【摘要】 目的:探讨平阳霉素(Pingyangmycin,PYM)瘤内注射治疗儿童腮腺血管瘤的临床疗效。方法:回顾性分析四川大学华西口腔医院1990年5月—2005年5月治疗的儿童腮腺血管瘤51例。其中,男21例,女30例,男女比例为1∶1.43;患儿年龄为6个月～4岁,平均年龄10个月。深部血管瘤38例,混合型血管瘤13例;26例(50.98%)瘤体大小在4cm×4cm以上;右侧27例,左侧24例,无双侧受累者。经全身体检和血常规检查,确定无其他严重疾病,6个月后接受PYM瘤内注射治疗。8mg注射用盐酸PYM溶解于8mL生理盐水,并加入5mg地塞米松磷酸钠注射液。每次用量0.5～1mg,每4周注射1次,连续注射5次后,间隔2～3个月。用药总量一般不超过20mg,最大剂量35mg。采用SPSS10.0软件包对瘤体直径≥4cm者与<4cm者的疗效进行χ2检验。结果:42例(82.35%)瘤体基本消失,皮肤色泽正常,面部对称;8例(15.69%)瘤体部分退化;1例(1.96%)无明显变化。无腮腺分泌障碍和面神经损伤症状;未发现肺纤维化或生长抑制现象。统计学分析表明,疗效与瘤体大小无显著相关性。结论:PYM瘤内注射疗法可作为儿童腮腺血管瘤的首选治疗方法之一,超声波检查对其诊断和治疗有辅助作用。更多还原

【Abstract】 PURPOSE: To investigate the indication and outcome of intralesional Pingyangmycin (PYM) therapy for parotid gland hemangiomas in early childhood. METHODS: 51 infantile patients with hemangiomas in the parotid gland were studied retrospectively, which had been treated in the clinic of West China Hospital of Stomatology, Sichuan University during the 15-year period from May 1990 to May 2005. In this study, 21 were male, 30 were female, and the ratio of male to female was 1∶1.43. The age of the children ranged from 6 months to 4 years, with an average age of 10 months. 38 were deep-seated hemangiomas, and 13 were mixed hemangiomas. 27 were in the right parotid gland and 24 in the left, no bilateral case. All the patients underwent intralesional injection of a solution of 8mg PYM in 8mL normal saline mixed with 5mg dexamethasone. The total dose of PYM ranged from 20mg to 35mg, which was administered 0.5 or 1 mg per injection. SPSS10.0 software package was used to compare the treatment efficacy between the patients with hemangioma≥4cm in diameter and <4cm in diameter. RESULTS: Hemangiomas of 42 cases (82.35%) showed complete resolution with good appearance, 8 cases (15.69%) were partly regressed, and 1 case (1.96%) had no obvious size change. No serious side effects were seen, such as pulmonary fibrosis and growth inhibition. No significant correlation was found between treatment efficacy and tumor size. CONCLUSION: Intralesional PYM therapy maybe is a selective primary therapy option for parotid gland hemangioma, and ultrasonography should be useful for diagnosis and treatment of this lesion.更多还原