平阳霉素联合地塞米松注射治疗咽喉血管瘤的疗效观察

Clinical observation of Pingyangmycin plus Dexamethasone local injection treatment for pharynx and larynx hemangioma

目的:评价平阳霉素联合地塞米松局部注射治疗咽喉血管瘤的效果。方法:对我科2007-01-2012-12期间收治的资料完整的112例咽喉血管瘤患者进行回顾性分析。全部患者均接受平阳霉素、地塞米松混合液局部注射,以电子喉镜观察瘤体大小变化作为主要评价指标。结果:本组患者接受药物注射治疗1~9次,平均4.3次,全身麻醉下实施手术253例,局部麻醉实施手术109例。痊愈46例(41.1%),显效55例(49.1%),好转11例(9.8%),总有效率100%。3例行预防性气管切开,1个月后均顺利拔管。4例患者复查胸片出现轻度肺间质纤维化表现,无功能障碍。结论:平阳霉素联合地塞米松局部注射治疗咽喉血管瘤效果显著,安全性较高,但仍应注意化疗药物本身毒副作用的发生,咽喉注射时应密切观察呼吸道水肿的发生及发展,防止喉梗阻的发生,必要时行预防性气管切开。

Objective： To evaluate the therapeutic effect of local injection of Pingyangmycin in combination with Dexamethasone in the treatment of laryngeal and pharyngeal hemangioma. Method：To conduct a retrospective analysis of the clinical data of 112 patients who diagnoses with laryngeal and pharyngeal hemangioma in our depart- ment from January 2007 to December 2012. All patients receive local injection of Pingyangmycin in combination with Dexamethasone, with the changes of the size of the tumor as determined by electronic laryngoscope as a pri- mary evaluation index. Result：Patients in this group receive a range between 1 times to 9 times of local injection with an average of 4.3 times. Of all the cases, 253 receive the treatment under general anesthesias109 under local anesthesia. Among all 112 patients, 46 were cured^55 got obvious effect and 11 changed for the better, which ac- count for 41.1% ,49.1 G and 9.8 respectively. The total effective rates of the group was 100 %. Patients received preventive tracheotomy in 3 cases and was successfully extubated after 1 month. 4 patients had mild chest radio- graphs pulmonary interstitial fibrosis, but no dysfunction. Conclusion：Local injection of Pingyangmycin combined with Dexamethasone is a safe and effective therapeutic measure for laryngeal and pharyngeal hemangioma. Howev- er, enough attention should be paid to the toxicity and side effects of the medicine itself. It is necessary to monitor the the patient carefully for edema of the upper airway with respiratory obstruction. The airway may be maintained by tracheotomy if necessary.