平阳霉素纤维蛋白胶复合剂与平阳霉素地塞米松复合剂治疗咽喉部静脉畸形的疗效比较  

Comparison of pingyangmycin fibrin glue composite and pingyangmycin dexamethasone composite in the treatment of pharyngolaryngeal venous malformation

作　　者：王博[1] 林宇[2] 乐慧君 郭文彬 陈林[1] 吕科兴 黄代营[3] 雷文斌[1] Wang Bo;Lin Yu;Yue Huijun;Guo Wenbin;Chen Lin;Lyu Kexing;Huang Daiying;Lei Wenbin(Otorhinolaryngology Hospital,the First Affiliated Hospital of Sun Yat-Sen University,Guangzhou Key Laboratory of Otorhinolaryngology,Guangzhou 510080,China;Department of Otorhinolaryngology-Head and Neck Surgery,the Second Affiliated Hospital of the Medical College of Shantou University,Shantou 515041,China;Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院耳鼻咽喉科医院,广州市耳鼻咽喉科重点实验室,广州510080 [2]汕头大学医学院第二附属医院耳鼻咽喉头颈外科,汕头515041 [3]中山大学附属第一医院口腔颌面外科,广州510080

出　　处：《中华耳鼻咽喉头颈外科杂志》2023年第6期552-557,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金(81972528,82273053,82203783);中山大学5010临床研究项目(2017004);广东省基础与应用基础研究基金(2022B1515130009)。

摘　　要：目的:分析并比较平阳霉素纤维蛋白胶复合剂(pingyangmycin fibrin glue composite,PFG)与平阳霉素地塞米松复合剂(pingyangmycin dexamethasone composite,PD)治疗咽喉部静脉畸形(venous malformation,VM)的疗效。方法:回顾性分析2013年6月至2022年11月在中山大学附属第一医院耳鼻咽喉科行平阳霉素复合剂硬化治疗的98例咽喉部VM患者临床资料,按治疗方式分为PFG组(34例)和PD组(64例),其中男54例,女44例,年龄1~77(37.06±18.86)岁。记录治疗前后病变大小、治疗次数和不良反应,将疗效分为治愈、有效和无效3个等级。总结2组总体治愈率、有效率和治疗次数,并按VM长径将所有患者分为3个亚组,分层对比2组间疗效和治疗次数差异,分析2组不良反应类型及处理措施。采用SPSS 25.0软件进行统计学分析。结果:PFG组有效率94.11%(32/34)、治愈率85.29%(29/34),PD组有效率93.75%(60/64)、治愈率64.06%(41/64)。分层比较,VM长径≤3 cm时,2组疗效、治疗次数差异均无统计学意义(Z疗效=1.04,t_(治疗次数)=2.18,P值均>0.05);VM长径>3 cm且<5 cm时,2组疗效差异无统计学意义(Z_(疗效)=1.17,P>0.05),但PFG治疗次数更少(t_(治疗次数)=4.87,P<0.01);长径≥5 cm时,PFG疗效明显优于PD(Z_(疗效)=2.94,P<0.01),且治疗次数更少(t_(治疗次数)=2.16,P<0.01)。治疗及随访期间2组患者均未发生严重不良反应。结论:PFG和PD均是治疗咽喉部VM安全有效的复合硬化剂,但对于较大体积的病变,PFG治愈率更高且治疗次数更少。Objective To analyze and compare the efficacy and safety of pingyangmycin fibrin glue composite(PFG)and pingyangmycin dexamethasone composite(PD)in the treatment of pharyngolaryngeal venous malformation(VM).Methods The clinical data of 98 patients with pharyngolaryngeal VM who underwent sclerotherapy with pingyangmycin composite in the First Affiliated Hospital of Sun Yat-sen University from June 2013 to November 2022 were retrospectively analyzed.According to their treatment,patients were divided into PFG group(n=34)and PD group(n=64),among those patients there were 54 males and 44 females,aged 1-77(37.06±18.86)years.The lesion size,total treatment times and adverse events were recorded before and after treatment.And the efficacy was divided into three grades:recovery,effective and invalid.According to the length of VM,all patients were divided into three subgroups,to compare the differences in efficacy and treatment times between each two groups.And finally the adverse events and their treatments were analyzed.SPSS 25.0 software was used for statistical analysis.Results The efficacy of PFG group was 94.11%(32/34),the recovery rate was 85.29%(29/34).And the efficacy of PD group was 93.75%(60/64),the recovery rate was 64.06%(41/64).No serious adverse eventst occurred in subgroup comparison,there was no statistical difference between the two groups in efficacy and the times of treatments when the length was≤3 cm(Z_(efficacy)=1.04,ttreatment times=2.18,P>0.05);when the length was 3-5 cm,there was no significant efficacy difference between the two groups(Z_(efficacy)=1.17,P>0.05),but the treatment times of PFG were less(ttreatment times=4.87,P<0.01);when the length≥5 cm,efficacy of PFG was significantly better than PD(Z_(efficacy)=2.94,P<0.01),and had fewer treatments times(ttreatment times=2.16,P<0.01).There were no serious adverse events in either group during treatment and follow-up.Conclusion Both PFG and PD are safe and effective composite sclerotherapy agent for the treatment of laryngeal VM,but PFG has a

关 键 词：静脉畸形 硬化治疗 平阳霉素 纤维蛋白胶 

分 类 号：R766.5[医药卫生—耳鼻咽喉科]