平阳霉素联合地塞米松对体表血管瘤患者的疗效及预后的影响

摘要

目的 观察比较平阳霉素联合地塞米松与单独使用平阳霉素的治疗方案对体表血管瘤患者的疗效及预后的影响.方法 选取蚌埠医学院第一附属医院于2014年1月至2015年7月收治的体表血管瘤患儿360例,按随机数字表法分为观察组和对照组,每组180例.同时,根据临床类型将观察组分为毛细血管瘤组(68例)、海绵状血管瘤组(56例)及混合型血管瘤组(56例),根据瘤体大小将观察组分为瘤体面积>2.5 cm2组(78例)及瘤体面积≤2.5 cm2组(102例).对照组患者给予平阳霉素治疗,观察组患者给予平阳霉素联合地塞米松治疗,比较两组患者及观察组内各临床类型、瘤体大小组的临床治疗效果,并记录两组患者治疗后的不良反应发生情况.结果 观察组治疗总有效率显著高于对照组(P<0.05),毛细血管瘤组总有效率高于海绵状血管瘤组及混合型血管瘤组(P<0.05),瘤体≤2.5 cm组的总有效率高于瘤体>2.5 cm2组(P<0.05),两组间并发症发生情况比较,差异无统计学意义(P>0.05).结论 平阳霉素联合地塞米松的治疗方案可有效提高体表血管瘤患者的治疗效果,尤其是对于毛细血管瘤效果更佳,安全性高,值得在临床推广应用.%Objective To investigate and compare the influence of therapy regimens with pingyangmycin alone or pingyangmycin combined with dexamethasone on the curative effect and prognosis in the patients with superficial hemangiomas.Methods 360 cases of children with superficial hemangiomas, ever treated in our hospital from Jan 2014 to Jul 2015, were selected and divided into the study group and the control group by random number table method, 180 cases in each group.Additionally, patients in the study group were further divided into the capillary hemangiomas subgroup (68 cases), the cavernous hemangiomas subgroup (56 cases) and the mixed hemangiomas subgroup (56 cases) according to their clinical classification.According to the size of tumors, the study group was also divided into the subgroup of tumor area>2.5 cm2 (78 cases) and the subgroup of tumor area ≤ 2.5 cm2 (102 cases).The control group was given pingyangmycin treatment alone, while the study group was treated with pingyangmycin combined with dexamethasone.The clinical curative effects in the study group and the control group, and the curative effects in each subgroup based on clinical classification and tumor size, were compared respectively.The occurrence of adverse reactions in the two groups after treatment was recorded.Results The total effective rate of the study group was significantly higher than that of the control group (P<0.05), and the total effective rate of the capillary hemangiomas subgroup was also higher than that of the cavernous hemangiomas subgroup or the mixed hemangiomas subgroup, with significant differences (all P<0.05).Furthermore, the total effective rate of the subgroup of tumor area ≤ 2.5 cm2 was significantly higher than that of the subgroup of tumor area>2.5 cm2 (P<0.05).No significant difference was found in the complications between the two groups (P>0.05).Conclusion The therapy regimen of pingyangmycin in combination with dexamethasone could effectively improve the curative effects in children with superficial hemangiomas, especially in those with capillary hemangiomas, with better efficacy and higher safety, and is worthy of clinical application and expansion.