超声引导下注射平阳霉素与无水乙醇治疗肝海绵状血管瘤疗效观察

Effectiveness of Ultrasound-guided Percutaneous Injection of Pingyangmycin or Ethanol in Treating Cavernous Hemangioma of the Liver

目的观察超声引导下注射平阳霉素与无水乙醇治疗肝海绵状血管瘤(CHL)的疗效。方法选择2008年2月—2012年5月我院门诊CHL患者70例(78个瘤体),按患者登记的出生日期单双日分为平阳霉素组36例(38个瘤体)和无水乙醇组34例(40个瘤体),分别采用超声引导下注射平阳霉素和无水乙醇治疗,根据CHL瘤体直径及患者情况调整药物用量及治疗次数。观察两组患者临床疗效、不良反应及瘤体缩小率。结果两组均未出现治疗无效患者,平阳霉素组治愈24例、有效12例,无水乙醇组治愈14例、有效20例,差异有统计学意义(χ2=4.58,P<0.05)。两组患者均未发现明显血常规及肝功能异常变化;平阳霉素组不良反应发生率为13.9%(5/36),无水乙醇组为38.2%(13/34),差异有统计学意义(χ2=5.43,P<0.05)。平阳霉素组平均瘤体缩小率为(91.6±5.6)%,无水乙醇组为(76.8±7.9)%,差异有统计学意义(t=9.38,P<0.001)。结论超声引导下注射平阳霉素或无水乙醇治疗CHL操作方便、安全性高、并发症少、疗效满意,可作为临床治疗CHL的有效方法;而超声引导下注射平阳霉素的效果优于注射无水乙醇,安全可靠,建议作为CHL的首选治疗方法。

Objective To evaluate the therapeutic effects of ultrasound - guided percutaneous injection of pingyangmy- cin or ethanol in treating the cavernous hemangioma of the liver （CHL）. Methods Totally 70 CHL patients （with 78 tumor nodules） who were treated in our hospital from February 2008 to May 2012 were divided into pingyangmycin group （36 patients and 38 tumor nodules） and ethanol group （34 patients and 40 tumor nodules） according to the odd and even days of date of birth. The two groups were respectively treated by ultrasound - guided percutaneous injection of pingyangmycin and ethanol. The dosage＇s were tailored according to the size of CHL. All patients were followed up for 6 months after operation. Results All pa- tients were responsive to the treatment. The treatment was markedly effective in 24 eases and effective in 12 cases in the pingy- angmycin group ; On the contrary, it was was markedly effective in 14 cases and effective in 20 eases in the ethanol group （χ2 = 4. 58, P 〈 0.05）. No obvious abnormality was detected in routine blood test and liver function test. The incidence of adverse effects was 13.9% （5/36） in the pingyangmycin group and 38.2% （13/34） in the ethanol group （ χ2 = 5.43, P 〈 0. 05 ）. The average tumor regression rate was （91.6 ±5.6）% in the pingyangmycin group and （76.8 ±7.9）% in the ethanol group （t = 9. 38, P 〈 0. 001 ）. Conclusion Ultrasound - guided percutaneous injection of pingyangmycin or ethanol is safe, effective, and simple for the treatment of CHL. In addition, pingyangmycin is superior to ethanol in terms of effectiveness and safety and therefore can be the treatment of choice.