Sclerotherapy of Microcystic Lymphatic Malformations in Oral and Facial Regions
Sclerotherapy of Microcystic Lymphatic Malformations in Oral and Facial Regions
复制标题
口腔和面部区域微囊性淋巴管畸形的硬化疗法
DOI：
10.1016/j.joms.2008.06.046
复制
发表时间：
2009-02-01
影响因子：
1.9
通讯作者：
Zhao, Yi-Fang
中科院分区：
文献类型：
--
作者：
Bai, Yi;Jia, Jun;Zhao, Yi-Fang
目的：淋巴管畸形是一种可导致畸形和功能障碍的良性血管病变。完全手术切除通常是困难的，并且已经提出病灶内注射硬化剂作为手术的替代方案。本研究的目的是回顾我们的经验与平阳霉素（博莱霉素A）。单独注射或联合手术治疗口腔和面部淋巴瘤，并观察病灶内注射平阳霉素后的组织学变化。患者和方法：回顾了79例接受病灶内注射平阳霉素治疗口腔和面部淋巴瘤的患者。男47例，女32例，男女比例为1：0.68。年龄范围为4个月至17岁。病变部位以舌部为主37例，其次为颊部18例，唇部10例，腮腺7例，口咽部5例，口底2例。其中单纯平阳霉素硬化剂治疗42例，硬化剂联合二次手术治疗14例，手术联合硬化剂治疗23例。末次治疗后随访6个月以上。结果评级为4级：优、良、一般和差（基于临床结局）。结果：79例LMs的原发解剖部位包括面部25例，口腔54例。每名儿童接受的中位注射次数为4.2次（范围为3至8次）。优44例（55.7%），良23例（29.11%），可10例（12.66%），差2例（2.53%）。单纯硬化组完全治愈或接近正常外观者（42.86%）少于手术加硬化组（73-91%; P
Purpose: Lymphatic malformations (LMs) are benign vascular lesions that can cause disfigurement and functional impairment. Complete surgical resection is often difficult and intralesional injection of sclerosing agents has been proposed as an alternative to the surgery. The aim of this study was to review our experience with pingyangmycin (bleomycin A.) injection alone or in combination with surgery for treatment of oral and facial LMs, and to observe the histologic changes after intralesional injection of pingyangmycin.Patients and Methods: Seventy-nine patients who received intralesional injection of pingyangmycin for the treatment of oral and facial LMs were reviewed. There were 47 males and 32 females, at a ratio of 1 to 0.68. Age ranged from 4 months to 17 years. The sites of the lesions occurred primarily in the tongue, which was found in 37 cases, followed by cheeks in 18, involved lips in 10, parotid gland in 7, oropharynx in 5, and floor of the mouth in only 2 cases. Among them, 42 patients received pingyangmycin sclerotherapy solely, 14 patients had sclerotherapy in combination with secondary surgery, and 23 other patients had surgery with sclerotherapy. Patients had been followed up more than 6 months after the last treatment. The rating of the results was 4-graded: excellent, good, fair, and poor (based on clinical outcome). The histologic changes were observed under microscope in 14 resected specimens after the sclerotherapy.Results: Primary anatomic locations of 79 LMs involved the face in 25 cases, and the oral cavity in 54. Median number of injections received per child was 4.2 (range, 3 to 8). Among the 79 patients, 44 cases (55.7%) were graded as excellent, 23 cases (29.11%) as good, 10 cases (12.66%) as fair, and 2 cases (2.53%) as poor. There were fewer totally cured or near-normal appearance in the sole sclerotherapy group (42.86%) than in the surgery with the sclerotherapy group (73-91%; P