腔内注射治疗婴幼儿颌面部巨大混合性脉管畸形疗效观察

Intra-lesional injection for the treatment of oral and maxillofacial lymphatic-capillary malformation in infants and children

目的:探讨颌面部巨大混合性脉管畸形的综合治疗方法,评判其治疗效果。方法:2006年1月～2011年5月,笔者科室采用平阳霉素结合A群链球菌溶液,间隔腔内注射的方法,治疗颌面及舌部巨大淋巴管畸形合并静脉畸形患者22例。先进行平阳霉素瘤腔穿刺注射,间隔5天腔内注射A群链球菌。注射平阳霉素10天后进行该药第2次注射,5天后注射第2次A群链球菌制剂。1个月后根据局部变化及瘤体大小进行下一个疗程。结果:一般2个疗程后皮损即明显缩小,颌面部畸形外观显著改善。经过3～4个疗程治疗,患儿多可达基本治愈。结论:采用平阳霉素结合A群链球菌溶液瘤腔内注射治疗颌面部巨大混合性脉管畸形,安全可靠,疗效明显,可有效改善面部外观。

Objective To evaluate the efficacy of combined modality therapy for oral and maxillofacial lymphohemangioma. Methods Between Jan 2006 and May 2011 twenty-two cases with huge combined lymphatic- capillary malformation arising in maxillofacial region and tongue were admitted to our department. All the cases were treated using combination of Group A Streptococcus Preparation and bleomycin a5 （pingyangmycin） for injection. The solution for injection was injected into lesions multipointedly and periodically. In each cycle, at the first day （dl） bleomycin a5 was used for intra-lesional injection; at d5 the Group A Streptococcus Preparation was injected into lesions; at dl0 the injection of bleomycin a5 was repeated （for the second time）; at d15 the Group A Streptococcus Preparation injection was repeated （for the second time）. The cycles of combined modality therapy were performed with an interval of 28 days. Whether the next cycle of therapy is needed depends on the local changes of lesion and volume of the residue. Results Most cases showed improved appearance of maxillofacial deformity and that the lesions significantly regressed after 2 cycles of therapy were given. After 3-4 cycles of therapy, most of cases were cured with almost completely regressed lesions.Conclusion The injection into lesion with combination of Group A Streptococcus Preparation and bleomycin a5 is a safe and effective method for the treatment of huge lymphohemangioma of maxillofacial region, and can improve appearance of maxillofacial deformity obviously in affected cases.