平阳霉素复合剂治疗口腔颌面部脉管畸形的有效性和安全性  

The therapeutic efficacy and safety of pingyangmycin complex in the treatment of oral and maxillofacial vascular malformations

作　　者：曹琮沅 黄烁金 何倩婷[1] 王安训[1] Congyuan Cao;Shuojin Huang;Qianting He;Anxun Wang(Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院口腔颌面外科,广州510080

出　　处：《中华口腔医学研究杂志(电子版)》2024年第6期368-374,共7页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：广东省自然科学基金(2020A151501091)。

摘　　要：目的探讨口腔颌面部脉管畸形(VM)患者瘤腔内注射平阳霉素(PYM)复合剂治疗的有效性及安全性。方法纳入2007—2021年中山大学附属第一医院口腔颌面外科收治的64例口腔颌面部VM患者,其中42例PYM复合剂治疗、22例传统PYM治疗,观察两组治疗前后的瘤体体积变化,评定疗效,评估术中及术后并发症发生情况。根据影像学检查结果确诊,治疗效果按照Achauer's分级标准评估。应用SPSS 25.0软件对数据进行独立样本t检验和卡方检验统计学分析。结果PYM复合剂治疗静脉畸形的疗效明显优于传统PYM组,两组差异有统计学意义(χ^(2)=6.141,P=0.013)。同时,在仅注射一次硬化剂的患者中,PYM复合剂组有效率(85%)明显高于传统PYM组(40%),差异有统计学意义(χ^(2)=7.704,P=0.006)。对于淋巴管畸形,PYM复合剂治疗大囊型病变的疗效优于微囊型(χ^(2)=10.585,P=0.001)。整体上,PYM复合剂组显著提高了治疗效果,并减少了治疗次数。结论采用PYM复合剂治疗口腔颌面部VM,可以有效缩小瘤体体积、提升治疗效果、减少治疗次数,有利于提升患者的治疗满意度和降低的医疗负担,并具有良好的安全性。Objective To evaluate the efficacy and safety of pingyangmycin(PYM)complex in the treatment of oral and maxillofacial vascular malformations(VMs).Methods A total of 64 patients with oral and maxillofacial VMs admitted to our department from 2007 to 2021 were enrolled,including 42 patients treated with PYM complex and 22 patients treated with traditional PYM solution.Diagnosis was confirmed based on imaging findings,and treatment outcomes were evaluated according to Achauer's grading criteria.Statistical analyses,including independent sample t-tests and chi-square tests,were performed using software(SPSS,v=25.0).Results The efficacy of PYM complex group was significantly better than that of traditional PYM group(χ^(2)=6.141,P=0.013).Moreover,in patients with only one injection,the effective rate of PYM complex group(85%)was significantly higher than that of traditional PYM group(40%)(χ^(2)=7.704,P=0.006).For lymphatic malformations,the efficacy of PYM complex treatment was superior in macrocystic lesions compared to microcystic ones(χ^(2)=10.585,P=0.001).PYM complex had a good and safe therapeutic effect,especially for venous malformations and macrocystic lymphatic malformations.Overall,the PYM complex group significantly enhanced therapeutic outcomes and reduced the number of treatment sessions.Conclusions The use of PYM complex in the treatment of oral and maxillofacial vascular malformations could effectively reduce the tumor volume,improve the treatment effect,reduce the number of treatments,and improve the treatment satisfaction of patients with less medical burden and good safety.

关 键 词：口腔颌面部脉管畸形 静脉畸形 博来霉素 平阳霉素复合剂 硬化治疗 

分 类 号：R73[医药卫生—肿瘤]