小剂量平阳霉素在婴幼儿口腔颌面部血管瘤早期治疗中的应用

目的：探讨小剂量平阳霉素早期治疗婴幼儿口腔颌面部血管瘤的临床疗效。方法：收集2004年6月—2009年6月应用小剂量平阳霉素注射治疗的婴幼儿口腔颌面部血管瘤82例。平阳霉素浓度为1～1.6g/L,每次注射剂量不超过4mg,用药总量一般不超过20mg,根据患儿的年龄、瘤体大小和深度决定用药浓度、剂量和注射次数。血管瘤进入消退期则停止治疗,随访6～24个月。随访时间最长4a,最短6个月。采用SPSS13.0软件包对瘤体直径≥2cm者与〈2cm者的疗效进行χ2检验。结果：治愈58例（70.73%）,基本治愈21例（25.61%）,好转3例（3.66%）,未见无效病例。治愈和基本治愈率合计为96.34%,有效率为100%。统计学分析表明,疗效与瘤体大小无显著相关性。3例病例出现注射部位溃疡、皮肤坏死,继而结痂,痂皮脱落后遗留浅表瘢痕。4例注射后食欲缺乏。无腮腺分泌障碍和面神经损伤症状;未发现肺纤维化或生长抑制现象。结论：小剂量平阳霉素早期治疗血管瘤的疗效显著,不良反应较少,具有远期美容效果,为目前治疗婴幼儿口腔颌面部血管瘤的有效方法之一,值得推广应用。

Application of low dose pingyangmycin in treating oral and maxillofacial hemangioma in infants for early intervention

PURPOSE：The aim of this study was to evaluate the effectiveness of low dose pingyangmycin on maxillofacial hemangioma of infants for early intervention.METHODS：From June 2004 to June 2009,82 infants with maxillofacial hemangioma were treated with low dose pingyangmycin injection.The concentration of pingyangmycin was 1 to 1.6 g/L.Generally,the dose of pingyangmycin was limited to 4 mg each injection,20 mg in total.The injection dose,concentration,times were determined by the age of the patients,the volume and depth of the lesion.As the lesion enters involution,any further intervention should be ceased and the patients needed to review a rational long-term observation.The follow up time was from 6 to 24 months.SPSS13.0 software package was used to compare the treatment efficacy between the patients with hemangioma ≥2cm in diameter and 2cm in diameter.RESULTS：There were 58 cases of complete involution（70.73%）,21 cases of partial involution（25.61%）,3 cases of improvement（3.66%）,no case without response.The involution rate was 96.34%,and the effective rate was 100%.No significant correlation was found between treatment efficacy and tumor size.3 cases demonstrated ulceration or necrosis of injection site,and then healed with superficial scars.4 cases experienced poor appetite.There was no malfunction of parotid gland and facial nerve.No fibrosis of lung and growth inhibition was noted.CONCLUSION：Early intervention with low dose pingyangmycin to the maxillofacial hemangioma of infants showed excellent effectiveness with little adverse effect and left perfect cosmetic outcome.We recommend the treatment protocol for maxillofacial hemangioma of infant.