激光与平阳霉素注射治疗小儿眼睑血管瘤的疗效分析

Outcomes of pediatric hemangioma treated with CYNERGY laser vs bleomycin

目的:通过临床应用CYNERGY脉冲染料激光与平阳霉素局部注射治疗小儿眼睑血管瘤,观察对比两者的疗效和不良反应。方法:收集2008-2010年在广州市妇女儿童医疗中心治疗的眼睑草莓状血管瘤患儿70例,混合型血管瘤患儿92例,两种类型血管瘤分别分组进行平阳霉素注射及激光治疗,随诊1～2年,对比其疗效及不良反应。结果:眼睑草莓状血管瘤患儿平阳霉素组及激光治疗组两组疗效比较,前者总有效率为93.9%,后者总有效率为97.3%,两者差异无统计意义(P>0.01)。眼睑混合型血管瘤惠儿平阳霉素组及激光治疗组两组疗效比较,前者总有效率为98.0%,后者总有效率为86.1%,两者差异有统计学意义(P<0.01)。激光治疗组的不良反应明显比平阳霉素组小,两者差异有统计学意义(x^2=9.370,P<0.05)。结论:针对病变较表浅的草莓状毛细血管瘤,激光及平阳霉素治疗两种方法均有显著效果。且激光治疗治愈率高,不良反应小。针对病变较深的混合型毛细血管瘤,平阳霉素注射治疗效果优于激光治疗效果。是目前理想治疗小儿混合型毛细血管瘤的方法之一。

Objective：To compare the outcomes and adverse effects in pediatric hemangioma treated with CYNERGY laser vs bleomycin. Methods： Seventy cases of capillary hemangioma and 92 of mixed type hemangioma registered to Guangzhou Women and Children＇s Medical Center between 2008 and 2010 were allocated to treatments on CYNERGY laser or injection with bleomycin. The outcomes and adverse effects were compared between groups after 1 to 2 years of follow-up. Results：The overall rate of response was 93.9% for bleomycin injection vs 97.3% for CYNERGY laser in children with capillary hemangioma （ P 〉 0.01 ）, and 98. 0% for bleomycin injection vs 86.1% for CYNERGY laser in children with mixed type hemangioma （P 〈 0.01 ）. CYNERGY laser resulted in remarkably less adverse effects than did bleomycin injection, with significant difference between the two treatments （X2 = 9. 370, P 〈 0.05 ）. Conclusion： While both CYNERGY laser and bleomycin may be effective for superficially located capillary hemangioma, the CYNERGY laser seems to be associated with higher rate of response and less adverse effects. However, for profound lesion of mixed type hemangioma, bleomycin injection can be more therapeutically effective than CYNERGY, and represents one of ideal treatment options currently available for mixed type hemangioma.