经电子支气管镜孔道注射博来霉素治疗咽喉部血管瘤的疗效观察

Clinical observation of Bleomycin local injection treatment for laryngeal and pharyngeal hemangioma with the association of electronic bronchoscope

目的探讨经电子支气管镜孔道局部注射博来霉素治疗咽喉部血管瘤的临床疗效。方法对该科2010年1月-2017年6月收治的有完整资料的34例咽喉部血管瘤患者进行回顾性分析。所有患者均经电子支气管镜孔道进行博来霉素的局部注射治疗,最多注射6次,最少2次,平均4.5次,以电子支气管镜检查瘤体大小变化作为疗效观察的主要评价指标。结果所有患者均表面麻醉下完成手术,痊愈28例(82.4%),有效6例(17.6%),总有效率100.0%。1例因为血管瘤瘤体大,行预防性气管切开,1个月后顺利拔管。所有患者术后复查血常规及胸片,未出现白细胞减少及肺纤维化等不良反应。结论经电子支气管镜孔道注射博来霉素治疗咽喉部血管瘤效果显著,具有创伤小,安全性高、可反复治疗和对喉功能保留好等优点,值得在临床上推广应用。

Objective To investigate the clinical effect of local injection of Bleomycin in treatment for laryngeal and pharyngeal hemangioma with the association of electronic bronchoscope.Methods We conducted a retrospective analysis of the clinical data of 34 patients who diagnoses with laryngeal and pharyngeal hemangioma from January 2010 to June 2017.All the patients received local injection treatment of Bleomycin with the association of electronic bronchoscope.The injection frequencies were 6 times at most and twice at least,and the average was 4.5 times.With the changes of the size of the tumor as examined by electronic bronchoscope as a primary evaluation index.Result All the patients received the treatment under surface anesthesia.28 cases(82.4%)were cured,and 6 cases(17.6%)were improved.The total effective rates of the group was 100.0%.One patient with giant hemangioma received preventive tracheotomy and was successfully extubated after 1 month.There was no case appeared adverse effect such as aleucocytosis and pulmonary fibrosis in all the patients who were reexamined of blood routine and chest X-ray after treatment.Conclusion The advantage of the methods of Bleomycin local injection treatment for pharynx and larynx hemangioma with the association of electronic bronchoscope was significant effective,which with small trauma,high security,repeatable treatment,good protection of larynx function and it was worthy of promoting in clinical practice.