平阳霉素新剂型瘤体内注射治疗婴幼儿血管瘤203例临床分析  

Clinical analysis of 203 cases of infantile hemangioma treated by intralesional injection of a novel pingyangmycin

作　　者：刘学键 刘志鹏 武宜雷 邰茂众 LIU Xue-jian;LIU Zhi-peng;WU Yi-lei;TAI Mao-zhong(Department of Oncology,Economic Development Zone People's Hospital. Linyi 276023;Department of Clinical Medicine,Shandong First Medical University,Taiwan 271000;Special Department of Hemangiomas,Linyi Tumor Hospital,Linyi 2760001,Shandong Province,China)

机构地区：[1]山东省临沂经济技术开发区人民医院肿瘤科,山东临沂276023 [2]山东第一医科大学临床医学系,山东泰安271000 [3]山东省临沂市肿瘤医院省级血管瘤特色专科,山东临沂276001

出　　处：《中国口腔颌面外科杂志》2019年第3期247-250,共4页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:总结平阳霉素新剂型瘤体内注射治疗婴幼儿血管瘤的临床经验,评价其临床疗效和安全性。方法:回顾分析2016年4月-2017年4月接受平阳霉素新剂型瘤体内注射治疗的203例婴幼儿血管瘤患儿的临床资料。其中男54例,女149例;年龄2个月~6岁,中位年龄10个月。血管扩张型33例,丘疹型52例,肥厚型59例,深在型30例,混合型29例。初次治疗者147例,前期接受其他治疗者56例,均疗效不佳(其中前期口服普萘洛尔治疗38例,激光治疗18例)。将注射用水+平阳霉素新剂型配成1 mg/mL注射液,从病变周边潜行进针,在病变内注射药物,至瘤体肿胀、表面稍变白为止,勿将药液注射到瘤体深部组织内。每次平阳霉素用量不超过8 mg,病变较大者间隔1个月重复注射1次。采用Achauer等提出的4级分级标准对治疗效果进行评价。采用SPSS 18.0软件包进行统计学分析,各分型等级计数资料疗效比较采用秩和检验,5种分型Ⅳ级疗效率的比较采用χ^2检验。结果:随访1~2年,疗效评定为Ⅰ级0例,Ⅱ级5例,Ⅲ级31例,Ⅳ167例。5种分型的疗效有统计学差异。丘疹型疗效最佳,疗效Ⅳ级占94.2%,依次为血管扩张(93.9%)、肥厚型(91.5%)、深在型(51.7%)和混合型(43.4%)。3例患儿出现注射区轻度色素改变,10例出现低热,2天后自行恢复正常。无高热病例,无瘤体破溃、过敏性休克、肺纤维化病例。结论:平阳霉素新剂型瘤体内注射治疗婴幼儿血管瘤安全有效,以毛细血管扩张型、丘疹型和肥厚型疗效更佳,建议临床推广应用。PURPOSE: To summarize the clinical experiences of intralesional injection with a novel of pingyangmycin in the treatment of infantile hemangiomas, and to evaluate its clinical efficacy and safety. METHODS: Clinical data of 203 patients with infantile hemangiomas treated with a novel pingyangmycin injection from April 2016 to April 2017 were retrospectively analyzed. There were 54 males and 149 females. Median age was 10 months ranging 2 months to 6 years old. All 203 cases were classified into 5 types according to the classification methods reported by Liu Xue-jian et al.There were 33 cases of telangiectasis type, 52 of papule type, 59 of plump type, 37 of deep type and 22 of mixed type.There were 56 patients having received other treatments in the early stage, all of them responded poorly(including 38 patients receiving oral propranolol and 18 patients with laser therapy). Pingyangmycin injections were performed at a concentration of 1 mg/mL, and the injections did not stop until the tumors had swelling with slightly pale surface. The dose of pingyangmycin should not exceed 8 mg each time, and patients with large lesions were repeatedly injected at an interal of 1 month. The efficacy was evaluated on a 4-level scale proposed by Achauer et al. SPSS 18.0 software package was used for statistical analysis. RESULTS: After follow-up for 1 to 2 years, there were 167 grade Ⅳ cases, 31 grade Ⅲcases, 5 grade Ⅱ cases and 0 grade Ⅰ case. There were significant differences in the efficacy among 5 different types.Papule type showed the best curative effect with a Ⅳ efficacy rate of 94.2%, followed by 93.9% in telangiectasis type,91.5% in plump type, 51.7% in deep type and 43.4% in mixed type. Three children had mild pigmentation changes in the injection area. Fever occurred in 10 patients, but returned to normal 2 days later. There was no case of high fever,necrosis, allergic shock and pulmonary fibrosis. CONCLUSIONS: Injection of a novel pingyangmycin is recommended in the treatment of infantile hemangioma for its

关 键 词：婴幼儿血管瘤 新型平阳霉素制剂 不良反应 

分 类 号：R739.8[医药卫生—肿瘤]