小剂量平阳霉素早期干预婴幼儿腮腺血管瘤疗效分析

Efficacy of early low-dose pingyangmycin intervention for infantile hemangiomas of the parotid region

目的:评价小剂量平阳霉素多次注射治疗婴幼儿腮腺血管瘤的临床疗效。方法:回顾分析2001—2011年间行小剂量低浓度平阳霉素+地塞米松瘤内注射治疗的78例增殖早期腮腺血管瘤患儿。分别用数码照片和MRI记录治疗前、后病变的面积,随访时间为0.5-10 a。按初诊年龄分为4组,比较用药剂量、治疗次数和时间,以及家长满意度。应用SPSS 13.0软件包对数据进行统计学分析。结果:治疗后大部分血管瘤体积明显减小,MRI检查显示瘤体组织纤维化。治愈67例(85.9%),显效11例(14.1%),总有效率为100%。仅15例出现食欲缺乏、发热和皮疹等不良反应。低年龄组治疗持续时间为(4.73±0.11)个月,注射总剂量为(2.82±0.12)mL,显著低于其他3组(P<0.05),家长满意度高。结论:小剂量平阳霉素多次注射治疗法对婴幼儿腮腺巨大血管瘤的疗效安全可靠。患儿接受治疗的时间越早,用药剂量越小,疗程越短,家长满意度越高。

PURPOSE：The purpose of this study was to evaluate the clinical efficacy of multiple low-dose pingyangmycin（PYM） intervention for infantile hemangiomas of the parotid region at early stage.METHODS：A total of 78 cases with early proliferating hemangioma in the parotid region were underwent therapy of intralesional injection with low-dosage and low-concentration PYM plus dexamethasone from 2001 to 2011.Digital photographs and MRI were obtained to measure the area of lesions before and after treatment.All patients were followed up for 0.5-10 years.They were divided into 4 groups according to baseline age.Comparative analysis of dosage,time and satisfaction of the parents were performed.SPSS 13.0 software package was used for statistical analysis.RESULTS：Most hemangiomas reduced its size after treatment,and had fibrosis in MRI.Cure was obtained in 67（85.9%） patients,while marked improvement occurred in 11（14.1%） patients.The total effective rate was 100%.Only 15 cases had complications such as poor appetite,fever and skin rash.Patients below 3 months of age had shorter treatment duration（4.73 ±0.11 months）,less total dosage（2.82 ±0.12 mL） and higher parental satisfaction（P ＆lt;0.05） than the other age groups.CONCLUSION：Low-dose pingyangmycin intervention for hemangiomas of the parotid region at early proliferating stage was a reliable and effective therapeutic choice.It takes a shorter duration,lower dose for treatment and higher parental satisfaction at earlier time.