硬化剂治疗口腔颌面部静脉畸形疗效的对比研究

Comparative study of the effect of sclerosing agent injection therapy on venous Malformation in the oral and maxillofacial regions

目的:评价平阳霉素(PYM)单独使用或联合鱼肝油酸钠(SM)和地塞米松(DXM)瘤内注射治疗口腔颌面部静脉畸形的疗效和安全性。方法:选择100例口腔颌面部静脉畸形患者,随机分为两组。PYM组50例瘤腔内单独注射PYM;联合用药组50例,用DXM 5 mg/ml加2%利多卡因4ml瘤内注射,尔后再据年龄、瘤体大小,局部情况注射0.5～2.0mlSM。均5～7d注射1次,3～5次为一个疗程。分析其疗效和安全性。结果:治疗后经6～48个月随访。PYM组有效率84.0%,联合用药组有效率96.0%。明显高于PYM组(P<0.05)。PYM组有5例(10.0%)出现发热,联合用药组无发热病例(P<0.05)。结论:PYM、DXM、SM联合注射治疗口腔颌面部静脉畸形,具有疗程短、不良反应小等优点,是一种安全、可靠、简便的治疗方法,其疗效优于PYM单独瘤内注射治疗。

Objective：To evaluate the effect and safty Pingyangmycin （PYM） injected single or PYM, Dexamethasonum （DXM） and Sodium Morrhuate （SM） combined injetction to treat venous malformation in the oral and maxillofacial regions. Method-100 patients with venous malformation were divided into two groups at random with 45 in each .Group of PYM （single）were given intralesional injection of PYM 1-5 ml （8 mg PYM was dissolved in 5ml of 2% Lidocain） ： Group of Combine were treated by combined intralesional injection of PYM, DXM and SM.Treatment procedure： ①Preparation： 8 mg PYM was dissolved in 5 mg / ml DXM and in 4ml of 2% Lidocain,which were ready for use：②1-5 ml （PYM 1.6 -8.0 mg） of mixed solution was first injected to the intralesion, then followed by an injection of 0.5 -2ml SM according to Patient＇s age, size of the tumor and local appearance.Each group of the injection was administered once erery 5 to 7 days for 3 to 5 weeks. The effect and safety was studied by clinical examination and follow-up. Result： The cases were followed up for 6 -48 months.The effective rate of intralesion injection of PYM is 84.0%, and the effectivity of conbined injection is 96.0%.There was statistically difference on the effect between the group of PYM and the group of combine. （P〈 0.05） 5patients （10.0%） got fever in PYM group .No cases was fever in combine group. （P〈0.05） Conclusion：This combined injection may be a safe, simple, short course, lower side reaction and effective therapy for venous malformation of the oral and maxillofacial regions.It was better than PYM single injection in the effectivity and safty.