of all patients.2.Eye of the disease come on：right orbit was 7 cases,accounted for 46.7%,and left orbit was 8 cases,accounted for 53.3 %.3.Follow up to Oct.2013,median time was 17 months （8-71 months）,15 cases were followed.The niduses of 13 cases were complete absorbed,the niduses of 2 cases were most absorbed.In 15 cases,no patient was relapse.Five patients with strabismus and diminution of vision and eyes pain were recover after chemotherapy and no function obstruction.Conclusions Malignant orbital eosinophilic granuloma in children insidious onset,and atypical clinical manifestations,should pay attention to the differential diagnosis.Orbital eosinophilic granuloma in children sensitive to chemotherapy.The focus absorption rate by comprehensive treatment and follow-up is higher.

关 键 词：嗜酸性肉芽肿 眼眶 化疗 手术 儿童 

分 类 号：R739.7[医药卫生—肿瘤]