平阳霉素治疗血管瘤不良反应和并发症的临床分析

目的：总结平阳霉素治疗血管瘤的不良反应和并发症，为临床治疗中预防或减少不良反应和并发症提供依据。方法：回顾性统计分析1991．1．～2005．8．用平阳霉素（PYM）治疗血管瘤1515例中的不良反应和并发症。结果：176例出现不良反应和并发症。144例不良反应中包括发热69例，食欲不振56例，皮疹18例，过敏性休克1例。并发血管瘤局部坏死性溃疡32例，发生在口腔颌面部10例，躯干8例，四肢14例，30例经抗炎，换药痊愈，2例经皮瓣移植治愈。结论：PYM治疗血管瘤时，先肌注地塞米松（DXM）可预防或减少发热反应和皮疹等过敏反应；颌面部血管瘤局部坏死性溃疡，经抗炎，换药等处理。一般均可愈合。但对下肢等血运较差部位的皮肤血管瘤，PYM的剂量不宜超过3mg，浓度应在1：2～1：3之间，作放射状注射，使药液均匀分布，避免因PYM在局部聚积而致瘤体坏死。

Clinical analysis of adverse reaction and complication in treating hemangioma with PYM

Objective:To evaluate the adverse reaction and complication in treating hemangioma with PYM trying to prevent or reduce them in clinical treatment.Method:To make a retrospective statistical analysis of 1515 cases of treating hemangioma by injecting PYM from January 1991 to August 2005.Result:176 cases of adverse reaction and complication occurred among the total 1515 patients.There were 144 cases of adverse reaction including 69 cases of fever,56 of inappetence,18 of rash and 1 of allergic shock.And 32 patients caught necrotic partial ulcer of hemangioma,ten of which was in the maxillofacial part,eight in the trunk and fourteen in the extremities.We cured 30 patients by anti-inflammation and dressing change.2 patients were cured by flap graft.Conclusion:The injection of DXM can prevent or reduce anaphylaxis.The necrotic ulcer of hemangioma in maxillofacial part can be easily cured by anti-inflammation and dressing change because this part is rich in blood.When the hemangioma in skin is treated,where the blood supply is poor,such as the skin of the lower limbs,the dosage of PYM should be no more than 3 mg and the concentration should be between 1:2 and 1:3.The liquid medicine should be distributed evenly in order to avoid the putrescence of tissue by the congregation of PYM.