安全剂量下平阳霉素瘤内注射治疗体表血管瘤和血管畸形

目的探讨平阳霉素瘤内注射治疗体表血管瘤和血管畸形的疗效。方法回顾分析2005年5月～2008年3月应用平阳霉素瘤内注射治疗体表血管瘤和血管畸形42例临床资料,其中男17例,女25例。年龄3个月～51岁。血管瘤18例,静脉血管畸形20例,血管瘤合并血管畸形4例。注射液按照平阳霉素8mg＋2%利多卡因2ml＋生理盐水2ml＋地塞米松2.5mg配制。术前测算瘤体面积,按照平阳霉素0.5mg/cm2多点注射,浅表皮肤及口腔黏膜可酌情减量至0.3mg/cm^2。一次注射未完全消失者可10天～3周或更长时间后重复注射。每次平阳霉素注射量不超过8mg,分次注射总量一般不超过70mg。结果治疗后1年,55个病灶治愈和显效率为85.5%（47/55）,好转12.7%（7/55）,总有效率为98.2%（54/55）。结论平阳霉素瘤内注射治疗血管瘤和小面积、低血流量静脉血管畸形疗效高,疗程短,患者痛苦小,是一种简便、安全的方法。平阳霉素瘤内注射时,0.5mg/cm^2是治疗血管瘤和小面积血管畸形的安全剂量。

Intratumor Injection of Pingyangmycin with a Safe Dosage for Superficial Hemangioma and Venous Malformation

Objective To evaluate the effect of intratumor injection of Pingyangmycin for the treatment of superficial hemangioma and venous malformation.Methods From May 2005 to March 2008,42 patients with superficial hemangioma or venous malformation,including 17 men and 25 women(aged 3 months to 51 years)were treated in our hospital by injecting pingyangmycin intratumorally.Among the patients,18 had hemangioma,20 had venous malformation,and 4 had the both.The injection consisted of a mixture of Pingyangmycin(8 mg),2% lidocaine(2 ml),normal saline(2 ml),and dexamethasone(2.5 mg).The volume of the tumor was evaluated before the injection.And then the mixture was injected intratumorally at a density of 0.5 mg/cm2(0.3 mg/cm2 for the patients with ulcers in the skin or mouth).For the patients who had residual tumor after the first injection,a second treatment was performed in 10 days to 3 weeks or longer.The maximum dosage of Pingyangmycin for a single injection was 8 mg,and the maximum total dosage was 70 mg.Results One year after the treatment,85.5%(47/55)of the patients were cured,and 12.7%(7/55)were improved.The total effective rate was 98.2%(54/55).Conclusions Injection of Pingyangmycin is an effective and safe method for superficial hemangioma and venous malformation with low blood flow.The maximum injection density is 0.5mg/cm2.