聚桂醇注射治疗皮肤血管瘤和静脉畸形临床疗效及安全性的Meta分析

Efficacy and safety of lauromacrogol injection in the treatment of cutaneous hemangiomas and venous malformations: a meta-analysis

目的 :利用Meta分析系统评价聚桂醇注射治疗皮肤血管瘤和静脉畸形的疗效及安全性。方法 :计算机检索MEDLINE、Cochrane Library、PubMed、中国知网(CNKI)、维普(VIP)期刊全文及万方电子期刊全文数据库,检索所有关于聚桂醇注射治疗血管瘤和静脉畸形的随机对照研究,文献检索日期截止至2019年4月1日。对最终纳入的所有研究进行质量评价,使用RevMan 5.3软件进行Meta分析。结果:共纳入17个随机对照研究,1 399例皮肤血管瘤和静脉畸形患者。结果显示,聚桂醇治疗血管瘤或静脉畸形的有效率和安全性均高于平阳霉素;聚桂醇治疗血管瘤的有效率和安全性与口服普萘洛尔组相比,差异均无统计学意义;聚桂醇联合平阳霉素治疗血管瘤或静脉畸形的有效率和安全性均高于单独使用平阳霉素;聚桂醇联合口服泼尼松治疗血管瘤的有效率高于单独口服泼尼松;聚桂醇联合脉冲染料激光(PDL)治疗血管瘤的有效率高于单独使用PDL,但2者不良反应率相比,差异无统计学意义。结论:聚桂醇注射治疗皮肤血管瘤和静脉畸形均有较好的有效性及安全性,聚桂醇单独用药或联合用药时均有确切的疗效。

Objective: The meta-analysis system was used to evaluate the efficacy and safety of lauromacrogol injection in the treatment of cutaneous hemangiomas and venous malformations. Methods: MEDLINE, Cochrane Library, PubMed, CNKI, VIP and Wanfang database were searched. All relevant randomized controlled trials of lauromacrogol injection in the treatment of cutaneous hemangiomas and venous malformations, up to April 1, 2019, were retrieved. All data were evaluated using the criteria recommended by Cochrane Collaboration. The meta-analysis was performed using RevMan 5.3 software. Results: A total of 17 randomized controlled studies were enrolled, including 1 399 patients with cutaneous hemangiomas and venous malformations. The results showed that lauromacrogol was more effective and safer than pingyangmycin in treating cutaneous hemangiomas and venous malformations. Compared with propranolol, lauromacrogol showed no statistical significance in either effectiveness or adverse effects. Pingyangmycin in combination with laurimacrogol was more effective and safer than using pingyangmycin alone. Prednisone or pulsed dye laser(PDL) in combination with laurimacrogol was more effective than using prednisone or PDL alone. However,there was no statistical significance in the adverse effects using prednisone or PDL alone, compared with prednisone or PDL in combination with laurimacrogol. Conclusion: This meta-analysis provides strong evidences that lauromacrogol injection alone and in combination with others have therapeutic efficacy and safety in the treatment of cutaneous hemangiomas and venous malformations.