局部注射平阳霉素和确炎舒松A治疗小儿皮肤血管瘤的比较研究

Comparison of the effects of intralesional bleomycin and triamcinolone acetonide in treatment of cutaneous hemangioma in children

目的 : 探讨和比较平阳霉素和确炎舒松A治疗小儿皮肤血管瘤的疗效。方法 : 2 80例皮肤血管瘤患儿随机分为平阳霉素治疗组 (10 4例 )和确炎舒松A治疗组 (176例 ) ,平阳霉素组采用平阳霉素瘤体内注射 ,浓度为 2～ 3.2mg ml ;确炎舒松A组采用确炎舒松A瘤体内注射 ,浓度为 8mg ml。每 2周重复注射一次 ,总疗程 3～ 10次。结果 : 平阳霉素组 10 4例患儿中 ,治愈 89例 (治愈率 85 .6 % )和有效 15例 (14 .4 % ) ,确炎舒松A组 176例血管瘤患儿中 ,治愈 86例 (4 8.9% )和有效 75例 (4 2 .6 % )。两组比较差异有统计学意义 (P <0 .0 0 1)。结论 : 平阳霉素瘤体内注射治疗小儿皮肤血管瘤安全有效 ,其疗效优于确炎舒松A。

Objective: To compare the effects of bleomycin and triamcinolone acetonide in the treatment of cutaneous hemangioma in children. Methods: Two hundreds and eighty children, aged 3 months to 6 years, with cutaneous hemangioma (80 capillary, 47 cavernous and 153 mixed) were divided into two groups. One hundred and four children were treated with intralesional bleomycin (2～3.2 mg/ml) injections and 176 children were treated with intralesional triamcinolone acetonide (8 mg/ml) injections. The injections were repeated every other week for a total of 3～10 times. Results: The cure rate and response rate in the bleomycin group were 85.6% (89/104) and 14.4% (15/104), respectively. The cure rate and response rate in triamcinolone group were 48.9% (86/176) and 42.6% (75/176), respectively. There was a significant difference in effectiveness of treatment of cutaneous hemangioma between the two groups (P<0.001). The side effects included fever (12 cases) and local necrosis (4 cases) in bleomycin group and temporary local subcutaneous fat atrophy (23 cases) and Cushing syndrome (8 cases) in triamcinolone group. Conclusion: Bleomycin sclerotherpy in the treament of cutaneous hemangioma of children was very effective, simple and safe. It is better than the triamcinolone acetonide sclerotherpy.