平阳霉素局部注射并手术切除治疗血管瘤和血管畸形

To treat the haemangioma and vascular malformation by surgical excision following the local injection of Pingyangmycin

目的:总结用平阳霉素局部注射并手术切除治疗血管瘤和血管畸形的经验。方法:本组287例患者,其中血管瘤134例,血管畸形153例。先用平阳霉素混合液进行瘤体腔内注射,每一进针部注入2～3ml混合药物。对血管瘤患者行多点注射,至瘤体稍发白为宜。一般经3～5次注射后进行手术治疗。对部分未能完全切除或完全切除后有可能导致严重继发畸形的患者,则于术中和术后继续应用平阳霉素治疗。结果:205例经平阳霉素注射后直接切除治愈(71.43%),72例经术后3～5次注射治愈(25.09%),有效8例(2.79%),无效2例(0.70%),总治愈率为96.52%。注射平阳霉素后发热21例,局部溃疡形成8例,术区血肿7例,伤口边缘局部愈合不良5例,经换药、血肿清除、对症处理等未影响最终治疗效果。结论:用平阳霉素局部注射并手术切除能有效减少术中出血,降低手术难度和风险,提高血管瘤和血管畸形的治愈率。

Objective To summary the experience of treating the haemangioma and vascular malformation by surgical excision following the local injection of Pingyangmycin. Methods There are 134 haemangioma cases and 153 vascular malformation cases in 287 patients. Pingyangmycin mixed liquids were injected into the neoplasm about 2-3 ml every point until the neoplasm pale. Surgical excision was carried out after 3-5 times injections. Pingyangmycin injection will be continued during the operation and post-operation if surgical excision is incomplete or thorough surgical treatment may result in serious secondary deformity. Results 205 cases full recover after surgical excision following the local injection of Pingyangmycin （71.43%）. 72 cases full recover after Pingyangmycin continuous injection for 3-5 times post- operation （25.09%）. 8 cases valid （2.79%）, 2 cases invalid （0.70%） and total recovery rate is 96.52%. All have satisfactory results but 21 cases for fever after injection, 8 cases for local ulceration, 7 cases for local haematoma and 5 cases for wound edge delayed healing. Conclusions The method of surgical excision following the local injection of Pingyangmycin can diminish the operative difficulty and risk by reducing haemorrhage during the operation, which will increase the recovery rate of haemangioma and vascular malformation.