~(90)Sr敷贴放射治疗不同类型小儿皮肤血管瘤的临床观察

目的观察放射性核素90Sr治疗小儿不同类型血管瘤的疗效。方法选择荆州医院经临床确诊的血管瘤患者450例,年龄2 d至10岁,确诊后按临床分型分为单纯性血管瘤(A组)、海绵状血管瘤(B组)和混合性血管瘤(C组)3组,每组各150例。选用国产90Sr敷贴器,核准其出厂时的放射参数。根据核素衰变公式N=N0e-λt计算治疗时所需照射时间,并以秒表计时。疗效判定分为4级:痊愈,指血管瘤完全消失,随访1年以上未见复发;显著好转,指血管瘤显著缩小并停止生长;好转,指治疗后血管瘤停止生长,颜色不同程度变浅;无效,指血管瘤无变化或继续生长。结果单纯性血管瘤(A组)治疗效果显著优于其他两组,经秩和检验有统计学意义(H=248.91,P<0.01),治疗的痊愈率为66.67%,有效率达94.67%。结论 90Sr敷贴治疗小儿单纯性血管瘤具有效果好、操作简单、易于接受、不良反应轻微等优点,值得临床推广应用。

Clinical Analysis of ~(90)Sr Plaque Radiotherapy Treatment on Children with Different Types of Skin Hemangioma

Objective To observe the efficacy of radionuclide 90Sr in the treatment of children with different types of hemangiomas.Methods Four hundred and fifty cases of infants and children aged 2 days to 10 years clinically diagnosed as skin hemangioma from Jingzhou Hospital were selected.They were divided into three groups according to the clinical classification,namely simple hemangioma(group A),cavernous hemangioma(group B) and mixed hemangioma(group C).Domestic 90Sr applicator was used,following confirming its factory radiation parameters before treatment.Radiation time required was calculated in accordance with the radionuclide decay formula N = N0e-λt and was kept by a stopwatch.Therapeutic efficacy was divided into four levles: cured,referring hemangioma completely disappeared,no recurrence during more than 1 year follow-up;significant improvement,meaning hemangioma significantly reduced and stopped growing;improved,meaning the growth of tumor blood vessels stops after treatment,the color faded to varying degrees;void,meaning hemangioma has no change or continue to grow.Results The therapeutic effect in simple hemangioma group was significantly better than the other two groups with statistically significant difference through rank sum test(H = 248.91,P < 0.01),the cure rate of which was 66.67% and the effective rate was 94.67%.Conclusion 90Sr applicator is advantageous over other methods with good therapeutical effects,simple operation,easy acceptance and minor adverse reactions in the treatment of simple hemangioma,and is worthy of wide application in clinic.