聚桂醇腔内灌洗联合低浓度平阳霉素治疗儿童大囊型淋巴管畸形的临床观察

Clinical observation of lauromacrogol intracavity lavage combined with low-concentration of pingyangmycin in the treatment of macrocystic lymphatic malformation in children

目的探讨聚桂醇腔内灌洗联合低浓度平阳霉素治疗儿童大囊型淋巴管畸形的临床效果。方法采用回顾性分析的方法,收集2018年1~12月山东大学齐鲁儿童医院血管瘤科&介入医学科收治的46例大囊型淋巴管畸形患儿的临床资料,男31例,女15例,发病年龄(3.7±0.5)岁,范围2个月至7岁。均在超声引导下穿刺,抽尽囊液,超声显示无液性暗区后,再进行药物注入治疗。按瘤内注射药物将46例分成3组,A组:17例,常规浓度平阳霉素治疗;B组:13例,聚桂醇治疗;C组:16例,聚桂醇腔内灌洗联合低浓度平阳霉素治疗。采用SPSS 20.0统计学软件进行分析,评价3组不同治疗方案的疗效及不良反应。结果在淋巴管畸形的治疗中,B组的平均治疗次数(t=4.685,P<0.05)、治疗有效率(χ2=4.067,P<0.05)均优于A组;C组的平均治疗次数(t=2.976,P<0.05)、治疗有效率(χ2=2.927,P<0.05)均优于A组;B、C组之间的平均治疗次数(t=9.261,P>0.05)、治疗有效率(χ2=7.213,P>0.05)差异无统计学意义;C组的不良反应发生率要明显少于A、B组(χ2=2.019、1.735,P<0.05);A、B组之间的不良反应发生率差异无统计学意义(χ2=8.407,P>0.05)。结论超声引导下使用聚桂醇腔内灌洗联合低浓度平阳霉素在治疗儿童大囊型淋巴管畸形中效果确切,且不良反应少,具有临床应用及推广价值。

Objective To explore the clinical effect of lauromacrogol intracavity lavage combined with low concentration of pingyangmycin in the treatment of macrocystic lymphatic malformation in children.Methods Using retrospective analysis method,the clinical data of 46 children with macrocystic lymphatic malformation admitted to the Department of Vascular anomalies and Interventional Radiology,Qilu Children′s Hospital of Shandong University from January 2018 to December 2018 were collected,There were 31 males and 15 females.with the age of 3.7±0.5 years.All patients were treated with percutaneous sclerosis under the guidance of general anesthesia.46 patients were divided into 3 groups according to the intratumoral drugs.Group A:17 cases,the conventional concentration of pingyangmycin treatment group.Group B:13 cases,lauromacrogol treatment group.Group C:16 cases,lauromacrogol intracavity lavage combined with low-concentration pingyangmycin.All cases were punctured under ultrasound guidance,the cystic fluid was drained,after the ultrasound showed that there was no liquid dark area,the drug was injected.After follow-up observation,the average number of treatments,treatment efficiency and adverse reactions were recorded in the three groups and statistical analysis was performed by SPSS 20.0 statistical software.Results In the treatment of lymphatic malformations,the average times of treatment(t=4.685,P<0.05)and the effective rate(χ2=4.067,P<0.05)in group B were better than those in group A.The average times of treatment(t=2.976,P<0.05)and the effective rate(χ2=2.927,P<0.05)in group C were better than those in group A.there was no significant difference in the average number of treatments(t=9.261,P>0.05)between groups B and groups C and the effective rate of treatment(χ2=7.213,P>0.05).The incidence of adverse reactions in group C was significantly lower than that in group A and B(χ2=2.019,χ2=1.735,P<0.05).There was no significant difference in the incidence of adverse events between groups A and groups B(χ2=8.407,P>0.05).Conclusions Lauromacrogol intracavity lavage combined with low-concentration pingyangmycin is effective in treating macrocystic lymphatic malformation in children,and has few adverse reactions,which deserves clinical promotion.